Using HIE to Improve Data Integration and Patient Care Delivery Tonya La Lande & Jonathan Sherman Carolinas HealthCare System 9/11/2017
ABOUT CAROLINAS HEALTHCARE SYSTEM 60,000+ team members Second largest public, not-for-profit healthcare system in the nation $9 billion in revenues 12.5 million patient encounters $1.65 billion in community benefit More than 40 hospitals 900+ care locations 2
MISSION To improve elevate and advance Health Hope Healing - for all VISION To be the first and best choice for care. 3
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CHS Information & Analytics Services Patient Portal/HIE Revenue Cycle Clinical Analytics Key 5
CHS Population Health Strategy Cerner HealtheIntent Platform Network Mgmt Platform Message Center/ Direct Physician Metrics Supplementary Solutions Care Team Communication Doc Halo Referral Management TBD Employer Group Management Cerner Pure Wellness Workflow Tools Care Mgmt Registries Point of Care Integration XG Care Plans MyCarolinas Pt. submitted data Device data Care plan mgmt Community Referrals Aunt Bertha, EDIE Outreach Capabilities Emmi, West, etc Decision Support Stanson, NDSC Post Acute Decision Support NaviHealth Analytics Engines Milliman Risk Adjusters HCC, 3M, Truven Measures Dashboards MIPS/ACO/GPRO Artificial Intelligence Watson, Jvion Advanced Analytics RowdMap, TBD Advanced Reporting PowerBI Data Management Data normalization Person Mgmt Data Warehouse Data Mgmt IBM, Informatica Cost Accounting Data Mart Application Programming Interface (API) Mgmt Akana, Mulesoft Data Replication Infrastructure 6 Italics indicated example solution
Interoperability Defined ONC adopted IEEE s definition: Ability of two or more systems to exchange information Ability of the systems to use the information that s been exchanged without special effort on behalf of the user Three key components Technical ability Active use Without any special effort on behalf of the user 7
CHS CareConnect HIE Overview CHS CareConnect, our Health Information Exchange (HIE), provides standards based, secure sharing of patient information between health care organizations CareConnect integrates and provides access to clinical information not available in existing CHS systems CareConnect connects 19 CHS hospitals with over 250 affiliated and independent physician practice networks in the Charlotte metro area Entity: Carolinas HealthCare Information Exchange, LLC d/b/a Carolinas HealthCare System CareConnect Production Date: April 1, 2011 Primary vendor: Medicity via an application service provider model, migrating to Cerner HIE application Across the Carolinas, connects 3 regional CHS hospitals, affiliated physician networks, 4 independent health systems, and 3 independent HIEs Expansion includes both CHS-affiliated and independent hospitals and physician practices, regional IDNs and HIEs, public health agencies, and post-acute networks across the region Current repository has over 6 million unique patient records 8
CHS CareConnect Timeline 2010 2011-12 2013-14 2015-16 2017 Created CHS CareConnect, LLC Selected Medicity as HIE VOC CHS data populated in HIE, April, 2011 1 st portal customers Elected not to charge in Charlotte metro Connected to Coastal Connect Exceed 3M unique records ehealth Exchange certification Access to portal via native EMR Converted to Cerner HIE New Q&R connections 9
CHS CareConnect Diagram Connections In Progress ehealth Exchange VA UNCH CaroMont CVMC Independent and Regional Q&R connections H (HIE Repository) Novant Health Mission HIE CHS Independent Community Practices H (CHS Record Repository) CHS Practices 10
CHS CareConnect Footprint 11 11
CHS CareConnect HIE Benefits Quick access to clinical information via multiple provider data sources within existing EMR workflow Labs, Cardiology, Pathology, & Radiology Reports Transcribed Documents Allergies, Problems, Medications Patient Demographics Family & Social History Promotes care coordination Reduces time to access clinical information Eliminates/reduces faxing from HIM departments Puts information in the hands of clinicians at the time of care 12
Cerner HIE Connection & Rollout Progress CHS Interfaces 2/15/17 Mission Connect CCD Query & Retrieve: 2/21/17 Coastal Connect CCD Query & Retrieve: 2/28/17 Novant Health CCD Query & Retrieve: 6/13/17 CHS End Users Access CareConnect via Cerner Millennium 6/21/17 Next up UNCH CHS Ambulatory Surgery VA Caromont 13
6 5 Participant Connection Matrix Highest Value & Readiness Complete 4 Clinical Value 3 2 CHS HCHB CHS Ambulatory Surgery Center 1 Lowest Value & Readiness CHS Powerchart ECG 0 0 1 2 3 4 5 6 Readiness 14
CareConnect Training & Communication Plan Training Objectives Audience Training Strategy: 1. To communicate the new CareConnect Outside Records mpage to Canopy users and the new CareConnect Community Health Record (CHR) to external customers 2. To train the CHS Support Center staff on password reset for external customers CAST Team E-Learning Team Clinical Informatics Coordinator CareConnect Team Ambulatory CAST Team Canopy Users: Acute Providers, ED Providers, Acute Nurses and Clinicians and Ambulatory Providers and staff Non Canopy Users: External end users CHS Support Center: CHS Support Team staff members Roles & Responsibilities Assist with communication and onsite training Acute and ED providers Create web based training video and job aide. Assist with communication and training acute nurses and ancillary clinicians Create & deliver communication, and train non CHS end users Train Support Center Staff on password reset Assist with communication to Practice Managers and assist with training Ambulatory Providers and Clinicians Types of Training Materials: Job Aid Interactive Video (less than 5 mins) Location of Training Materials: Canopy Users Education Repository mpages Canopy EDU, Clinician EDU PeopleLink Learning Section PeopleConnect Canopy Education Page Non-CHS Users (External) CHS Website outside of firewall, hidden link for users to access CHS Support Center Knowledge Base Repository Training Material Communication: Canopy Users Canopy Monthly Release Canopy Pop-up Alert Yammer Non-CHS Users (External) Onsite training Skype virtual web training sessions Email communication CHS Support Center Email Communication Physician Liaison Assist with communication to Ambulatory Providers 15 15
HIE Impact on Patient Care Implemented new HIE application on 6/21/17 Dr. Geoffrey Rose, Cardiologist at Sanger Heart & Vascular Institute immediately saw the value Accessed CareConnect when treating a patient from Novant Health Saw the patient had undergone several cardiac tests prior to seeing him at Sanger Was able to avoid retesting the patient Easy to see how CareConnect will lead to care that is better coordinated, more efficient, and ultimately, more effective. 16
CareConnect Success Stories Nurse confirmed patient seeking opioids Pharmacist confirmed patient med list to contraindication for med prescribed elsewhere HIM worker reports decrease in calls for fax reports Skilled Nursing Facilities have quick access to info Pediatrician accessed recent records from nearby Novant Urgent Care facility and adjust treatment 17
CareConnect Portal Use via CHS EMR 5,319 unique users of CareConnect portal via Canopy EMR (exceeded goal of 4,271) 30,045 total patient searches since inception 18
Other CareConnect Plans 19
QUESTIONS? Contact Information: Tonya La Lande 704-446-6243 tonya.lalande@carolinashealthcareconnect.org Jonathan Sherman 704-355-0382 jonathan.sherman@carolinashealthcare.org 20