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Mass HIway Overview MEDITECH Client Pilot Kick-off. June 24, 2013. Mass HIway Overview. - PowerPoint PPT Presentation
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Commonwealth of MassachusettsExecutive Office of Health and Human Services
Mass HIway OverviewMEDITECH Client Pilot Kick-off
June 24, 2013
– Hospitals– Health Care Providers– Laboratories– Pharmacies
– Skilled nursing facilities– Public Health Agencies– Health Plans– Patients (future release)
Mass HIway Overview
The Massachusetts Health Information Highway (Mass HIway) enables the secure electronic exchange of health information among diverse participants in the Commonwealth and supports meeting Meaningful Use requirements:
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MassHIway
Health System
Hospital
Small Practice
Skilled Nursing Facility
Public HealthLaboratory
Pharmacy
Patient (future release)
Health Plan
Hub for Health Information Exchange
1. Patient name 2. Sex3. Date of birth 4. Race5. Ethnicity 6. Preferred language.7. Smoking status 8. Diagnostic codes9. Medications 10. Medication allergies11. Laboratory tests12. Laboratory value/results13. Vital signs (height, weight, BP, BMI)14. Care plan fields, including goals and instructions15. Procedures 16. Care team members17. Immunizations
Depending on the specific application, data exchanged may include:
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Connection options
Participant directory
Certificate repository
Secure messaging
Message Transformation
Secure web mail
HIway ServicesUser types Methods of connecting to the Commonwealth’s HIE
Connect with local gateway
Browser access to webmail inbox
Physician practice
Hospital
Long-term careOther providersPublic healthHealth plans
Laboratories and imaging centers
Connect through LAND Device(Local Application for Network Distribution)
EHRConnect directly
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• Participant directory - provides HIway network addresses of all the participants in the network and enables communication via the network
• Certificate repository – holds, manages the private/public key that enables the participant to encrypt and decrypt messages
• Secure messaging - encrypted message will be sent in a secure manner within the network (HL7 2.5.1 format)
• Message transformation – technical format of messages are automatically changed to meet the requirements of the receiving system
• Secure Webmail – secure email and attachments among participants of the network
HIway Services
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Phase 1 Phase 2HIE
components• Provider directory• PKI infrastructure• Direct/HL7 gateway• Web portal mailbox
• Master Person Index• Record locator service• Consent database• Patient-directed messaging• Query/retrieve infrastructure
HIEend-points
• Any TPO participant
• Public health• SS, CBHI, MIIS
• MassHealth clinical data repository
• Medicaid/HIX participants• Public health
• ELR, PMP, Opioid, Lead
Capabilities phasing plan
A richer set of services available to a broader set of participants
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SMTP (Push)S/MIME
IMAP (Pull)S/MIME
Mass HIEEmail Server
Mass HIE Direct Gateway
Encrypted XDR
SMTP (Push)S/MIME
Organization ProviderSMTP Server/Client
Organization ProviderXDR
Organization Provider(Direct Enabled)
SMTP Client
SMTP Client Receive
EncryptedXDR
IMAP (Pull)S/MIME
Organization Provider(Direct Enabled)
SMTP Client
Mass HIETransformation
Service
SMTP (Push)S/MIME
IMAP (Pull)S/MIME
SMTP (Push)S/MIME
Organization ProviderSMTP Server
Organization Provider(Direct Enabled)
SMTP Client
Organization ProviderXDR
Mass HIEEmail Server
SMTP Client Send
Direct S/MIME Overview
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HIway Operations, Services and Support
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Organization Use Case Status/Target Date
In ProductionBIDMC Several use cases – registries, data
analytics and information exchanged between provider organizations.
• In production: MAeHC; Network Health and DPH – Immunization
• Testing: Boston Public Health; Atrius; Partners and DPH – Lab Reporting
Tufts Medical Center Discharge Summaries to Network Health; • Successful transmission of up to 1M test transactions
• Worked through consent – implementing processes, forms; moving to production with NH – 6/24/13
Network Health Receive Discharge Summaries from Tufts Medical Center and BIDMC
• Production with BIDMC and Tufts Medical Center
HIway Clients: In Production
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Organization Use Case Status/Target Date Live Holyoke Medical Center/Holyoke HIE
First implementation of Direct connect among Holyoke Medical Center and its HIE, HealthConnect. Successful implementation will allow exchange among the current 43 independent providers, HMC and HIway participants
• Successful test with S/MIME and XDR • Working toward exchange with HIway
customers – Network Health
Beaumont Medical Part of the IMPACT grant with 16 other organizations including Reliant, Metrowest and several LTC facilities
• In process of provisioning services for the other participants
• Move to test with intent to move to production
Dr. Gregory Harris Coordination of behavioral care with multiple facilities
HIway Clients: Live
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Organization Use Case Status/Target Date
ImplementationBoston Public Health, Atrius, Children’s, Partners
Care coordination, management • Various levels of testing
Harvard Pilgrim Health Discharge summaries; data analytics • Completed extensive security testing – moving to implementation
Metrowest, St. Vincent, Pediatric Care Associates, Notre Dame Long Term Care,
Care coordination • Provisioning with some level of testing
Pilot Project:MEDITECH Pilot Pilot project with 4 MA key MEDITECH
clients• Kick-off session June 24
HIway Clients: Implementation and Onboarding
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Organization Use Case Status/Target Date
Near Horizon:
Baystate
Opiod Treatment Providers (DPH)
DPH – Immunization, ELR, Syndromic and CBHI
Several – Implementation Grant and PVIX
Intake, Enrollment, Assessment and Treatment
More active outreach to current users of DPH programs to move traffic to HIway
Kick-off expected in July
Provider kick-off – 6/25/13
Ongoing – with more concerted focus beginning in 3rd quarter
Last Mile Program Innovation Implementation Grants
Extensive set of use cases among community providers, local HIEs, facilities and service entities
Active ongoing efforts ; project plans being finalized
HIway Clients: Horizon
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MA HIway Operating Model
OutreachOutreach SalesSales
ImplementImplement SupportSupport
Select outreach/salesSelect outreach/sales
Operations
Operations
Last Mile
Customer Acquisition Customer Implementation
On-boardOn-
board VerifyVerify ProvisionProvision
OutreachOutreach SalesSales
ImplementImplement SupportSupport
Select outreach/salesSelect outreach/sales
Operations
Operations
Last Mile
Customer Acquisition Customer Implementation
On-boardOn-
board VerifyVerify ProvisionProvision
Pre-Implementation: LM Customer Relationship Managers or through a Service Manager if client is ready for Implementation
Operations: Service Manager as single point of contact supported by Technical Engineers, Operations staff, web portal and 1-855-MA-HIway13
MA HIway Delivery Model
Client Experience
Project ManagementInstallation
Participant RelationshipCall Center
Back Office Support
ContractsVerificationReporting
BillingDocumentation
Technical ExcellenceEnvironmental Stability
System PerformanceEnhancementsChange ControlComplex Clients
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HIway Operations Monitoring
To ensure delivery meets objectives , we have and continue to implement operational metrics and performance measures of the end to end process
Date Opened ST# Issue Summary Jira # Escalated Current Status
Last Activity
Days Since Last Activity
Closed Date
Sat. Survey Returned
Total Days Open
2/25/2014 29956 Send/Receive error St. Eligious Alexi Strogonoff ICS-2090 Y Closed 3/2/2014 - 3/2/2014 - 5 2/27/2014 29988 Printing failure General Hospital Bob Adams N Closed 3/3/2014 - 3/3/2014 - 4
3/1/2014 30009 Out of memory message General Hospital Mary Janes N Closed 3/1/2014 - 3/1/2014 9 - 3/1/2014 30058 LAND swap County General Alexi Strogonoff N Closed 3/5/2014 - 3/5/2014 - 4 3/2/2014 30067 Connection not recognized Hope Bob Adams ICS-2099 Y Closed 3/13/2014 - 3/13/2014 - 11 3/2/2014 30069 Password Reset BIDMC Bob Adams N Closed 3/2/2014 - 3/2/2014 10 - 3/2/2014 30071 Password Reset Medical Center Alexi Strogonoff N Closed 3/2/2014 - 3/2/2014 10 - 3/3/2014 30082 LAND swap County General Mary Janes N Closed 3/8/2014 - 3/8/2014 9 5 3/4/2014 30085 Connection not recognized Hope Alexi Strogonoff N Closed 3/10/2014 - 3/10/2014 - 6
Client Metrics Period: 04 Nov 2012 - 10 Nov 2012
System Access Metrics Volume MetricsLogin Access Total Patient Records Total Unique
Total Login as of Last Month 29,521 Total Received as of Last Month 1,009,765 700,543Login This Period 3,236 Received This Period 3,457 2,267Login This Month 4,328 Received This Month 8,564 6,102Total Login To Date 33,849 Total Received To Date 1,018,329 706,645
Patient Records Accessed Total User IDs - Total Total LvL 1 & 2Total Access as of Last Month 10,721 Login IDs Existing Last Month 6,441 1,762Access This Period 1,456 Created This Period 54 0Access This Month 1,823 Created This Month 103 0Total Access To Date 12,544 Total Accounts To Date 6,544 1,762
Break The Glass Attempts TotalTotal Attempted as of Last Month 1,446Attempted This Period 12Attempted This Month 25Total Attempted to Date 1,471
Performance MetricsProduction Environment (Percentage) Total
System Uptime - Period 99.999%System Uptime - This Month 99.999%Portal Uptime - Period 99.999% Direct Secure Messsaging MetricsPortal Uptime - This Month 99.999% Accounts TotalDSM Uptime - Period 100.000% Accounts Existing Last Month 5,503DSM Uptime - This Month 100.000% Created This Period 123
Created This Month 175Outages (Minutes) Total Total Accounts To Date 5,678
Scheduled Outage - Period 5Scheduled Outage - This Month 5 Sent TotalUnscheduled Outage - Period 0 Total Sent as of Last Month 15,245Unscheduled Outage - This Month 2 Sent This Period 3,325
Sent This Month 4,871Security Incidents (Occurances) Total Total Sent To Date 20,116
Incidents Detected - This Period 0Incidents Detected - This Month 0 Received Total
Total Received as of Last Month 32,456Issues Report Total Received This Period 4,235
Issues Created - This Period 1 Received This Month 5,987Issues Resolved - This Period 2 Total Received To Date 38,443Issues Created - This Month 1Issues Resolved - This Month 2Issues Remaining - To Date 5
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Connection Method Client ID Client Name MIIS ELR Syndromic CBHI HIWay
Inbound Transactions
Total Transactions
LAND 12345 Hospital A 255,600 144,450 103,350 34,023 29,902 34,530 601,855 LAND 12346 System B 255,600 144,450 103,350 34,023 29,902 12,340 579,665 LAND 12347 Hospital C 255,600 144,450 103,350 34,023 29,902 9,940 577,265 TOTAL LAND 766,800 433,350 310,050 102,069 89,706 56,810 1,758,785
Outbound Transactions
Transaction Analysis by Client Usage Reports
Request Tracking
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HIway Environment Monitoring
• State of the art security practices and monitoring of the technical environment has been established to fortify the trust of the HIway use
• 24/7 monitoring of the environment has been implemented – Network, – Applications,– Database, operating systems, – Infrastructure
• Performance thresholds are established to automatically notify and escalate when threshold limits are within range of thresholds for system level agreements
• Within the environment, constant security monitoring and reporting occurs for the following:
– Environment security – identifying access and frequency of changes to the firewall source IP, opened ports in the firewall, changes to the VPN access in the firewall and changes in the IP routing
– Intrusion, penetration monitoring and detection of incidents, vulnerabilities
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Pilot Proposal to Move Forward
Project Management:• Ryan Thomas: Service Manager
– Will be the single point of contact for the pilot coordination, planning, and oversight of effort, resources within the HIway Operations Team
– Ryan’s contact information• Cell : (781) 790-6101• E-mail: [email protected]
Suggested Next Steps:• Plan
– Plan effort with MEDITECH to test connection with the 3 platforms;– In parallel, begin coordination planning, onboarding with all pilot clients– Ensure that these efforts are in-sync, dovetail with the Implementation Grant plans
• Checkpoint: Status, Go-forward Review • Execute
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