Baby s First Message: Next Steps and Lessons Learned after Achieving Statewide Implementation of an Electronic System
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1 Baby s First Message: Next Steps and Lessons Learned after Achieving Statewide Implementation of an Electronic System Amy Gaviglio Genetic Counselor/Follow-Up Supervisor September 12, 2017
2 A look back: September 2014 to June 2017
3 Electronic Reporting EHR Demographics and contact information sent through HL7 ADT (via OZ NANI TM ) Hearing screening results uploaded or streamed from screening device (via OZ Telepathy EHDI/CCHD TM ) MNSCREEN Newborn Screening and birth hospital staff view reported information in MNScreen web portal
4 100 MNScreen Implementation Timeline Contacted hospitals and hosted first informational calls Declared Meaningful Use Contract signed with vendor Today: 90/90 birth hospitals live! /5/2014 6/5/2014 7/5/2014 8/5/2014 9/5/ /5/ /5/ /5/2014 1/5/2015 2/5/2015 3/5/2015 4/5/2015 5/5/2015 6/5/2015 7/5/2015 8/5/2015 9/5/ /5/ /5/ /5/2015 1/5/2016 2/5/2016 3/5/2016 4/5/2016 5/5/2016 6/5/2016 7/5/2016 8/5/2016 9/5/ /5/ /5/ /5/2016 1/5/2017 2/5/2017 3/5/2017 4/5/2017 5/5/2017 6/5/2017 4
5 Paper Reporting Staff update demographics in EHR Staff admit patient to EHR Staff type demographic information into database Staff use EHR to write demographics on blood spot card Staff mail blood spot card to Newborn Screening program Staff type screening results into database Birth Hospital Staff type demographics into screening device Staff write screening results on blood spot card Staff follow-up on patient if needed Staff rescreen patient if needed Staff screen patient Staff type screening results into EHR Newborn Screening 5
6 Electronic Reporting Staff update demographics in EHR Staff admit patient to EHR MNScreen receives HL7 ADT message (via OZ NANI TM ) and record is created OZ Telepathy EHDI TM matches screening results to record Birth Hospital Staff type demographics into screening device Staff follow-up on patient if needed Staff rescreen patient if needed Staff screen patient Staff upload screening results from device to network folder Newborn Screening 6
7 Electronic Reporting Challenges Stakeholder engagement Obtaining certain data elements and device connectivity issues Critical access hospitals and outof-hospital birth population Staff time, end user training, ongoing training, and maintenance Successes All birth hospitals onboarded as of June 2017 MNScreen declared as a specialized registry for Meaningful Use Timely and accurate reporting Integration of clinical decision support 7
8 Lessons Learned Always be ready for the unexpected Utilize project management tools and techniques and keep a problem log Each facility is different. Electronic Reporting Removes Some Issues, and Creates Others: Post-production monitoring necessary when project involves workflow changes Still see: Serial screening Algorithm adherence Mis-entry into EMR 8
9 Looking forward: 2017 and beyond
10 What s next? Send hearing & CCHD screening results to hospitals EHRs for auto charting Electronic reporting of outpatient hearing screening results and diagnostic assessments Send demographic information to laboratory information system for newborn blood spot screening NewSteps 360 Grant Electronic Lab Ordering and Reporting via HL7 through Exchange Hub
11 Need versus Nice to Have Currently have 37 fields on Newborn Screening Card Program analyzed data quality and use of each field and decided to remove in order to simplify the order message: Birth Defects: Y/N Deceased Siblings: Y/N and Cause of Death: Maternal Pregnancy Complications (AFLP/HELLP): Y/N Family Hx of Disorder on Screening Panel: Y/N Antibiotics: Y/N Collected By Breast vs. Milk vs. Soy formula (retained TPN (Y/N) only) 9/13/2017 Optional Tagline Goes Here mn.gov/websiteurl 11
12 Utilizing the Existing Connection EHR HL7 ADT (via OZ NANI TM ) MNSCREEN This process will capture 22/30 fields on card NATUS MDH INTERNAL EXCHANGE HUB
13 What about the remaining 8 fields? EHR HL7 ORM 1) Currently constraining HL7 Version Implementation Guide: Laboratory Orders (LOI) from EHR DOC TOC TPN (Y/N) Transfused (Y/N) Transfusion Date PCP/Clinic Barcode 2) AOEs will be used to obtain fields not readily accessible in EHR: TPN (Y/N) Transfusion (Y/N) Primary Physician/Clinic MDH INTERNAL EXCHANGE HUB NATUS Matched to demographics from OZ NANI TM ADT in holding table
14 Amy Gaviglio Thank you: Kaitlin Houlihan, Jill Simonetti, Heather Brand, Sarah Shaw, OZ Systems, Natus, MN Birth Hospitals, Rebecca Johnson
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