New Mexico Health Information Collaborative The Statewide Health Information Exchange (HIE) Network

Transcription

1 New Mexico Health Information Collaborative The Statewide Health Information Exchange (HIE) Network Thomas East, Ph.D., CHCIO, CEO/CIO April Salisbury, Director of Education and Training Michelle Bowdich, Provider Relations August 18, 2016

2 Overview NMHIC HIE- What It Is and How It Works What the NMHIC HIE Offers Data Providers and Data Elements NMHIC Status and Outreach Update NMHIC Benefits Privacy & Security and Patient Consent Hospitalization Notifications Success Stories Examples of NMHIC HIE {Demonstration} Next Steps

3 Perfectly informed healthcare for New Mexico

4 What is a Health Information Exchange? Technology and services to make sure health information is available when and where it is needed. Interoperability - the ability of systems to exchange & use electronic health information from other systems without special effort on the part of the user.

5 Why use a Health Information Exchange? 18 different doctors in your lifetime >65 years old- 28 different doctors Your health is dependent on equivalent of 200 pieces of paper in almost 19 different locations. Average values for the US from the Practice Fusion survey conducted via omnibus survey April 17-18, The GfK OmniWeb survey is a weekly national web survey of US households. Interviews were conducted from among a nationally representative sample of 1,035 adults age 18 or older

6 EHRs and the Tower of Babel

7 Healthcare Interoperability Today Clinician Office A Hospital A Hospital B Clinician Office B Diagnostic Tests & Imaging Emergency Department

8 Integrated Clinical Record Clinical Portal, Clinical Data Repository, EMPI, and Vocabulary Services Workflow Integration Single Sign On (SAML) Send to my EHR Interoperability Query Retrieve Services Mobile V2.x, CCD, CCDA Event Notifications Consent Flag Automation Interoperability Services Hospital Clinician Office Diagnostic Tests & Imaging Emergency Department XDS / XDR NMHIC is more than just a Clinical Portal Secure Messaging Data Analytics

9 Clinical Portal

10 Portal- Data from 1/1/2013 to present (35 months) Browse with document view 3 clicks to most documents Focus document tree to a date range

11 Notification Delivery Options Notification Event Options

12 Notifications are Dependent on Relationships Notifications are based on relationships between organizations, providers and patients. A relationship store is created as data flows into the HIE from organizations and providers identified in clinical messages this includes both identity of provider as well as their role (i.e., primary care provider, attending, admitting, etc.). NMHIC also has the ability to upload a relationship table creating a relationship to those that are not a provider of record (i.e., care coordinators or providers that do not yet send data).

13 Core HIE data Demographics Lab Data Allergies Radiology Data Medications Clinical Notes Immunizations Insurance Procedures Problem List Encounters (Visits) & Diagnoses Note: Data available varies by organization

14 Data Providers & Elements

15 NMHIC Status HIE Orion System Live since 5/2015 Data from Jan. 1, 2013 forward >1B Messages in clinical data repository Over 1.7 Million patients--all of Centennial Care 100 M Messages inbound each month Public health reporting 58K ED admission reports/mo. 18K Elec Lab Reports/mo. Direct secure messaging now available ehealth Exchange gateway (Sequoia Project) went live 2/10/2016 Data Providers Not Providing Data % 293K 36% 52% NM Hospital Beds Providing Data % 522K 64% 64% NM ED Admissions in NMHIC 2014 Data

16 NMHIC HIE Participants 27 Hospitals 14 Provider groups NM Medicaid Commercial payer organizations 3 Laboratories 1 Statewide diagnostic imaging organization 1 Pharmacy Public health NM Primary Care Association representing FQHCs NMHIC welcomes additional stakeholders including: home health, hospice, skilled nursing facilities, behavioral health, professional healthcare associations and ancillary service providers.

17 NMHIC HIE Use is Climbing Rapidly

18 NMHIC HIE Use is Climbing Rapidly

19 NMHIC HIE Benefits Appropriate, timely sharing of vital patient information can better inform decision making at the point of care and allow providers to: View an integrated clinical record from NM and the surrounding area Receive notifications of clinical events such as ED admission Avoid readmissions Avoid medication errors Improve coordination of care Improve efficiencies Improve diagnoses Decrease duplicate testing Reduce costs Streamline referrals Improve the patient experience

20 Privacy and Security Information within the NMHIC HIE is subject to Federal and State Privacy and Security Regulations which includes HIPAA, HITECH and other regulations. Information is encrypted at rest and in transit. Access is limited to authorized users only. Security meets industry standards such as SSAE16 (auditing), ISO and EHNAC

21 Patient Consent New Mexico is an Opt-Out State: Data can flow into the HIE without patient consent However, patients control which organizations can access the record Break the Seal

22 Success Stories

23 Dr. Sally L. Harris Albuquerque's Best Docs Best Doctors in America I had a complicated patient today who had lots of labs done elsewhere, I was able to look at them all and make a hypothetical diagnosis on that basis, which I could not have done at all without this interface. THANKS!!!!!! 5pm 7/10/2015, (first day of HIE access) Thank you, I am using this for about 30% of my patients and it is a huge time saver!!! 7/16/2015 (less than one week being live) If I had known how useful this was I would have signed up a year ago. It makes my life so much easier to be able to track labs more effectively than my patients can with their portal interfaces. Your interfaces is fast, easy to use, and seems to know nearly everyone I see. I love that I can access labs and tests from UNM and Pres and ABQ in one place. This is an incredible tool. Thank you for providing it! 8/4/15

24 David Glass, MD, EMT-P Resident Physician Department of Emergency Medicine University of New Mexico Hospital USAF Reserve Pararescue Team Leader NM Health Information Exchange is a powerful tool that is improving the quality and safety of care every day in New Mexico Our team had a patient with severe vaginal bleeding arrive in OB Triage. She had received all of her prenatal care at another hospital. Getting access to her records made all the difference. The following day, our team was called down to the EDRU (ED resuscitation unit) for a 37 week pregnant patient in a MVC (Motor Vehicle Collision) and I was able to get consent, log in, and gain access to much needed prenatal care information because we needed to admit her immediately to our institution. The OB service had no idea this portal existed and have been impressed with the speed and efficiency that I've been able to gather medical information. In fact, they have asked me to contact my EM point-of-contact about how they can gain access. 4/16/2016

25 {Please contact NMHIC to schedule a follow up Demonstration}

26 Next Steps: Complete Readiness Document Administration Training (90 mins.) End User Admin, Privacy Officer, Trainer Consent Administrators (20 mins.) (Most often, front desk personnel) Clinical End Users (35-60 mins.) Levels 1-4, 6c Hand off to Operations

27 NMHIC HIE Training Training methods: Live and/or recorded brief lecture and demonstration Hands-on Review References Training materials: Visuals Quick Reference Guides Portal training environment Recorded training videos

28 Questions? Contact us: Call: (505) Visit:

29 Supplemental Slides

30 Remotely Hosted by Orion Health

31 Immunizations and clinic visits Passed our testing, went live 2/10/16 Starting planning with SSA, VA, HIEs in surrounding states

32 Participating Organizations Hospitals / Health System Christus St. Vincent Regional Medical Center Gerald Champion RMC Gila Regional Medical Center Holy Cross Hospital Los Alamos Medical Center Lovelace Health System Memorial Medical Center Nor-Lea General Hospital Presbyterian Health System San Juan Regional Medical Center - In testing now Sierra Vista Hospital Union County Hospital UNM Health System Diagnostic Service Centers Laboratory Corp. of America Quest Diagnostics- In testing now TriCore Reference Labs X-Ray Associates of New Mexico - In development now Payers New Mexico Health Connections BCBS NM Molina United Healthcare Data Provider Only Portal User Only Data Provider and user of HIE portal Contract signed, in queue for implementation

33 Participating Organizations Provider Groups and Public Health ABQ Health Partners First Nations Community HealthSource Hematology Oncology Associates Heather Brislen, MD InnovAge Jeffrey D. Miller, MD Monica Luna, DOM New Mexico Department of Health NM Oncology Hematology Consultants (NM Cancer Center) 200 Christus St. Vincent Community Providers NM Orthopaedics NM Primary Care Association (Represents FQHCs) Rio Abajo Family Practice Sandia Neurology PC Surgical Oncology & Gastroenterology Associates Taos Clinic for Children and Youth Vida Pharmacy Data Provider Only Portal User Only implementation Data Provider and user of HIE portal Contract signed, in queue for

34 Albuquerque Ambulance Service Albuquerque Healthcare for the Homeless Albuquerque Urology Associates DaVita Healthcare De Baca Family Practice Clinic Duran Central Pharmacy Eye Associates of New Mexico Genesis Healthcare Guadalupe County Hospital Healthcare Resources, LLC Kindred Hospital Las Cruces IPA Lovelace Heart Hospital and Lovelace Medical Group Miner s Colfax Medical Center Mountain View Regional Medical Center Interested Organizations Oak Street Clinic & Urgent Care OnPointe Health Pecos Valley Medical Center Petroglyph Pathology Services Presbyterian Medical Services Project ECHO Rehoboth McKinley Hospital Rio Arriba Community Health Council Sandia National Laboratories- Med Clinic Santa Fe Community Providers (after CSV hospital) Santa Fe Imaging Southwest CARE Center Southwest Gastroenterology Associates Taos Family Practice Taos Medical Group Women s Specialists of NM

35 Privacy and Security Unique user IDs and rigorous passwords required Inactivity time out at 15 min or less Inactive user accounts are identified and deactivated Audit tools are provided.

36 Patient s HIE Consent Decision Give Consent Full access to all information by that organization. Do Not Give Consent Consent Not Granted Decision Not Made, or Consent Has Been Withdrawn Information is in NMHIC HIE, but no access is permitted unless Break the Seal conditions exist. Break the Seal is available for limited time and is audited. Opt Out No access to any information by anyone, even in an emergency. A search will return Patient not found Overrides any previous consents given.

37 Greatest Access to Protected Health Information 1 Full Clinical View, Import, 2 Full Clinical View and Import 3 Full Clinical View Least Access to PHI and Notifications 4 Front Desk, with demographics and little clinical info 6 5 Role-Based Access Levels Privacy Officer, with patient demographics and user auditing End User Admin, with no patient data Users should be assigned role with minimum necessary access to PHI to do their job

38 Example Integration (Cerner) Single Click access to Clinical Portal

39 Timeline View: See big picture of all encounters with fly over and drill down Zoom in on a period of time Hover over data point for detail Drill down

40

41 EMR / HIE Workflow Options

42 Workflow Enhancement Options* Single-sign-on from your EMR Automated consent flag through EMR/ADT feed Send CCDs and results into your EMR Upload your patient lists to enhance notification performance (creates relationships in the portal) Single-sign-on in portal for DIRECT messaging *See NMHIC for quote