Welcome to Rochester RHIO s GET DIRECTed! Denise DiNoto Director of Community Services March 2014 1
Agenda Introductions What is Direct? Direct Messaging Functionality Incorporating into Workflow RHIO Enhancements Next Steps Questions & Answers 2
What is Direct? 3
Rochester RHIO Services: Rochester RHIO Services: Virtual Health Record (VHR) Web-based query tool for physicians & staff to access patient information Contains >70+ million results for patients in 13-county region Patient consent required EMR Integration Currently connected to 22 EHR systems Lab, radiology & transcribed results delivery into EHR Over 550,000 eresults delivered/month to 239 practices DIRECT Secure, HIPAA compliant messaging service (No charge for RHIO Participants) Supports transitions of care, referrals, peer-to-peer data exchange Transportation method for ALERT notifications ALERTS Delivers Admission & Discharge notifications using DIRECT (No charge for RHIO Participants) Includes inpatient, ED and EMS visits Patient consent required
What is DIRECT? DIRECT: A simple, scalable, standard-based way to transport encrypted health information over Internet to known, trusted recipients Secure, HIPAA compliant messaging service Supports transitions of care, referrals, peer-to-peer data exchange Easy as email with same ability to attach multiple data types including documents, photos, Excel files or patient summary documents (CCD) Can use RHIO Direct web-portal OR integrate within EHR Supports Meaningful Use 5
What is a HISP? HISP Health Information Service Provider Rochester RHIO is one of many HISPs Your EHR vendor may be a HISP, or may have a preferred HISP For example: Medent & STI using SureScripts, Meditech is agnostic Enables cross-community access For example: Patient accesses services through several different health systems in multiple regions *Note: Rochester RHIO is already connected to SureScripts, Buffalo RHIO, Syracuse RHIO and Albany RHIO HISPs
Why DIRECT? DIRECT Benefits Supports speedy adoption & simple use cases Augments other ways information is exchanged electronically today Designed to coexist gracefully with existing methods for data exchange Could replace slow, inconvenient, and expensive methods of exchange (ex. paper & fax) Provides a future path to advanced interoperability 7
Direct Messaging Functionality 8
Opportunities to Use Direct Sender Direct Recipient Medical Doctor Care Manager Patient Registration Message Patient Summary CCD Referral ROI (Release of Information) Medical Doctor Care Manager Patient Registration Coder/ Biller 9
Use Case Example #1 Patient is seen by PCP PCP refers patient to Cardiologist PCP office sends DIRECT message to Cardiologist office to schedule patient s appointment (just like typing an email) PCP sends patient summary document (CCD) to Cardiologist through a DIRECT message Cardiologist has additional inquires and communicates with PCP through Direct messaging Patient is seen by Cardiologist Cardiologist follows up with PCP to transition care Cardiologist sends report, test result, or CCD to PCP Care is transitioned back to PCP 10
Use Case Example #2 Patient is in Monroe County Jail Patient is released When released, Monroe County Jail sends ROI (Release of Information) to Anthony Jordan Health Center Jordan sends Direct message within organization to coordinate care for patient How does this impact workflow? Patient has a smoother transition when released Patient doesn t fall through the cracks Improves turn around time from receipt of information to patient care. Insures accurate delivery of health information 11
Meaningful Use Why it s important? Sending & receiving Transition of Care (TOC) documents required in Meaningful Use (MU) Stage 2 There are 3 approved transport mechanisms, and 2 of these options use Direct messaging Care Transitions critical junctures in maintaining quality patient care Limited & untimely information transfer can have negative resulting health outcomes Use of Direct Messaging not limited to EHRs Users can stretch from any health system, private practice, and even providers with no EHR, can send and receive such information *For more information on MU2 & Direct: http://www.healthit.gov/sites/default/files/directbasicstoc_webinar_2013_02_19.pdf 12
RHIO Direct Functionality Tailoring RHIO Direct to Meet your Needs 13
Secure Provider Login 14
Secure Provider Login (cont.) 15
DIRECT Log in from the Provider Portal DIRECT users can receive message notifications in their everyday email
Set Up Options Address Customization Individual vs. Group Addresses Single vs. Multiple Addresses Examples: FirstName_LastNameMD@DIRECT.RRHIO.org PracticeName@DIRECT.RRHIO.org PracticeFAX@DIRECT.RRHIO.org PracticeLocation@DIRECT.RRHIO.org PracticeAlerts@DIRECT.RRHIO.org 17
Rochester RHIO DIRECTory
But wait there s more! RHIO Enhancements 19
Alerts Designed to improve navigation through community health information by providing: Right information Right person Right time Travel through DIRECT Messaging Notifications Include: ED and Inpatient Admissions ED and Inpatient Discharges EMS Encounters Patient Vitals from connected Kiosks 20
Alerts *Note: Currently the Rochester RHIO receives ADT messages automatically from 18+ hospitals in 13 county region. For more detailed on participating providers: http://www.grrhio.org/patients/doctors.aspx
Alerts Patient consent is required to receive Alerts Consider possible options once you receive an Alert message Follow up with patient Check VHR for more information Notify a scheduler Ex. ED Discharge Alert sent to practice, practice reaches out to patient to schedule follow up appointment. Who will manage Alert messages workflow Notifications to alternate email addresses Can change recipients notified to accommodate on-call rotation or shared job responsibilities 22
Use Case Example #1 Adding Alerts Patient presents at ED with chest pains and is admitted. NOW: Alert delivered through Direct message to PCP Practice. PCP Practice receives notification that they received a message and have designated staff to retrieve message and act on it. PCP Calls patient to schedule a follow-up visit Patient is seen by PCP PCP refers patient to Cardiologist PCP office sends DIRECT message to Cardiologist office to schedule patient s appointment PCP sends CCD to Cardiologist through a DIRECT message Cardiologist has additional inquires and communicates with PCP through Direct messaging 23
Use Case Example #1 Adding Alerts (cont.) Patient is seen by Cardiologist Patient places a call to 911, Patient declines transport to ED. Cardiologist is notified though an Alert that event occurred and has staff follow up with patient to schedule an appointment. Patient seen by Cardiologist again and then is referred back to PCP for follow up care Cardiologist follows up with PCP to transition care Cardiologist sends CCD to PCP Care is transitioned back to PCP 24
List Based Alerts Where are we now? Currently, alerts can be managed and changed based on patient listing Must be consented Opportunity to add or remove patients from list Changes submitted through DIRECT message Flexibility to fit into practice workflow Where are we headed? Increase customization by event 25
Continuity of Care Documents What is a Continuity of Care Document (CCD)? Electronic summary of care document CCDs can be exchanged between providers through DIRECT messages Pushing CCDs to the RHIO Cc: the RHIO on DIRECT message to also send CCDs to RHIO (making it available on VHR) Contribute CCDs to make clinical data available to patient s subsequent providers Examples: Child aging out of pediatric practice Following sub-acute rehab or home care 26
Next Steps How to Enroll? Does your EHR vendor offer DIRECT or have a preferred HISP? If so, provide it to the RHIO, Alerts can be sent to that address If not, contact Rochester RHIO for FREE DIRECT account, or multiple accounts What to Consider? Workflow efficiency Who will manage the DIRECT account(s) in your office Ask about Options Ready, Set, Go! 27
For More Information: Support Center 1.877.865.RHIO Or contact your RHIO Account Coordinator E-Mail info@grrhio.org Website: www.grrhio.org
Questions & Answers 29