Connecting Your Community: Interoperable Solutions to Mobilize Your Data

1. Connecting Your Community: Interoperable Solutions to Mobilize Your Data John Valutkevich Senior Marketing Supervisor – EHR Initiatives MEDITECH

2. Surveying the Health Information Exchange Landscape • Meeting Industry Demands with Interoperable Solutions • MEDITECH Solutions • MEDITECH/Forward Advantage Solutions • Choosing the Right Toolsets

3. The Health Information Exchange Landscape

4. History Repeats HIE’s are maturing • CHIN - 1990’s Community Health Information Network • RHIO – Regional Health Information Organization • LHIN – Local Health Information Network(s) • Canada Most states have a named Health Information Exchange entity Industry mandates are demanding connectivity

5. Why so few successful HIE’s?

6. Latest HIE Statistics The Market Growth is in Private HIE’s • Triple the number in 2011 • Less red tape among trusted entities • Readiness • Security • Local vs. GRAND scale • Better support clinician use cases Public HIE’s growth down 50% • Questions about future of funding • Funding by Grants – not sustainable entities • Changes in Leadership in 2013 ? Clinician Adoption is an issue • Less than half deliver data directly to an EMR • Data will not be used if workflow is interrupted • Especially important in fast paced Inpatient Environment

8. Meeting Industry Demands, a Health Information Exchange

9. Higher Demands on EHR’s • Meaningful Use requires Exchange • Capability to exchange key clinical information (CCD) • Lab Results • Physician Practices want better connectivity from their EHR • Seamless Order Referral Management • Discharge/Referral Reports • Multiple Location Data requirements • Regional/State mandated participation • State HIE • Registry Reporting Requirements • Payer Systems expecting data

10. Meeting Demands with MEDITECH

11. Proven Solutions – HIE components • Patient Identity Management • Admission DT • Lab Results Outbound • Reports Outbound • CCD Interface Suite • Meaningful Use Public Health Interfaces • Reportable Labs • Immunizations • Syndromic Surveillance • e-Prescribing • Ambulatory Orders and Results • Eligibility/Payer/Financial Interfaces

12. Managing Patient Identity • MEDITECH as Enterprise Master Patient Index • Query • Bi-Directional EMPI • Smart Search • Other Vendor as Enterprise Master Patient Index • Demographic Update • Quick Registration

13. Ambulatory Order Management Stage 2 Requirement – 40% Ambulatory Lab Orders

14. CCD Interface Suite

15. e-Prescribing • Stage 2 Requirement for Hospitals • Integrated into MEDITECH’s EDM, PCS/Nursing, and PCM • Access medication histories • Update patients' records • Check benefits while ordering • Communicate orders to retail and mail order pharmacies • Standards-based NCPDP Script interfaces • DrFirst as transaction clearinghouse

16. Other Interoperability Solutions • General Financial • Claims • ANSI 278 - ARM - Authorization and Referrals • ANSI 270/271 - Insurance - Checks for insurance eligibility • ANSI 837 - Electronic Claims Submission • ANSI 835 - Electronic Payment Remittance • ANSI 276/277 - Claim Status Inquiry/Response - Checks Status of Claims • Materials Management • ANSI 810 Invoices • ANSI 832 Catalogue Updates • ANSI 850 Transmit Purchase Orders • ANSI 856 Pre-shipment Notifications • Payroll • Time and Attendance vendors

17. HIE Use Cases Choosing the Best Model

18. Centralized - Early Iterations Patient EHR HL7 • Repository • HL7 Provided In-bound • Viewer Access • Workflow Consideration

19. De-Centralized (Federated) • Bi-Directional Interface Support • Standards are Imperative • Multiple EHR Coordination • Workflow Benefits

20. Hybrid – Best of Both • Federated for those that are closely coupled together • Repository for community

21. HIE Use Cases Building Your Model

22. Building Your Model Inventory systems

23. Building Your Model Other Infrastructure Requirements • Technical Support • Governance • Rules • Who can play • Finance

24. Continuing collaboration to develop cost effective solutions to support customer interoperability initiatives:

25. Comprehensive HIE Solution set • Record Locator Service (RLS) • Master Patient Index (MPI) • Healthcare Provider Directory (HPD) • Flexible configuration to adapt to various use cases and scenarios • Policy and Consent Management • Provider Portal • Supports IHE and HL7 source and consumer transactions • DICOM Image Exchange • Physician Referral Exchange • CCD Aggregation • Secure communications/transactions • ATNA Support

26. Planning Your Connected Community Getting Started • Inventory Players • Funding Short Range (may all need to be met at once) • Meet MU • Connect Physicians • Local/State Network Long Range • Connect to Other HIE’s • Federal Level

27. Interoperability Futures

28. Projects under Review – Stage 2 • Discharge Summaries • CCD’s • Referral • Consolidated CDA • SOAP transport option to Direct