hie use case design group - portal.ct.gov · 10/4/2017 · meeting schedule 4...
TRANSCRIPT
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HIEUseCaseDesignGroup
October4,2017|2:30– 4:00pmSession#10
ADesignGroupoftheConnecticutHealthITAdvisoryCouncil
FacilitatedbyCedarBridgeGroup
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AgendaWelcome/RollCall MichaelMatthews 2:30PM
Commentson8/30/17Minutes DesignGroupMembers 2:32PM
ReviewMeetingSchedule MichaelMatthews 2:34PM
PlanningFramework MichaelMatthews 2:35PM
SuggestedApproachesforUseCases Michael Matthews 3:00PM
PreliminaryRecommendationsDiscussion
Michael Matthews 3:40PM
MeetingWrap-upandNextSteps MichaelMatthews 3:55PM
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Commentson8/30/17Minutes
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MeetingSchedule
4
Milestones/Deliverables Dates
Session1:Kick-OffMeeting 6/27/17
Session2:ReviewUseCases(Part1) 7/12/17
Session3:ReviewUseCases(Part2) 7/19/17
PresentupdatetoHealthITAdvisoryCouncil 7/20/17
Session4:ReviewUseCases(Part3) 7/27/17
Session5:ReviewUseCases(Part4) 8/2/17
Session6:ReviewUseCases(Part 5)andPrioritizationCriteriaforUseCases 8/9/17
Session7:ReviewFinalUseCases(Part 6);ApplyPrioritizationCriteria 8/16/17
PresentUpdatetoHealthITAdvisoryCouncil 8/17/17
Session8:Select“Top10”UseCases;DiscussFinalPrioritizationCriteria 8/23/17
CedarBridge toConductAnalysisof“Top10”UseCases;ResearchFinancial,Business,Legal,andPolicyConsiderations
8/23/17-8/30/17
Session9:ValidateValuePropositions,ImplementationPriorities,andHIEServicesNeededtoEnablePriorityUseCases 8/30/17
Session10:ReviewofAdditionalInformationandPreliminaryRecommendations 10/4/17
Session11:FinalRecommendations 10/11/17
FinalReportandRecommendationstoHealthITAdvisoryCouncil 10/19/17
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SustainabilityConsiderations
5
PrimaryfocusoftheDesignGrouptodatehasbeenonvaluecreationandtechnicalrequirements.
FortheState’spurposes,recommendationsforinitialusecasesaredrivenbyexperience,intuitionandbestpracticesfromotherHIEs.
TheHITOshouldincludeinthefundingrequesttoIAPDadequateresourcestodevelopasoundfinancialsustainabilityplan.
InoperationsoftheHIE,rigorousmeasuresofusageandvaluecreationshouldbeimplementedtoensureallservicesyield
positivereturnforthestakeholdersofCT,enablingadjustmentstobeimplementedasneeded.
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ProcurementTimeline
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SystemComponents
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SystemComponentsandServices:Clinical
EncounterAlerts
LongitudinalHealthRecords
PublicHealth
Reporting
PatientPortal
ImageExchange
eCQMReporting
MPI x x x x x xProviderDirectory x x x x x xActiveCareRelationship x x x xTransformation x x x x x xMapconceptsandcodesacrosscontrolledterminologies(VSAC,SNOMED,HCPCs,etc.)
x x x x
Normalizationandstandardization x x x x xRulesEngine(s) x x xDeduplication x xConsolidation x x x xErrordetectionandcorrection x x x x x xInterfaceengine:transport/validation/translation/routing x x xDatagovernance x x x x x xLogging x x x x x xAccountmanagement x x x x xErrortrapping x x x x x xSecurity x x x x x xAuditing x x x x x xMeasurespecificationdata xSchemaMapping x x x x xCompliantGateway x xReportingtoolintegration(i.e.SSRS) x xImageExchangeGateway xEnterpriseViewer xConsentManagement x x x x x xAPIandothersubmissionmethodsofmeasurestoCMS x
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HPD
MPI
ACRS
SCD
CTHub:• ExchangeBroker• Connect-NwHINexchange• XCAExchange• XDS.BExchange• RestfulInterfaces• Direct
PublicHealthBHACO/AN/CINHIEsPayersHospitalsProvidersLabsPharmacyLTPACEMSOralOther
Portals:• LongitudinalHealth
Record• PatientPortal
• eCQM• PopulationHealth
• ClinicalEncounterAlertsService• ImageExchange• PublicHealthExchange• MedicationReconciliation• MOLST/ADRegistry
CoreServices
UseCaseServices
DataSharingOrganizations
eHealthExchangeCarequalityCommonwell
NationalNetworks
HL7C-CDACCD,QRDAFlatFileReport/PDF
C-CDACCD
HL7C-CDACCD,QRDAFlatFileReport/PDF
HIEServices
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UseCasesUnderReview
n eCQMReportingSystemn ImmunizationInformationSystemn LongitudinalHealthRecordn PublicHealthReportingn Clinicalencounteralertsn Imageexchangen Medicationreconciliationn MOLST/advancedirectivesn Populationhealthanalyticsn Patientportal/personalhealthrecord
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eCQMReportingSystem
Priorusecasehighlights
• eCQMDGrecommendations• Functionandpurpose• Valueproposition• Actors
Additionalinformation
• Business,financial,legal,andpolicyconsiderations• Requirementsdocumentation• RFPpreparation
Proposedapproach
• Procurement• NecessaryenablingserviceswillbeincludedintheIAPD-U;developmentand
deploymentofeCQM analyticswillbefundedbySIM
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ImmunizationInformationSystem
Priorusecasehighlights
• IISDGrecommendations• Functionandpurpose• Valueproposition• Actors
Additionalinformation
• Business,financial,legal,andpolicyconsiderations• AcceptanceofrecommendationsbyHealthITAdvisoryCouncil9/21/17
Proposedapproach
• InclusioninIAPD-U• Procurement
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LongitudinalHealthRecords
Priorusecasehighlights
• Functionandpurpose• Valueproposition• Actors
Additionalinformation
• Business,financial,legal,andpolicyconsiderations• RequirementsofPA16-77• 21st CenturyCuresAct• Privacyandsecurity• Value-basedcare• Nationalnetworks(eHealthExchange,CareQuality,Commonwell)• BorderstatesHIEinitiatives• ExistinginteroperabilityassetsinCT
• Technicalrequirements
Proposedapproach
• “FirstWave”usecase• Federatedmodel• Leveragenationalnetworks• Providerportal• InclusioninIAPD-U
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SampleProviderPortal
o ClinicalDocumentSummary(C-CDAandC62)renderingthathasmultipleclinicalcomponents– Demographics,Providers,Allergies,Encounters,Immunizations,Medications,Payers,Problems,Procedures,Results-ClinicalNotes,Laboratory,Radiology,Pathology,etc.
o Filteringandprintingbyparticipant,acrosssources,withinsections,withinresults13
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PublicHealthReporting
Priorusecasehighlights
• Functionandpurpose• Valueproposition• Actors
Additionalinformation
• Business,financial,legal,andpolicyconsiderations• IISDGrecommendationsacceptedbyHealthITAdvisoryCouncil• Needforgatewaytosubmit/queryforimmunizations(plussyndromicsurveillance,
reportablelabs,tumorregistry)• APHLInformaticsMessagingServices(AIMS)• Technicalrequirements
Proposedapproach
• “FirstWave”usecase• Furtherassesspotentialtoleverage/expandAIMS• Onboarding• Technicalassistance• InclusioninIAPD-U
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AIMS:APHLInformaticsMessagingService
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ClinicalEncounterAlerts
Priorusecasehighlights
• Functionandpurpose• Valueproposition• Actors
Additionalinformation
• Business,financial,legal,andpolicyconsiderations• PA16-77• Value-basedcare
• ConnecticutHospitalAssociation/PatientPingreview• Technicalrequirements
Proposedapproach
• “FirstWave”usecase• Furtherrefinebusinessandtechnicalrequirements• RFItoassessexistingCTassets• Procurement/contracting• InclusioninIAPD-U
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PatientPing
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MedicationReconciliation
Priorusecasehighlights
• Functionandpurpose• Valueproposition• Actors
Additionalinformation
• Business,financial,legal,andpolicyconsiderations• Furtherresearchonmedicationreconciliationprocess• DiscussionswithUCONNPharmacyre:initiativetoaddressprocessandtechnology
Proposedapproach
• Initialprojectfocusonprocessre-designandassociatedtechnologysupport• Technologyprocurementasindicated• Statewiderollout• InclusioninIAPD-U
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MedicationReconciliationChallenges
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ImageExchange
Priorusecasehighlights
• Functionandpurpose• Valueproposition• Actors
Additionalinformation
• Business,financial,legal,andpolicyconsiderations• Furtherresearchonimageexchange• Discussion/informationfromNYeC• Radiology-to-radiologyusecase• Referralusecase
Proposedapproach
• “FirstWave”usecase• InclusioninIAPD-U
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NYeCImageExchangeSolution
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Image Exchange Workflow CapabilitieseHealth Connect® Image Exchange has been designed to integrate with all common PACS technologies and with virtually all HIE and EHR platforms, providing the following image-enabled clinical workflows:View all imaging studies from within the patient record on an HIE portalWith a single click, authorized HIE users can launch a study of interest from any connected imaging location on eHealthViewer® ZF—a zero-footprint, web-based viewing platform—a fully diagnostic-quality FDA 510(k) Class II medical device.View and compare imaging studies from different locationsAuthorized HIE users can access a Community-Wide Imaging Worklist for their patient. Users can manipulate, sort, and view one or multiple imaging studies from different imaging provider locations in a common eHealthViewer ZF image viewing session.Collaborate with other healthcare providers anywhere in the community in real timeWith a single click from the eHealthViewer ZF, users can initiate an immediate screen sharing consultation session with any other authorized care provider in the community—for wet reads, second opinions, and consultations between referring physicians and specialists.Access images from external locations directly from their EMR or Direct Messaging inboxCare providers seeking access to patient records from their Direct Messaging inboxes, or as delivered to directly to their EMRs can be provided “one-click” access to view imaging studies on eHealthViewer ZF. This capability has the added benefit of enabling participating institutions to meet a key imaging menu criterion of Meaningful Use Stage 2.Transfer external imaging studies directly into a local PACSRadiologists and other clinicians frequently have access to relevant external prior imaging studies on their local PACS in order to properly diagnose and treat more complex medical conditions. eHealth Connect® Image Exchange accomplishes this transfer with a few clicks directly from an HIE user interface, and will assure the key image attributes in the DICOM header, such as patient ID (MRN) and accession number, are updated prior to transferring images.
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MOLST/AdvanceDirectives
Priorusecasehighlights
• Functionandpurpose• Valueproposition• Actors• AssociatedusecaseofAdvanceDirectives
Additionalinformation
• Business,financial,legal,andpolicyconsiderations• LegislationforMOLSTPilot• ExpansionofMOLSTstatewide10/1/17• Paper-based/patient-controlledprocess• DiscussionwithmembersofMOLSTTaskForceandAdvisoryCommittee9/25/17
Proposedapproach
• PartnerwithMOLSTTaskForceandAdvisoryCommitteetoassesstechnologyvalue-add
• FurtherassesscomplementaryAdvanceDirectivesRegistry
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MOLSTForm
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PatientPortal
Priorusecasehighlights
• Functionandpurpose• Valueproposition• Actors
Additionalinformation
• Business,financial,legal,andpolicyconsiderations• Patientas“NorthStar”• MUrequirements• MACRA• Technicalrequirements• Safetyconcerns• Competitiveissues• Funding
Proposedapproach
• Furtherassessbusinessandfunctionalrequirements• Assessmarketplacevendorsolutions• ConsiderimplementationafterLongitudinalHealthRecordimplementation
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PopulationHealthAnalytics
Priorusecasehighlights
• Functionandpurpose• Valueproposition• Actors
Additionalinformation
• Business,financial,legal,andpolicyconsiderations• Technicalrequirements• OverlapwitheCQMReportingSystemusecase
Proposedapproach
• Furtherassessbusinessandfunctionalrequirements• ConsiderforimplementationaftereCQMReportingSystemimplementation
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ProposedWave1:Summary
•Procurement•ImplementationeCQMReportingSystem
•Implementation•IntegrationwithPublicHealthReporting
ImmunizationInformationSystem
•LeverageeHEX,CeQ,CW•ImplementproviderportalLongitudinalHealthRecord
•Potentialtoleverage/expandAIMS•Implementexpandeddataelements;onboardingandTAPublicHealthReporting
•Finalizebusinessrequirements•Procurement/contracting(includingleverageofexistingassets)ClinicalEncounterAlerts
•Finalizebusinessandfunctionalrequirements•FurtherdiscussionswithNYeCImageExchange
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CandidatesforWave2:Summary
•Implementpilotforprocessre-design•Implementtechnologytosupportre-designedprocessMedicationReconciliation
•PartnerwithexistingMOLSTTaskForceandAdvisoryCommitteetoassesstechnologyvalue-add
•FurtherassessvalueofcomplementaryADRegistryMOLST/AdvanceDirectives
•PlanforrolloutafterimplementationoflongitudinalhealthrecordPatientPortal
•PlanforrolloutaftereCQMRSandrequiredtechnicalarchitecturePopulationHealthAnalytics
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RevalidateSequencing
ProposedWave1
eCQMReportingSystem
IIS
Longitudinalhealthrecord
Publichealthreporting
Encounteralerts
Imageexchange
CandidatesforWave2
MOLST/AD
Medicationreconciliation
Patientportal
Populationhealthanalytics
Wave3+
TBD
TBD
TBD
TBD
TBD
Governance
RevalidateSequencing
RevalidateSequencing
CoreServicesTechnicalArchitecture
SupportServices 28
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Rollout
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Year1
• Coreservicesimplementation• Supportservicesimplementation• “Wave1”usecaseimplementation• “Wave2”usecaseplanning
Year2• “Wave2”usecaseimplementation• “Wave3+”usecaseplanning
Year3• “Wave3”usecaseimplementation
RevalidateSequencing
RevalidateSequencing
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DiscussionandNextSteps
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