Gregory L. Smith - [email protected]

Gregory L. Smith - [email protected] Smith and Associates

Bundled Telecommunication Strategyfor Health Information Exchange

Collabortive opportunity for telecommunication providers, HIE, and healthcare providers also promotes sustainability, security and

functionality to drive and support change in healthcare.


Naked Telecommunications:Traditional Approach of Deploying Telecommunications in Healthcare

(Note: FCC’s $417m recent funding under Rural Healthcare Pilot Program continued the underutilization strategy.)

• Under-utilization of telecommunications

• Each provider must facilitate● content● determination of effectiveness

• Is cost directly related to underutilization?● $1,400 to $300● 25% subsidy for 3-4% utilization● so, will an 85% subsidy alone promote use?

NOTES:

Note: in Kansas only healthcareproviders that are hospitals can usethe state network, even that proposedunder the FCC application

Note: other network required fornon-hospital healthcare providers.


Phase 1: Bundled Service: HIE Sustainability and Promoting Change in Healthcare through Telecommunications Deployment(Note: this is the view from the purchasing healthcare provider and consumer.)

• Healthcare providers will subscribe to:● bandwidth and● valued content as data

• Healthcare providers and consumers use this data in EMR/PHR through SOA interoperability• No medical software is purchased as part of the bundle; only push/pull of information

BASICS:

Supporting definitions from the FCC



• Telecom providers promote and support bundled product; including offering customer service• Telecom providers collaborate with others to offer the content of the bundle

NOTES:



• Advanced security strategy that includes multiple security dimensions.• Must have security device to participate; dedicated telecom not necessary.• Randomness within network control improves security.

NOTES:

Security device plus routing and bandwidth management


Phase 1: Bundled Service: HIE Sustainability and Promoting Change in Healthcare through Telecommunications Deployment

(Note: This is a full architectural view.)

• Within the bundle:● Local bandwidth● Regional data● Statewide and national data● Statewide and national bandwidth on backbone networks, such as Kan-Ed and Internet 2

NOTES:


Phase 2: Integrating Bundled Service SOA into Medical Home Healthcare System(Note: Additional services offered in support of bundled service concept.)

• Regardless of HIE approach workflow re-engineering is a key activity.• SOA tends to make that activity easier.• Telecom providers and others now have a vested interest in supporting this re-engineering, thus promoting greater utilization of bandwidth and HIE data

NOTES:


Phase 2: Integrating Bundled Service SOA into Medical Home Healthcare System(Note: Patient presents at ED and is sent to a referral facility or to inpatient care.)

• Much like Telemedicine, data from the subscribed service can be integrated into the care process.

• Healthcare provider uses their own EMR/EHR and interoperability is achieved through SOA.

• Each SOA transaction includes push/pull of data.

• Therefore, tracking use of the bundle includes knowledge of:

● number of transactions● data capacity of each transaction

• Therefore, subscription to bundled service could be a bulk monthly rate or a per transaction charge.

NOTES:


Phase 2: Integrating Bundled Service SOA into Medical Home Healthcare System

(Note: Patient presents to their ambulatory “Medical Home” around an episode of care.)

• Much like Telemedicine, data from the subscribed service can be integrated into the care process.

• Healthcare provider uses their own EMR/EHR and interoperability is achieved through SOA.

• Each SOA transaction includes push/pull of data.

• Therefore, tracking use of the bundle includes knowledge of:

● number of transactions● data capacity of each transaction

• Therefore, subscription to bundled service could be a bulk monthly rate or a per transaction charge.

NOTES:


Phase 3: Integrating Bundled Service SOA into Medical Home “System” of Care(Note: Patient presents anywhere within the system and is moved among system of providers.)

Collaborative support environment, cost model and sustainable organizations encourage investigation of other system type activities which lead to additional tiers within the bundle or more transactions.

NOTES:


Collaborative support environment, cost model and sustainable organizations encourage investigation of other system type activities which lead to additional tiers within the bundle or more transactions.

NOTES:

Phase 3: Integrating Bundled Service SOA

into Medical Home “System” of Care

(Note: Patient presents anywhere within the system and is moved

among system of providers.)

Documents

Gregory L. Smith - [email protected]