Interoperability to Improve Healthcare HIMSS EHR Vendors - - PowerPoint PPT Presentation

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Interoperability to Improve Healthcare

HIMSS EHR Vendors Association

Hugh Zettel Hugh Zettel

GE Healthcare GE Healthcare Director, Government & Industry Relations Director, Government & Industry Relations Vice Chair, HIMSS EHRVA Vice Chair, HIMSS EHRVA

HL7 HL7

HIMSS Annual Conference HIMSS Annual Conference February 28, 2008 February 28, 2008

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Today’s Agenda

• EHR Vendors Association (EHRVA) Overview
• Why Interoperability?
• EHRVA Interoperability Roadmap
• Where is Interoperability Today?

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EHRVA Overview

• Mission

– To improve the quality of patient care and the productivity of the healthcare system through the rapid, widespread adoption of EHRs and interoperable systems

• Founded in 2004

– Provides unified voice and a forum for cooperation for the EHR vendor community

• All major EHR suppliers in US market

– Large and small companies serving ambulatory and acute care provider organizations of all types

• Support accelerated EHR adoption

– Interoperability Roadmap – Certification – Advocacy / Public Policy

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EHRVA Member Organizations

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EHRVA Member Organizations

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Why Interoperability?

• High-quality care across the continuum
• Patient safety: reduced medical errors
• Clinical decision support: standardized, coded

data

• Streamlined workflow: results reporting
• Population health: quality reporting
• Emergency management: disaster response

and recovery

• Reimbursement: claims attachments
• Empowering consumers: personal health

records (PHRs)

• Local, regional and national networks

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Industry Engagement

• EHR Certification

– 3 members appointed as Certification Commission for Health Information Technology (CCHIT) commissioners – >30 members participate in various CCHIT workgroups – 31 member companies certified since 2006

• Health Information Technology Standards Panel

(HITSP)

– EHRVA represents vendors on HITSP Board – Member participation in HITSP workgroups

• American Health Information Community

– Participation in Quality and EHR workgroups

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Interoperability Initiatives

• EHRVA Interoperability Roadmap

– Collaboratively developed to provide guidance to EHR vendors and other industry stakeholders – Aligns with CCHIT and HITSP direction

• Demonstration/Adoption of Roadmap in

Products

– Integrating Healthcare Enterprise (IHE) Interoperability National Showcase & Regional Implementations – Implementation in NHIN and international pilots – Building upon IHE to create common immunization registry use-cases, as well as implement HISPC activities (e.g., the consent work in CT, the use of CCD in Iowa)

• Outreach to organization and communities
• ASTM/HL7 Continuity of Care Document (CCD)

Quick Start Guide

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Interoperability Standards

HHS Recognized Efforts

• Health Information Standards

Panel (HITSP)

– Defines the standards to use – Interoperability specs

• Certification Commission for

Health Information Technology

– Requires the standards

Industry Interoperability Efforts

• IHE Interoperability

Showcase

– 77 disparate vendors

• EHRVA Interoperability

Roadmap

– Outlines path to provide “packaged” interoperability

EHRVA Members Working Together to Achieve Interoperability

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HITSP Readiness EHRVA Member June ’07 Survey*

• 76%** have assessed

HITSP specifications

• 76%** expect CCD to

be required in 2008

• 72% see synergy of

CCD w/ other HL7 CDA requirements

• Limited member

experience with IHE

– 32% - 48% with various interoperability profiles

* 28 total responses; 61% of respondents ambulatory EHR vendors ** Agree or Strongly Agree; 0% Disagree or Strongly Disagree

“The survey feedback from our members, especially small ambulatory vendors that comprise the majority of EHRVA member companies, underscores the growing consensus and collaborative effort in our industry to implement a single set of standards using the HITSP process.”

Don Schoen, CEO, Medinotes Corporation EHRVA Chair

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Phone Network Provider

• Phone number
• Routing
• Call services

“Mega-Phone”

• Mute
• Speaker
• Conference
• Speed Dial

Rotary Dial

“Do the Job Phone”

Interoperability: An Analogy

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Health Information Technology Interoperability

HIT System A HIT System B Interoperability Standards Patient Information Patient Information

• Patient matching
• Information Location

Conformance to interoperability standards “out of the box” reduces communication costs

Network Communication and Services

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EHRVA Interoperability Roadmap

– Provides concise, benefit-based, incremental approach – Promotes industry collaboration, standards planning and convergence – Uses industry best practices for profiling and testing standards – Adopts a single set of interoperability standards – Ensures standards support multiple levels of sophistication now and in future

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Requirement 1: Allow “Edge” Systems to Retain Functionality and Autonomy

• Leverage functionality of edge systems…where workflow

innovation occurs

• Cost-effective… minimize core duplication of services

Edge System Edge System

Edge to Edge Communication

Interoperability Functions Defined By NCVHS

Edge to NHIN-Core Communication

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Requirement 2: Allow Flexibility to Support Multiple Architectures

• Minimize proliferation of interfaces for different data

storage schemes

• Flexibility to evolve configurations between edge systems

& sub-network

Edge System e.g. Lab Edge System e.g., Inpatient EHR Edge System e.g., Ambulatory EMR Edge System e.g., RHIO Central Repository

data data Edge to NHIN-Core Communication

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Requirement 3: “Thin” NHIN Core

• Limit NHIN core functions, ensuring robust

interoperability between edge systems

• Ensure transparency at the boundaries between core

and edge systems, as well as between edge systems

and Provider Access

Edge System Edge System

Interoperability Functions Defined By NCVHS

Edge to NHIN-Core Communication

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EHRVA Interoperability Roadmap

Available now 6 mos to 3 yrs 3 yrs +

Phase 4: Active Quality Reporting & Health Surveillance Phase 3: Advanced Clinical Support and Dynamic Query Phase 2: Share Diagnostic Results & Therapeutic Information Phase 1: Share Medical Summary Information

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EHRVA Interoperability Roadmap Aligns Major Industry Drivers

• Office of the National Coordinator for HIT

– Open and ongoing dialog

• HITSP standards

– Supported successful harmonization of care record summary – Developed CCD Quick Start Guide

• CCHIT requirements

– Collaborative, non-competitive analyses and feedback during all public comment periods

• HL7

– Worked to support development of lab result implementation guide to meet AHIC use case requirements

• AHIC priorities and use case roadmap

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EHRVA Interoperability Roadmap CCHIT EHR Certification Alignment

Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec Jan Feb Mar Apr May June July Aug Sept Oct Nov Dec

2008 2009

Development Timetable

2009 CCHIT dev. 2008 CCHIT dev.

Phase 1: Share Medical Summary Information

EHRVA Interoperability Roadmap

Continuity of Care Document (CCD) HITSP-C32 * Share Medical Summaries – CCD + IHE/XDS Transport; HITSP-32 / TP13 *

2010 CCHIT dev.

Phase 2: Share Diagnostic Results & Therapeutic Info. Phase 3: Advanced Clinical Support

* Proposed in CCHIT Incremental Adoption of CCD Through HITSP Specifications, Jan. 14, 2008

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Example: Continuity of Care Document Education

• June 2007 Internal Survey Highlights

Interoperability Training Needs

– Standards & Interoperability Workgroup Creates CCD Quick Start Guide Specification – Quick Start Guide delivered to Members in October, 2007

• Collaboration… Share tools with all stakeholders

– EHRVA CCD Quick Start Guide Publicly Available Free of Charge November, 2007 – Over 800 downloads first four months

• Accelerate Adoption within EHRVA

– EHRVA Hosted CCD Web Training – Focused on HITSP Implementation – Over 130 EHRVA Members Attend

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Operational Interoperability Today

• South Shore Hospital) and Atrius Health (MA)
• Community Hospitals and Physician Practice

Systems (CHAPS) project

– Serving 600,000 patients with over 2.3 million visits/year – Exchanging records between hospital Emergency Department and physician offices – "Medical Summary" to the hospital that contains patient information including visit history, problems, medications, allergies, immunization history, medical/surgical/obstetrical history, social and family history.

• Standards-based approach from MEDITECH and

Epic

– CDA/CRS Medical Summary exchange profile from IHE – Use HL7 v3 specifications

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In Conclusion, EHRVA is…

• Committed to supporting national interoperability

and transparency goals

• An advocate for standards that meet current

market needs

• Working to leverage HIE interoperability progress

to advance data sharing

– Among shared customers – With other HIT suppliers – Within states, regionally and nationally

• An active participant in open standards

harmonization process

• Delivering interoperability based on EHRVA

roadmap TODAY

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