Post on 14-Feb-2017
transcript
INTEROPERABILITY
ABOUT ME Jarod Ferguson CEO of Royal Jay, Chief Architect of Kno2
15 employees 80% of revenue is Health Technology Kno2, Aprima EHR, IHDE, St Luke's Health Partners
Technical Career path 3x Microsoft Data Platform MVP, AspInsider
“The extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user.” - HIMSS
What is interoperability?
“What if you had a cell phone plan that only allowed you to call other customers of your carrier? That’s the situation for most healthcare providers today, when they join a data sharing network.” – Sequoia Project
What is Interoperability?
How many mg do I take?
When was that surgery?
HOW DID WE GET HERE?
THE PAST
Why is patient data sharing so complicated?
Mary Smith, TX ???
But data sharing isn’t new? Why is healthcare so far
behind?
Let’s take a look…
ASTM
American Society for Testing and Materials
Formed in 1898 First Standard on steel rails issued Henry Ford Emerging standard during WWII
COMMITTEE F04
Formed in 1962 Global Agenda for Medical Device Medical and surgical instruments,
orthopedic devices, implant systems MRI to Manufacturing
HL7 Formed in 1979 Reached maturity 1992 Defines the “What”
I think you missed a pipe on line 4…
IHE Formed in 1998 “improve the way computer systems
share information” Defines the “How”
[XDR] Cross-Enterprise Document Reliable Interchange[XDS-SD] Cross-Enterprise Sharing of Scanned Documents [MPQ] Multi-Patient Queries [PAM] Patient Administration Management[PIX] Patient Identifier Cross-Referencing (PIX)
IHE Profiles
HL7 V3 2005 Based on XML and Object Oriented Principles Far more rich and flexible
RIM 1.0 (first non-draft) – Jan 2001 ANSI/HL7 RIM Release 1 – Approved July 2003 ISO 21731 (RIM Release 1) - Approved 2006
IHE CCD =
HL7 RIM CDA + ASTM CCR
Connecting with the right format is not enough
We can help!
DIRECT TRUST 2010 A “Network” of HISP’s (no more peer to peer) Provides addressing similar to email Establishes security standards Uses IHE XDR as the protocol Can transport many document types (CCD, CDA, DICOM, PDF) Based on web technologies (HTTP, DNS) Private non-profit ultimately governed by HITPC & NwHIN
Sending……
WHERE ARE WE GOING?
THE FUTURE
I don’t see any patients?
THE SEQUOIA PROJECT 2012 Non-profit “advance the implementation of secure, interoperable
nationwide health information exchange” Teamed with Care Connectivity Consortium ONC transitioned management of eHealth Exchange for
maintenance to Sequoia Supports Carequality initiative
COMMONWELL ALLIANCE❮ 2013❮ Interoperability group❮ Cerner, McKesson, Athena, Allscripts❮ Epic NOT a member❮ IHE XCA or FHIR❮ Roles
❮ Enrollment❮ Record Locator❮ Patient Identification & Linking❮ Data Query & Retrieval
CAREQUALITY 2014 Common Framework “dedicated to accelerating progress
in health data exchange among networks, providers, payers, EHR and HIE vendors.”
EPIC, ORION, eClinicalWorks, Nextgen, Surescripts, Kno2 Record Locator Services, EHR Vendors Existing private/public networks and platforms Uses IHE profiles
CAREQUALITY Uses IHE Profiles Roles
Initiator Responder Record Locator Service
XCPD Flow
THE ARGONAUT PROJECT 2015 Private Sector Open internet standards Promotes FHIR to replace CCDA, FHIR APIs to replace
DIRECT “replace healthcare-specific document and messaging
standards with the more universal and essentially free equivalents taken from the Internet.” - John Halamka
ARGONAUT SPONSORS Accenture athenahealth Beth Israel Deaconess
Medical Center Cerner Epic Intermountain Healthcare Mayo Clinic
MEDITECH McKesson Partners HealthCare System SMART at the Boston Children’s
Hospital Computational Health Informatics Program
The Advisory Board Company Surescripts
FHIR Fast Healthcare Interoperability Resources Lightweight, no overhead Uses “Modern” web stacks. HTTP, REST Developers love it, integrates the same as other apps Pronounced “fire”
Just stay to the right….
INTEROPERABLE?Can your HIE receive an HL7 CDA via DIRECT IHE XDR over the Surescripts HISP?
Then, Yes.
THANK YOUjarod@royaljay.com@jarodf