Kentucky HIE Examples of Successful Interoperability Description Template

Transcription

1 Kentucky HIE Examples of Successful Interoperability Description Template Profile Element Description Responsible Entity The owner of the project The responsible entities or owners of the project are the Kentucky Health Information Exchange and the Cabinet for Health and Family Services, as well as the provider community, associations and organizations. Participating Entities Types of organizations participating, e.g., hospital, provider The Kentucky Health Information Exchange, housed at the Cabinet for Health and Family Services (CHFS), is the statewide designated health information exchange in Kentucky. KHIE, through its partnership with key stakeholders and healthcare organizations across the Commonwealth, seeks to advance interoperability while building a robust health information exchange to allow providers to access relevant information at the point of care when it is most needed. The participating entities include: ambulatory providers including specialists and primary care organizations, hospitals and its affiliated organizations, behavioral health, corrections and local health departments. Pharmacies and emergency medical services are scheduled for future participating entities. Description Short description of the project Some of the most important uses cases of interoperability are KHIE s EHR data submission to public health entities both at the state and national level. As the public health authority for Meaningful Use, providers are required to connect with KHIE in some capacity, in order to attest to the EHR Incentive Program. Serving in this function has allowed KHIE to broaden its interoperability efforts and capture a range of data that is used for public health reporting. For the purposes of this report, we will focus on the following public health data submissions: syndromic surveillance through the capture of admit, discharge, and transfer (ADT) data feeds that are routed to the Centers for Disease Control and Prevention; electronic disease reporting through the capture of electronic laboratory data that is routed to the Kentucky National Electronic Disease Surveillance System

2 (NEDSS); and cancer case reporting which is routed to the Kentucky Cancer Registry (KCR), housed at the University of Kentucky. Serving as the designated public health authority in the state of Kentucky for Meaningful Use reporting has allowed KHIE to leverage existing data feeds for robust public health reporting KHIE leverages its existing relationship within CHFS to support the implementation of KHIE s ehealth initiatives. Among some of the most comprehensive levers are KHIE s relationship with the KY Medicaid EHR Incentive Program and the Department for Public Health. Seated within CHFS has allowed KHIE to connect with a multitude of providers as they are required to submit public health data in order to attest to Meaningful Use. Additionally Kentucky passed legislation in May, 2015 that requires all providers to submit electronic laboratory data to KHIE beginning in October, Thus exemplifying KHIE s interconnected relationship within CHFS and the state level HIT initiatives. Governor Steve Beshear issued an Executive Order in August 2009, establishing an agency to oversee the advancement of health information exchange in Kentucky. Work immediately began on the technical infrastructure of the Kentucky Health Information Exchange. Kentucky received more than $9 million to advance the use of electronic health information exchange and support eligible healthcare providers across the state in achieving stage 1 meaningful use of certified technology. Eligible providers who demonstrate meaningful use of certified EHRs began receiving incentive payments in January 2011.Today, KHIE is administered by the Division of Kentucky Electronic Health Information. Hospitals send ADT messages. 100 hospitals are eligible. Also work with behavioral health and rehab. MU has been a big driver. Immunizations, reportable labs, and cancer reporting to registry. Technology has lagged. This has been a major issue. Working with over 130 EHR vendors. Only half are interoperable at the most basic level. Half cannot set up a VPN and send HL7 messages.

3 Standards Implemented Policies Adopted What standards were implemented in the project What policies were implemented/adopted to support the implementation ADT to HIE to NEDSS and syndromic surveillance. BIO Sense gets full ADT feed. NEDSS wants full ADT and lab feed. Cancer case reporting is CCD and CCDAs. Have major oncology vendors that elected not to build the cancer registry functionality. Looking into using Direct secure messaging. Immunization Connect to providers EHR. HL7 Immunization messages. Direct being used for transitions of care. SNFs referrals from hospitals. Partnering with the KY REC. Contracted with 3 rd party to provide Direct messaging to providers who did not have support of vendors. There are 19 HISPS across Kentucky. Implemented the Direct phone book. Providers can enter their addresses and look up addresses. Behavioral health Sending CCDAs to PCP. Working with Netsmart. Challenge is the redisclosure requirements. Work in progress. Have program around patient consent. Worked with University of Kentucky to develop videos. Query Many connections are VPN. Have a lot of data coming in. Have a community record that providers can use to look up data. Can query for CCDs and CCDAs. This is going slow. Participating in ehealth Exchange. HL7 ADT HL7 Immunization messages CCD Direct IHE XDS.b Behavioral health policies on consent. KHIE is in the same cabinet as Public Health and Medicaid and is written into state health plan. Last legislative session passed a regulation that mandates all electronic laboratory reporting be done through KYHIE. Will be in force in Hope to legislate immunization.

4 Timeframe Start date, key milestones In 2010, the first hospital pilot (out of six hospital system) went LIVE and was actively exchanging health information. In 2011, KHIE established an interface with the Kentucky Immunization Registry, and in 2012 an interface was established with the Kentucky Cancer Registry. In 2012, KHIE took its first behavioral health facility, Penny Royal Behavioral Health facility; LIVE with CCD exchange. In 2013, KHIE was LIVE with Syndromic Surveillance and Electronic Laboratory Reporting. KHIE hit a milestone in 2014 with a 1,000 LIVE connections to the HIE across the state. To date there are currently 1,084 connections as of July 10, In 2014, KHIE began the Direct secure messaging roll-out and currently has 383 LIVE connections using Direct technology. In 2015, the Fayette County Detention Center went LIVE with laboratory results and ADTs. Also in 2015, KHIE rolled out its HIE upgrade to a new level of connectivity called to XDS.b, and began piloting in March with three hospitals. Volumes Impacts Quantitative indicators, e.g., number of providers, number of records exchanged Quantitative results, e.g., reduction in delays, cost savings 90 hospitals are live with at least one of the following: immunizations, reportable labs, and cancer reporting to registry. Currently there are on average 250,000 queries per week within the HIE. 762 signed participation agreements representing 3,077 locations 1,087 provider locations submitting live data and actively exchanging information 692 ADT 895 VXU 451 SS 56 TRN 48 LAB 46 RAD 90% of acute care hospitals are live in KHIE 384 providers/points of care are live with Direct messaging KHIE cannot currently provide impact results and references as described in this profile as projects are still very much in implementation. Qualitative results, e.g., provider satisfaction, perceptions, testimonies

5 References Contacts Links or attached documents Point of contact for further information Polly Mullins-Bentley: Deputy Executive Director, State Health IT Coordinator, KHIE, x 2809 Sue Anderson-Lenz, Onboarding Project Manager, KHIE, sue.anderson-lenz@ky.gov, x2477.