Sean Cassidy: The Naked Health Information Exchange

© 2010 IBM Corporation

The Naked Health Information Exchange

Sean Cassidy, SVP, GM, Healthcare – Initiate, an IBM Company

26 August 2010

Document number


What is a naked HIE?

Open to all stakeholders

Provides seamless and transparent access to all available information

Accessible by any application, no technology constraints

Maintains accurate patient and provider identity

Respects policy, privacy and preferences

Enables evolution as well as revolution

Demonstrates clear value to participants

Supports ‘meaningful use’

Helps deliver better care and outcomes

2

Information Management


Value

Scope of Information Sharing

EMR at the point of care

Connect organizations

Uniquely identify patients,providers & organizations

Aggregate & harmonize

Seamless access

HIE value delivery roadmap (UMass Memorial view)

3



Value


Connect

Exchange

Access

Analyze

HIE technology deployment roadmap

“Push Data”

Secure Connectivity

Message Translation and Mapping

Auditing and Logging

“Subscribe to Data”

Orders, Results and Referrals; Admin Transactions

Queuing and Reconciliation

Community Enabled EMPI and Provider; XDS; Consent

“Request Data”

Virtual Patient Record

Integrated Workflow

Terminology/Vocabulary Services

“Get Information”

Quality Reporting

Outcomes Analysis

BI Platform

4



Value


Connected and Collaborating

“Easier to do Business with”

Meaningful User

Accountable

HIE organizational evolution roadmap

Computerized

5



How HIE roadmap impacts patients

Impact Over Time

Population

Patient

Population-LevelHealth Research

Chronic DiseaseManagement

ClinicalInformationSharing for Patient

ImprovePatientAccess

Admission History

66



Private health information exchange

7



ResultsPortal

Orthopedic

Interoperability Services

Foundational connectivity & exchange application architecture

IPA

Network

Order/Results Mgmt

Shared Registration

Maintainlocal Interfaceto Initiate Agent

InterfaceEngine

EMR-Generated Orders

Remote Printing& Document

Capture

ClinicalSystems

OtherSystems

Identity Services: Patient & Provider

Results Delivery

Referral & Consults

Document Registry & Repository (XDS)

Document & Image

Sharing

HostedEMR

Health System A

RemoteOffice 6

RemoteOffice 5

RemoteOffice 4

EMR

RemoteOffice 2

Office 1

Family Practices

EMR PM

Oncology/Hematology

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Traditional uses of an EMPI

PATIENT INFORMATION

Debbie

9146 E. Via Del Sol

Netown

Becker

CA / 45883

F

30

1/1/65

First:

Last:

Address:

City:

State/Zip:

Gender:

Age:

DOB:

HospitalRegistration

Data Quality

Clinical Info Sharing

CustomerSvc / Billing

EMPI

HEALTHCARE PROVIDER #01

Dr. Debbie Dozier-Becker

Netown, CA 45883

9146 E. Via Del Sol

Name:

Address:

Address 2:

LocalIdentifier:

12/19/61 - 727

HOSPITAL #02C

Debbie Becker, M.D.

Netown, CA 45883

9146 E. Via Del Sol

Name:

Address:

Address 2:

LocalIdentifier:

ABC98765

CLINIC / DOCTOR’S OFFICE

Debbie Becker

480-473-3486

9146 E. Via Del Sol

Name:

Address:

Phone:

LocalIdentifier:

VR:1432141234

PHARMACY

Deb Becker, M.D.

5555-55-1234

Null

Name:

UPIN #:

ID#:

LocalIdentifier:

DBECKER1234

Dr. Debbie Dozier

5555-55-1234

1918282

Name:

UPIN #:

ID#:

LocalIdentifier:

PIN122341

9



EnterpriseMaster PatientIndex

HIS

HIS

CommunityMaster PatientIndex

ADT

Shared registration

‘Trusted’ ‘Un-trusted’

“Enterprise”Patient

ADT

ADT

Search

Search

AmbulatoryEMR

10


Health System HIE Services Affiliate


Lab SystemResults

Reconciliation& Delivery

Results (With MRN)

Results reconciliation & delivery


Results (No MRN)Ambulatory

EMR

Exceptions Mgmt.

11





HISDocument

Subscription Mgmt Documents

Document ‘subscription’

DocumentsAmbulatory

EMR

XDS Registry/

Repository

Request

Relationships

SubscriptionRequest


Provider Index

Documents

12




Lab SystemOrder/ResultsReconciliation

& Delivery

AmbulatoryEMR

Results

Order reconciliation & delivery


Results

HIS

Orders

Order Queue Mgmt.

Exceptions Mgmt.

ADT

ADT

Orders

13



Meditech

Imagecast

VISICU

Allscripts

Soarian

NextGen

Community patient search


14


PATIENT INFORMATION

John

123 Main Street

Anywhere

Smith

CA/12345

First:

Last:

Address:

City:

State/Zip:

Allergies

Medications

Problem List

Surgical History

Immunizations

Etc.


Additional identity management related HIE scenarios

Referrals & consults

PHR integration/authorization

Inter/cross network exchange and ‘hub of hubs’

Patient consent (patient master)

Provider policy management (e.g., Information sharing preferences)

Data governance/stewardship

15



Mission: Enable high-quality, patient-centric care by making all relevant information about a patient available at the point-of-care, irrespective of organization, geography or care setting.

Document distribution (‘push’, ‘pull’ & ‘subscription’)

Referral management

Shared registration

Community patient search (virtual patient object support)

Provider management

Strategy: Establish an advanced community HIE platform that connects stakeholders in central Massachusetts and improves relationships with providers. Leverage off-the-shelf technologiesthat can be deployed quickly.

IBM Solution: IBM® Initiate® Exchange, Patient, and Provider

Revenue: $1.4B

Hospitals: 7

Beds: 1,100

Employees: 13,500

Physicians: 1,600

RegisteredNurses: 3,000

16


Case study


UMass MemorialHealth Care

PhysicianPractice

Orders & referrals

Results & documents

Efficiency

Quality

Cost-effectiveness

Patient satisfaction

Revenue

Efficiency

Quality

Patient satisfaction

at

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What is a naked HIE?

Open to all stakeholders

Provides seamless and transparent access to all available information

Accessible by any application, no technology constraints

Maintains accurate patient and provider identity

Respects policy, privacy and preferences

Enables evolution as well as revolution

Demonstrates clear value to participants

Supports meaningful use

Helps deliver better care and outcomes

18


© 2010 IBM Corporation19


Thank you

“ The SaaS model allows us to support our mission of improving the healthof our communities by being able to quickly connect our physician community while giving us the flexibility to expand the scope at our own pace.”

– Jeff Allport, Vice President, IT Solutions Delivery,St. Joseph Health System

Contact:

Sean Cassidy, Senior VP, GM, Healthcare

Phone: 312-208-0468

Email: [email protected]

mailto:[email protected]

© 2010 IBM Corporation20


Trademarks and notes

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Health & Medicine

Sean Cassidy: The Naked Health Information Exchange