Transport Mechanisms: Making it Possible to Share Your Health Story. Monday, April 4 th 12:00-1:00 pm ET

Transcription

1 Transport Mechanisms: Making it Possible to Share Your Health Story Monday, April 4 th 12:00-1:00 pm ET

2 Moderator Nick Mahurin CEO, InfraWare Co-chair, Health Story Project

3 Transport 101 Why this Topic? Health Story Project Objectives Relationship to C-CDA Transport Concepts Modern Options Challenges

4 Health Story Project Objectives A health record is the patient s health story and is shared by the patient and the circle of caregivers involved in his/her care. Sharing encompasses both access and authorship. The primary purpose of the record is to support care delivery, which in turn, will support better health. Secondary reuse should be supported. Electronic records must produce a longitudinal record of lasting value. That record must express the thought process behind the delivery of care, preserving for future readers. Clinical records must be complete, well organized, easy to navigate, concise, logical and adaptable to the needs of the user, sharable, readily available and secure. The electronic record and new technologies support shared decision-making, document use of practice guidelines, and support evidence-based practice.

5 Relationship of Transport with C-CDA Persistent document with rich content Value limited by ability to share with trusted collaborators

6 Transport of Traditional Documents Postal Service Slow/expensive Facsimile (Fax) Flat image Non-secure

7 Modern Transport Health Information Exchange (HIE) Direct Messaging

8 Health Information Exchange Hub-and-spoke: Push-pull method 2 step process: Content creators push new clinical data to the HIE Content consumers pull data from the HIE Source: AHIMA

9 Direct Messaging Transport Mechanism: Push Method sender recipient Direct messaging: Secure and interoperable , specifically designed for healthcare, HIPAA-compliant More efficient than secure or portals Includes any type of file attachment; message & attachments are both encrypted

10 Promising Outlook Fluid user experience right in EMR workflow Mix of structured and narrative content Accept or reject content as desired into encounters

11 Challenges with Transport Early adoption (rough around the edges) Setup or enabling Knowledge of potential, how to use Awareness of collaborators Limitations of parsing upon receipt

12 Today s Speakers Michele Darnell Senior Vice President Sales Secure Exchange Solutions Therasa Bell President and CTO Kno2 Didi Davis Director, Testing Programs The Sequoia Project

13 Direct in Action Example Use Cases Care Transitions Referral / Consults Event Notifications Lab Results Patient Communications Medical Record Requests 2015 HIMSS HIE and Direct Messaging Survey

14 2015 HIMSS HIE and Direct Messaging Survey

15 Direct and Workflow Current State Manual Automated Hybrid

16 Direct Implementation Challenges and Opportunities Identifying Endpoints -> Directory Services Inherent in Workflow -> Integration / Access Managing Multiple Addresses -> Routing and Preferences Beyond C-CDA -> System Readiness

17 Today s Speakers Michele Darnell Senior Vice President Sales Secure Exchange Solutions Therasa Bell President and CTO Kno2 Didi Davis Director, Testing Programs The Sequoia Project

18 Content Challenges Consolidated CDA Document Types 1 Consultation Note 2 Continuity of Care Document (CCD) 3 Diagnostic Imaging Report (DIR) 4 Discharge Summary 5 History & Physical Note (H&P) 6 Operative Note 7 Procedure Note 8 Progress Note 9 Unstructured What about everything Document else? Capture the ENTIRE patient story!

19 CDA in Action Challenges Providers find it difficult to navigate the CDA Providers only want the information they need CDA-Direct Message combination does not provide enough context, i.e. type of transaction

20 EMR Workflow Challenges The Digital Divide Different levels of technology adoption EHR/EMR developed according to minimum MU requirements, i.e. TOC & Referrals (structured documents only) Multiple ways of exchanging patient information EMR Scan Mail Fax Inefficient & unsecure exchange continues to dominate with paper & fax e-files Patient Record

21 Moving Forward Actions Being Taken Different work groups & initiatives developed to improve CDA viewing/processing for the benefit of the provider. EMRs are expanding their implementation of Direct to improve user experience and for other use cases. Additional document types are being considered to expand more structured information flowing between systems.

22 Today s Speakers Michele Darnell Senior Vice President Sales Secure Exchange Solutions Therasa Bell President and CTO Kno2 Didi Davis Director, Testing Programs The Sequoia Project

23 Health Information Exchange Model

24 Transport: Options for Using DIRECT * Health Information Service Provider (HISP)

25 Transport: SOAP + Web Services Options

26 The Software Platform Hub and Spoke Design delivering secure solutions! Webmail Mo b ile PC I/ PHI/ PII Filter Em a il Clie nts Encryption Automation Customer Initiated Integration APIs Optimized for Mobile, Web and Desktop Client Access Architected for Cloud, Premise or Hybrid Deployment Secure Data Exchange Supports a wide range of workflows Extensible without losing security efo rm s Managed File Transfer Direct Project Use r-based File Transfer

27 Q&A for the Speakers Michele Darnell Senior Vice President Sales Secure Exchange Solutions Therasa Bell President and CTO Kno2 Didi Davis Director, Testing Programs The Sequoia Project