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Brian E. Dixon, MPA, PhD CandidateHealth IT Project ManagerRegenstrief Institute, Inc.
Bi-Directional CommunicationEnhancing Situational Awareness in Public Health and Clinical Practice
1
TUESDAY, 12:30 – 12:50PM
Bi-directional Communication
PurposeDemonstrate how health information exchange (HIE) can facilitate efficient and effective dissemination of information to clinicians that keeps them informed of public health threats in their communities
Situational Awareness• Recognition of an Emergent Threat• Raise Awareness of Threat• Action in Response to Threat
HIMSS 2010 2
Health Information Exchange
NHIN-EnabledHealth Information
ExchangeOutpatient RXs
Physician Offices
Ambulatory Centers
Local Public HealthDepartments
State Public HealthAgencies
Imaging Centers
Hospitals
Laboratories
HIMSS 2010 3
Health Information Exchanges (HIEs)
HIEs provide common infrastructure to connect medical providers and public health organizations
• Minimizes duplicative technical connections as well as healthcare services
Common infrastructure can be reused over time for new services and applications:
• Maximizes initial investments
HIMSS 2010 4
The Indiana Network for Patient Care (INPC)
• 15 year old HIE operated by the Regenstrief Institute– Partner with the Indiana Health Information Exchange
• Facilitates data exchange between– 35+ Hospitals– Independent and Reference Laboratories– Public Health Departments (State and local)– 100+ clinics and imaging facilities
• Indianapolis metropolitan area, Lafayette, and Evansville
HIMSS 2010 5
DOCS4DOCS® (D4D)
» Delivers laboratory and other clinical messages from one organization to the patient’s responsible provider (PCP)• Managed by the Indiana Health Information Exchange
» Delivered in three formats• Fax• Electronic inbox (Web-based application)• Integration with the Electronic Health Record (EHR) system
» 6 million messages each month to 13,000+ physicians
HIMSS 2010 6
Results Delivery – An Illustration
HIMSS 2010 7
DOCS4DOCS
DOCS4DOCS
Expanding D4D to Support Public Health
» D4D delivers ISDH laboratory reports to providers throughout the state
» Marion County Health Department (MCHD) partnered with Regenstrief and IHIE to notify physicians of important, emergent situations involving public health threats• Salmonella exposure at local restaurant
» System went live in May 2009• Utilized several times for H1N1 updates
HIMSS 2010 10
DOCS4DOCS
Process Diagram
Hospitals, IDNs
`
Health Information Exchange
IN
Physician Practice
Generate H1N1 Alert
HIMSS 2010 12
Bi-directional Communication Methods
• Clinical messaging is a “push” technology
– Message authored by Public Health entity
– Message integrated into clinical workflow using established systems and processes for communication
• Other methods to support bi-directional communication
– Decision Support (Infobutton) – Query public health knowledgebase for alerts relevant to a given patient’s demographics (e.g., age, home address, chief complaint)
– Case Reporting – Pre-populate notifiable condition reports with HIE data to increase rate of “spontaneous” reporting
HIMSS 2010 13
DOCS4DOCS
Reporting Form
Thank You
15
The participation of any company or organization in the NHIN and CONNECT area within the HIMSS Interoperability
showcase does not represent an endorsement by the Office of the National Coordinator for Health Information
Technology, the Federal Health Architecture or the Department of Health and Human Services.