2/2/2012. Health Care Information Technology Reform: The challenge for MCH programs and an Alaska Case Study. Agenda.

Transcription

1 Health Care Information Technology Reform: The challenge for MCH programs and an Alaska Case Study Lura W. Daussat, MPH Thalia Wood, MPH Agenda Welcome and Introductions Presentation Interactive Discussion Health IT and MCH The federal government is committed to EHRs and two-way data sharing among healthcare providers MCH needs to: Understand Interoperability and EHRs Understand Meaningful use of EHRs 1

2 A world of Alphabet Soup PCD 01 CCHD IHE HIE What is Interoperability? The ability to share or exchange information between systems Systems talking to each other Same language and data formats LOINC Codes, ISO Codes, HL7 Same protocols IHE Technical Profiles Examples Type of Code Description Code LOINC Codes Hydroxyprogesterone Congenital Adrenal Hyperplasia HL7 Codes HL7001 Ambiguous, Female, A, F, M, U Male, Other HL7005 American Indian or Alaska Native ISO Codes Grams G Microgram/deciliter ug/dl 2

3 Complete HL7 message HL7 Message Patient ID PID LASTNAME M^Male^HL ^Other Race^HL70005 N^Not Hispanic or Latino^HL70189 N^No^HL P Next of Kin info NK1 LASTNAME^FIRSTNAME MTH^Mother^HL N 14 ST^^TOWN^PA^18052 ^^^^^484^ IHE Technical Profiles Integrating Healthcare Enterprise Promotes standards to address specific clinical need in support of optimal patient care 3

4 IHE Profiles Acquired on from Examples of Interoperability Newborn Admission Notification to Public Health Demographic details from mom and baby Screening Results to Public Health CCHD EHDI NBS Immunizations EHRs and Public Health Electronic Health Record (EHR) An electronic record of patient health information created as a result of any care delivery EHRs must be able to send information to other systems using messaging standards 4

5 Certified Systems and Meaningful Use of EHRs A Certified System EHRs should be certified to assure that they perform certain functions Meaningful use of EHRs A healthcare organization confirms that it can use their certified system to improve patient care Meaningful Use of EHRs Improve Care Coordination Reduce healthcare disparities Engage patients and their families Improve population and public health Ensure adequate privacy and security Acquired January 6, Take home questions - Where to start with EHRs Do the hospitals in your states have EHRs? If so, how many? What systems do they use? What kind of information can the hospitals send? How can they send it? 5

6 Health Information Exchange Mobilization of healthcare information electronically across organizations within a region, community or hospital system Acquired December 28, Health Information Exchange 17 Goals of HIE Facilitate access and retrieval of clinical data to provide: Safe More Timely Efficient Effective Equitable Patient centered-care Acquired December 28, Exchange of data among the systems How messages are sent Delivery by Point to point Delivery by a web service 6

7 Why exchange data? Increases consistency and quality in healthcare Can provide better denominator to public health Better health care and outcomes Decreases duplicate entry Timeliness of data entry Data from a device What is a Patient Care Device? Contains patient identifying information and Device configuration information Examples: Pulse OX Device Newborn Hearing Screening Equipment Vital Signs How to get data from devices Transmit screening results from equipment to Public Health using HIT Standards Based on IHE s Patient Care Device (PCD) Device Enterprise Communication (DEC) Profile 7

8 IHE profile Patient Care Device Profile Acquired on from: Patient Care Device PCD Profile Enterprise Communication Profile Data from a device needs to be consistently sent to EHRs and clinical decision support applications i Benefits of electronic sharing include: o Minimizing errors o Improved productivity o Decrease in decision time o Increase in information shared Acquired on 12/5/ Why exchange data from a device directly? Protection from accidental or intentional data change Validation of correctness of information Positive identification of results pedigree Encryption Auditability 8

9 Requests of HIT standards in Alaska 2011 CDC EHDI Grant HIE Integration CDC EHDI Cooperative Agreements These agreements are all about data, tracking, surveillance, and data integration Previous funding cycles required integration ti with newborn blood spot screening Current guidance required working with Health Information Exchanges within states Alaska Application for CDC One goal was to conduct a needs assessment of EHRs in use at hospitals/birthing facilities 9

10 Alaska Application for CDC Another goal was to develop a plan for interoperability for the screening program records to interface with the HIE This cooperative agreement period is for 5 years with time to develop and hopefully implement this integration AK Working with HIE Deciding who is pushing/pulling information Immunization registry first program to pilot use of the HIE MOAs within state agencies being examined to determine levels of data sharing Challenges to HIT Privacy and security issues who and how do providers/facilities have access to these records? Who controls access rights? Do patients as consumers opt-in or opt-out for sharing their data? 10

11 Challenges to HIT Who can change/edit existing data? Will the EHR participate? What does HIT mean to you? What is happening in your state? Status of HIEs Exchange of data with MCH How many of you have HIEs in your state? What is the status of EHRs in your state? What does HIT mean to you? How many receive information from EHRs in your state? If you do receive information, what kind do you receive? For what program? 11

12 Questions? Thank you! Contact information: Lura Daussat, MPH Thalia Wood, MPH 12