Us Case 5

Delivery Coordination with Closed-loop OB/GYN and Hospital Interaction

Care Theme: Maternal and Newborn Health

Use Case 1

Interoperability ShowcaseIn collaboration with IHE

Primary Goal: To demonstrate the ability to provide efficient and accurate maternal health care, formally close the episode of baby delivery with the patient’s obstetrician, and show interoperability of patient data across MD offices, hospital, and health plan. Patient data are sent from the OB/GYN office to the hospital when the patient is ready to deliver. After hospital discharge, delivery summary data are available to the OB/GYN and PCP. Hospital sends discharge data to the health plan enabling additional care coordination.

Key Points:

• When patient goes to the hospital to delivery her baby, the hospital retrieves data from the OB/GYN office and thereby enables hospital staff to provide accurate and efficient care.

• All bedside patient care devices for the laboring mother (fetal monitor, vital signs monitor, programmable infusion pump,

and “smart bed”) are linked to the hospital EMR, so that data are readily available to hospital staff.

• Patient care device alarms are electronically linked to hospital staff’s wearable communication devices (phones, badges)

to speed alarm response and enhance patient safety.

• With messages sent from the hospital EMR to the patient’s health plan at admission, transfer and discharge, the health plan is able to initiate care coordination activities, such as sending a nurse to the patient’s home post-discharge.

• Patient data move seamlessly between OB/GYN office, hospital, and PCP office, each of which uses a different EMR system.

Meaningful Use (MU) Relevance: Care Coordination Coordination of Care as evidenced by movement of patient data from MD office to the hospital, and back to the MD office. Information about the patient prior to delivery will improve quality, safety, efficiency, and reduce health disparities.

Clinical Workflow: A patient presents at the OB office for evaluation, including sonogram. The patient goes to the hospital labor & delivery department for further evaluation and delivery of her baby. The patient returns to the OB office for routine follow-up and then to the primary care doctor.

Care Theme: Maternal and Newborn HealthUse Case 1: Delivery Coordination with Closed-loop OB/GYN and Hospital Interaction

1. The Patient visits her OB/GYN and gets a sonogram at the OB/GYN office which uses an EMR and is then referred to the hospital.

2. The patient goes to the hospital L& D unit, which uses an EHR system and is admitted. The health plan is sent an admission message.

3. The patient is monitored by several patient care devices at the hospital L&D unit.4. The patient is prescribed a medication which is obtained from an automated drug cabinet located on the L&D unit.5. The patient’s medication is administered using a programmable I.V. pump.6. An alarm goes off on the programmable I.V. pump and the message is automatically communicated to designated

staff via personal communication devices.7. After delivery of a healthy baby the patient is transferred to the Postpartum Unit. A message is sent to the health plan.8. The patient is discharged. A message is sent to the health plan. Patient visits her OB/GYN for a follow-up visit.9. The patient visits her PCP for a follow-up visit

1- OB/GYN 2- Labor & Delivery 3- Monitoring Devices 4- Rx Dispensing

5- Rx Admin 6- Rx Alarm 7- Postpartum Unit 8- OB/GYN 9- PCP

Care Theme: Maternal and Newborn HealthUse Case 1: Delivery Coordination with Closed-loop OB/GYN and Hospital Interaction

Clinical Workflow:

HIE1| HIE2

HIE2| HIE1

Domain Profile Vendors Actors

IT Infrastructure (ITI)

PAM BCBSF, EpicPt Encounter Consumer, Pt Demographics Consumer,

Pt Encounter Supplier

PIX, PIXv3 Alert, ICW Manager, Consumer, Identity Source, Repository

XCA ICW Initiating Gateway, Responding Gateway, Registry

XCPD ICW Initiating Gateway, Responding Gateway

XDS-b Infinitt Repository

XDS-SD Alert Content Creator

Patient Care Coordination (PCC)

XPHR Alert Content Creator

AP* MIE, Epic Content Creator, Content Consumer

PPVS MIE, Alert Content Creator, Content Consumer

Patient Card Device (PCD)

DEC Epic, B. Braun, iSirona, NKA Device Obs. Consumer, Device Obs. Reporter

IPEC Epic, B. Braun Device Obs Consumer, Device Obs. Reporter

PIV Epic, B. Braun Infusion Order Programmer, Infusion Order Consumer

ACM B. Braun, Philips, Vocera Alarm Reporter, Alarm Manager, Alarm Communicator

Pharmacy HMW Epic, OmnicellPrescription Placer, Medication Dispenser, Med. Admin

Informer

Radiology (RAD)SWF Sono Modality

XDS-I.b EMC, Merge Image Document Source, Image Document Consumer

IHE Profiles & Domains:

Visit the IHE Product Registry at: ihe.net/registry

Care Theme: Maternal and Newborn HealthUse Case 1: Delivery Coordination with Closed-loop OB/GYN and Hospital Interaction