North Dakota Health Information Network (NDHIN) April 2015
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1 North Dakota Health Information Network (NDHIN) April 2015
2 Life begins at the end of your comfort zone. Neale Donald Walsh
3 Governance
4 Health IT Advisory Committee (HITAC) Chair-Lynette Dickson, Associate Director Center for Rural Health, UND School of Medicine and Health Sciences Vice Chair - Dan Kelly, CEO McKenzie County Healthcare System Lisa Feldner, CIO State of North Dakota, North Dakota University System Barb Groutt, CEO North Dakota Healthcare Review Courtney Koebele, Director of Advocacy North Dakota Medical Association Caryn Hewitt, CIO Sanford Health System, Fargo Darin Meschke, North Dakota Department of Health Dave Molmen, CEO Altru Health System/Chair Hospital Association Janis Cheney, Executive Director AARP Jennifer Witham, IT Director North Dakota Department of Human Services Jerry Jurena, President North Dakota Healthcare Association Jim Long, CEO West River Health Systems Senator Judy Lee North Dakota Legislature Laurie Peters, RHIT, Past-President North Dakota Health Information Management Assoc. Lisa Clute, Executive Officer First District Health Mike Ressler, CIO, State of North Dakota Neil Frame, Operations Director Metro Area Ambulance Representative Robin Weisz North Dakota Representative Shelly Peterson, President Long-term Care Association Tami Wahl, Sr. Policy Advisor-HHS Governor s Office Todd Bortke, Director of Information Systems, St. Alexius Medical Center Troy Aswege, Senior Vice President Noridian Healthcare Solutions 10/03/2014
5 Step 1 Provider EHR s In order to have a functioning HIE, we needed Providers to have certified EHRs
6 Barriers to Implementation All entities identify lack of financial resources, for initial purchase and ongoing investment, as a significant barrier to implementation Less significant among hospital respondents Significance of barriers was dependent on where the entity is with regard to selection and implementation of EHR Source: Center for Rural Health Study
7 Health IT Loan 25 loans to hospitals and clinics $12.2 Million Dollars ND Administration and Legislature Bank of North Dakota 1% interest 10 years LOOK FOR NEW LOAN OPPORTUNIES COMING OUT SHORTLY
8 Step 2 Procure and Implement NDHIN To be able to exchange information an infrastructure needed to be put in place.
9 NDHIN-Orion Contract Status ID Deliverable Progress 1 Core Infrastructure and Direct Complete 2a Implementation of Core HIE Solution Complete 2b Integration of Initial Participants Complete 3 Implementation, Integration and Onboarding with One Additional Participant Complete 4 Patient Portal Complete 5 Public Health Reporting Implementation Complete 6 Immunization Registry Integration Complete 7 ehealth Exchange Gateway Almost Complete 8 DSM 2.0 with HPD Complete 9 Business Intelligence Utilization Dashboard Complete 10 User Adoption Services Complete 11 Training Services Complete
10 Push Services Example: I have a piece of information and want to send it to someone else securely.
11 Direct Secure Messaging Orion Health Trust Network DSM Web Basic Direct Secure Messaging Web-based access client access Managed Direct Secure Messaging Client-deployed hardware device Monitored by OH Managed Services DSM Connect HPD MSG CERT DSM Direct Direct Secure Messaging with EHR System integration Encrypted S/MIME access Encrypted XDR access
12 Pull (Query based) Services Example: I have someone in the ER/office that I know little or nothing about. How can I get information from other sources to help me make sound medical decisions quickly and efficiently? Query the NDHIN for information!
13 Data Feeds to HIE Admission, Discharge, Transfer (ADT) Patient Demographics Encounter History Allergies Diagnosis Procedures Observation Results (ORU) Lab Results Imaging Studies Radiology Reports/Documents Medical Document Management (MDM) (Clinical Documents) Work Types Discharge Summaries H&P s ED Visit Notes Consult Reports Operative Notes Immunizations (VXU) CCD/C-CDA Exchange
14 NDIIS Bi-directional Interface
15 Prescription Drug Monitoring Program
16 Viewing CCD s
17 HealtheWay
18 NDHIN Image Exchange - Architecture Results Reporting ehealth Gateway CV EHR or RIS PACS HIE Web Services ehealth Technologies ehealth Gateway CE DICOM EHR or RIS PACS DICOM EHR or RIS User Authentication Patient ID & Consent Workflow Tools HIE User Community Image Access ehealth Gateway SE DICOM PACS Imaging Provider(s)
19 Viewing Images With Rad Result
20 ehealthviewer ZF
21 NDHIN Benefits to Providers Public Health Reporting Electronic Lab Reporting Syndromic Surveillance Bi-Directional Interface to ND Immunization Registry Clinical Portal/Patient Portal Statewide Advance Directive Repository Prescription Drug Monitoring Program access ehealth Exchange Connectivity Connect to other HIE s/federal Agencies across country Image Exchange View images from PACS networks across state Disease Registries NDHIN Direct Simplifying Future Interface Work and much more!!
22 What about the data? Workgroup involvement Clinical Workgroup Data Use Workgroup Data Stratification Discreet Data is essential Lots of Potential but rules/use need to be defined ACO, MSSP PCMH Research Community Needs Assessments More Statewide Data Hub?
23 NDHIN Stats 170+ Organizations have signed Participation and Business Associate Agreements with NDHIN 6 Prospective Payment Hospitals 36 Critical Access Hospitals Public health organizations, long term care, pharmacies, clinics etc. Direct Secure Messaging Web based Direct 680+ users XDR Direct (EHR system functionality) 2,000+ users Altru, Essentia and Sanford are using XDR in Production Veteran s Administration, Other States, HealthVault etc. Query Based Services Onboarding over 50 organizations right now (data providers) Unique Patient Records 615,000 (Nov 2014) User Accounts set up to access patient data 1,000 + providers (Nov 2014) Automatic Immunization, reportable conditions and syndromic reporting to the Health Department
24 ONC Cooperative Agreement Submitted Estimated Notification Date Competitive Available from 1 3 Million Each North Dakota Submitted (1.7 Million Federal /.6 Million Match) CAH s / Rural Providers Long Term Care Behavioral Health Pharmacy Focus Technical Assistance Certification Interface Assistance Medication Management Consent Management
25 Duplicates >100 Duplicates in the NDHIN Working to Resolve
26 NDHIN Staff
27 Coming together is a beginning. Keeping together is progress. Working together is success. Henry Ford
28 A REVIEW OF BENEFITS REALIZED FOR THE VALUE OF HEALTH IT
29
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