ecw Integration PIX, XACML, CCD with Basic Clinical Event otifications Project Scope Definition April 27, 2017
I. Key Contacts: Healthix Project Manager and Contact Information: Healthix Business Development and Contact Information: ame of main contact Healthix liaison at <<Participant>>: ame of main Project Contact at <<Participant>>: II. Project Requirements Document - Purpose The purpose of this document is to provide enough information about the project in order to 1) Identify the scope of the project for all parties including <<Participant>> Entity, Healthix, and any other associated vendors or subcontractors; 2) estimate project cost; and 3) Will be used as an initial draft for the creation of any formal contract. Subsequent to this document will be any associated contracts and a final project plan. III. Project Overview <<Participant>> ( ETIT ) and Healthix are establishing interoperability of patient clinical records between organizations. This integration is defined as an IHE interface for patient registration, consent and CCD from eclincalworks (ecw) EMR to Healthix. ETIT would also like to implement Clinical Event otifications. This project will take approximately 8-10 weeks to complete from the initial start date. IV. Project Requirements Data Contribution 1. ETIT will send Patient ame, Sex, DOB, Race, Ethnicity, Preferred Language and consent via PIX v3 and XDS.b (XACML) message to Healthix. 2. The CCD interface from ETIT to Healthix will provide Problems, Medications, Medication Allergies, Lab Value, Vitals, Encounter, Diagnosis, Immunization and other clinical information. 3. Healthix will work with ETIT to complete below table which will determine if the required data elements are getting captured in ETIT s EHR and if these data elements will be sent to Healthix via CCD feed. Data Categories DOH Common Data Set ame Sex DOB Race Ethnicity Pref. Lang. Smoking Status Problems Medications Med. Allergies Included in data feed (/) Capture in EHR (/) otes 2
Lab Test Lab Values Vitals Care Plan fields* Procedures Care Team Members* Encounter Diagnosis Immunizations Functional & Cognitive Status Discharge Instructions Additional Primary Procedure Primary Diagnosis Radiology EKG Advance Directives Provider PI Discharge Disposition CCD Integration 1. ETIT must have a live ecw implementation in which they are capturing patient demographic information and clinical data. 2. ETIT must have appropriate agreements to connect their ecw implementation to an instance of ecw s interface engine, ehx, and be intending to send over only the data encompassed in the HL7 v3 specifications. 3. ETIT must complete a user list for user provision in the RHIO. 4. ETIT s EMR must be currently capable of sending patient registration HL7v3 PIX Add and XACML consent information to Healthix. The PIX Add transaction feed from ETIT to Healthix must provide at least the minimum required demographic data to support patient matching. 5. ETIT must maintain a unique and persistent internal ID for each patient that will be communicated to Healthix to support Master Patient Index (MPI) matching. 6. ETIT s EMR must provide CCD via IHE Provide and Register (XDS.b- PR) 7. ETIT s EMR will send newly locked encounters to the RHIO in batches every 24 hours. 8. ETIT must implement a Healthix consent process in compliance with Healthix policies and procedures: i. Collect signed electronic or paper consent forms from patients to allow authorized ETIT staff access to records in Healthix. Patients 18 years and over can provide consent. Parents or guardians can provide consent on behalf of minors under the age of 10. ii. Maintain signed copies of consent forms and make forms available to Healthix for periodic audits. Consent may be captured in electronic or paper format. 3
iii. Enter patient consent values into the ehx Patient Consent module of ecw PM to support electronic consent submission to Healthix through the PIX v3 and consent feed. 9. ETIT will send message to Healthix on Encounter closed/signed off. Following protocol will be used for patient registration and to register & upload encounters: i. PIX Add or update patient into the Healthix database. ii. XACML consent iii. PIX Retrieve the Healthix empi for the given patient. iv. XDS.b Provide & Register the encounter as CCD with the given Healthix empi 10. ETIT will be able to query Healthix for longitudinal CCD for their patient registered at Healthix with consent. Document query will be triggered based on the following workflow: a) Request a List of Available Documents for Patient: i. ETIT s EMR sends PIX query to Healthix and Healthix returns the EMPI ID ii. ETIT s EMR sends XDS.b Registry Stored Query (RSQ) to the Healthix document registry endpoint containing the EMPI ID iii. Healthix dynamically generates the CCD and inserts it into the Healthix registry and repository. iv. Healthix responds with a list of available documents, including stable documents and the dynamically generated CCD b) Retrieve CCD from Healthix i. ETIT s EMR requests the CCD whose Document ID was returned in Step above using an XDS.b Retrieve Document Set (RDS) sent to Healthix. ii. Healthix sends a response with the CCD. iii. The retrieved document will be displayed in ETIT s EMR in an approved format. iv. The CCD from Healthix MA include any of the following data sections: a) Encounters b) Medications c) Allergies d) Diagnosis e) Procedures f) Vitals g) Labs Clinical Event otifications: 1. ETIT s IHE feed to Healthix must include all the patients that ETIT chooses to enroll in the notification service. 2. Subscription Criteria ETIT chooses to subscribe to all of its patients registered at Healthix. 3. Trigger Events - Clinical Event otifications will be sent from Healthix to ETIT when a consenting patient has one of the following events at a Healthix participant acute care facility: ED registration, ED discharge, Inpatient admission, Inpatient discharge, incarceration at ew ork City jail, or release from that incarceration. 4
4. Payload - Healthix will provide the following information in each event notification: i. Patient identification: ame, date of birth, ETIT unique ID ii. Type of encounter: ED visit, inpatient admission or inpatient discharge, death iii. Place of encounter: Facility where patient had an encounter iv. Date and time of encounter 5. Delivery Method Healthix will send event notifications to ETIT via Healthix s Clinical Message Center (CMC) format through the Healthix portal and the user will be notified through an Email otification to a standard email address V. Overview of Tasks Specific Deliverable CCD Integration 1. Establish TLS/SSL connection between Healthix and ETIT 2. Software / Interface Build 3. Healthix outbound feed to ETIT 4. Interface Testing 5. Promotion to production and validation of notification workflow Description ETIT will work with Healthix to establish TLS/SSL connection. 1. Establish IHE interface with ETIT s EMR to receive patient registration, consent, medication, diagnosis, encounters and other clinical information. 2. Build Consent flag ETIT to build necessary fields to support capturing Healthix consent. Healthix will work with ETIT to establish outbound CCD integration which will be triggered on user request. Complete System Integration Testing for IHE interface with ETIT established in stage. Modify data feeds as needed. Validate IHE interface from ETIT to Healthix in production. Healthix Clinical Event otifications 1. Setup the CE service. Healthix will setup ETIT s Basic CE service in Healthix Production environment. 2. Go-live Promote development to production. VI. Project Contingencies 1. Prior to activating the interface or notification service in production, ETIT must be in compliance with Healthix privacy and security requirements. VII. Assumptions 1. ETIT will collect Healthix consent from patients. The consent collected from patients will allow ETIT staff to access data only in the Healthix Clinical Viewer and receive notifications to support care coordination. 2. Appropriate personnel resources at ETIT will be available to work on this project. These resources may include but not limited to: a site liaison/implementation sponsor, a site project coordinator, site interface lead, site applications subject matter expert, site clinical lead, site registrar lead. 5
VIII. Approval of Project Requirements The information as described above meets our business requirements and we do hereby validate that we can meet the technical approach as outlined in this document. For <<Participant>> Date Print ame 6