CLIQ CLinical InQuiry

1. CLIQCLinical InQuiry MaRDI Last update 2/04

2. Information Access Challenge • Delays / failures in dissemination of reports/ results to primary care community clinics • Unavailability / incompleteness of the paper medical record • Inefficiency of access to “basic” clinical information for busy clinicians • Difficult to use, non-intuitive systems

3. Silos of Information Patient demographics Paper transcribed reports Laboratory Results Pathology Reports Radiology Reports Cardiology Reports

4. Information Access Solution • Efficient communication channel enabling dissemination of results and reports • Centralized repository of all electronically available clinical results/reports data • Minimize redundant registrations and duplicate medical records • Single/common user interface to clinical information • Easy-to-use • Intuitive and efficient • Patient-centric approach to information access • Scalable, platform independent and available “anywhere”

5. Information Access Solution Patient demographics e-Transcribed Reports MPI CLIQ CDR Laboratory Results CLIQ Pathology Reports Radiology Reports Cardiology Reports

6. MaRDI = CDR/MPI/IE/ACS • Real-time HL7 data interfaces • ~ 50, 000 HL7 messages / day • ~ 29,000,000 results and reports total • Redundant MR registrations • 10-20 potential duplicates / day • Daily email report and MPI Merge GUI • > 5,200 merged since Apr 2003 • 96% true positive duplicate identification rate • Challenge: Electronic registration systems at CHCs

7. Data Currently Available • Demographic / registration data • Visit history • General laboratory and microbiology results • Pathology, radiology, cardiology and EMG reports • Operative notes • Admission H&P and discharge summaries • OP consultation notes • OP pharmacy prescriptions Most data types with > 18 months historical data

8. Benefits • Efficient access to needed clinical information at CHCs and tertiary facility • Basic information set supporting care decisions in absence of paper medical record • “From 20% in 10 days to 100% in 10 minutes” • Enable community-level care delivery model • Reduce redundant test ordering and risk to patient • Reduce dependence on shadow charts • Potentially • Enhance timeliness and quality of care • Improve patient and provider satisfaction • Reduce medical errors • Reduce cost

9. Deployment • Current • Medical Center of Louisiana New Orleans • Kenner Family Medicine Clinic • Daughter’s of Charity Carrollton Clinic • Excelth New Orleans East Clinic • Healthcare for the Homeless Clinic • Musician’s Clinic • Orleans Parish Prison • City of New Orleans Clinics • Fiscal ’04 • Earl K. Long Medical Center • Leonard J. Chabert Medical Center • Bogalusa Medical Center • PATH Community partners

10. Utilization: July ’03 – Feb ‘04 • > 2350 unique clinician users • ~ 550 unique users / day • ~ 1950 logins / day • ~ 2000 unique patient records accessed / day • ~ 9175 patient record accesses / day

11. Future • Common registration methodology • Medical home / PCP “implementation” • Two-way data sharing with CHCs • Near real-time interfacing to clinically relevant “financial” data (CPT, ICD-9) • Disease Mgt / Preventive Health reminders • Diabetes registry (STEPS) • Physician inbox / pushing reminders and events • Immunization list