Transcript Slide 1

A San Diego Health Information Exchange
Jami Young, MPA
San Diego Beacon
Project Manager
San Diego Health Care Association
April 26th, 2012
Office of the National
Coordinator for Health
Information Technology (IT)
Health Information
Technology Extension
Program
(Meaningful Use adoption)
State Health Information
Exchange Cooperative
Agreement Program
Beacon Community
Program
Strategic Health IT
Advanced Research
Projects (SHARP)
Program
Education programs
(curricula development at
community colleges and
universities)
Beacon community program priorities
I. Health IT and Exchange Infrastructure
II. Integration of Health IT into Care Delivery
• Instituting clinically relevant decision supports
• Improving medication management
• Improving care coordination
• Engaging patients and families
III. Evaluation, Monitoring and Feedback
Establishing systems for measurement and feedback of
health systems quality, safety, and costs relevant to
project goals
17 Beacon communities
http://sandiegobeacon.org
San Diego-specific components
• Reduce hospital readmissions by sharing
patient health information (health
information exchange)
• Reduce STEMI field-to-intervention time
• Increase childhood immunizations via texting
• Transmit cardiac device information through a
single interface
• Reduce repeat radiology use
Exchange architectural model
Hospital
Master Patient Index
Facility A
Point
Click Care
Facility B
ResCare
Exchange Architectural Model
Master Patient Index
(AG|A=AG|B)
Facility A
(clinical
data)
Facility B
(clinical
data)
AG
AG
Master patient index
• Demographic information
• Highly depending on the data collected by
partner organizations
• Inappropriate matching and lack of
appropriate matching are both bad
Exchange Architectural Model
Master Patient Index
User Directory
Facility A
(clinical
data)
Facility B
(clinical
data)
User directory
• Who can access the information?
– Front desk
– Nurses
– Providers
• Authentication
• Expiration and renewal
Exchange Architectural Model
Facility A
(clinical
data)
Master Patient Index
User Directory
Consent and Auditing
Facility B
(clinical
data)
Consent and auditing
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•
All-or-none
Consent types
Changing consent status
Determining if a privacy breach occurred
Exchange Architectural Model
Immunization
Registry
Facility A
(clinical
data)
Public Health
Reporting
Master Patient Index
User Directory
Consent and Auditing
Facility B
(clinical
data)
Value case for Skilled Nursing Facilities
• Access to recent patient health information from
other care settings-
Data types shared
•
•
•
•
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•
ADT information
Problems
Medications and allergies
Lab results
Radiology reports
Immunizations
Clinical documents (e.g., discharge
summaries)
Value case for Skilled Nursing Facilities
• Access to more patient health information
• Notification about care transitions-
Outside the exchange
• Use ADT messages to determine if a patient
has been admitted or discharged from a
facility
• Notify other members of the care team about
the care transition using secure email (DIRECT)
Value Case for Skilled Nursing Facilities
• to ensure care continuity especially in regards
to e-prescribing
• Promote person centered care and culture
change initiatives
• Prevent medical errors and diagnostic testing
redundancy
Next steps
• Connecting medical centers, medical groups and
skilled nursing facilities to the Exchange
• Using messaging to notify providers about patients
undergoing care transitions
• Establishing an independent governance structure
and sustainability model
• Expanding HIE network to encompass all care
providers in region
Questions?