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A collaboration to provide better information for better care.

Kim Norby, State HIT Coordinator &Executive Director, Iowa e-Health

I. Adoption II. IHIN Services◦ Direct◦ Patient Look-Up◦ Health Analytics◦ Patient Engagement

National Connectivity IHIN Materials becoming available

HIT adoption as a whole continues to make strides forward nationally. Iowa has moved up from a # 8 national rank to # 6 by the Surescripts network.

Surescripts looks at several things including the number of e-prescribers and pharmacies accepting e-Rx.

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Four services

1. Direct Secure Messaging Service2. Patient Look-Up Service3. Health Analytics Service◦ Public Health Reporting◦ Medicaid Health Home

4. Patient Engagement through PHR, Patient Portal and Provider Portal

Direct Secure Messaging is a transport tool which enables providers to send patient health information via the internet in a secure and encrypted format to recipients outside of their network using an IHIN Direct address (a special email address).

Direct Secure Messaging went live July 2, 2012 660+ users currently 51 organizations 22 additional participation agreements signed but

some not ready to on-board yet

Vendors who’ve announced that they will support Direct

• Allscripts

• CareEvolution

• Cerner Corporation

• Covisint

• eClinicalWorks

• Epic

• Greenway Medical Technologies

• Kryptiq Corporation

• MedPlus (A Quest Diagnostics Company)

• Microsoft Corporation

• NoMoreClipboard.com

• OpenEMR

• Siemens

• Surescripts

• VisionShare

• CPSI

Direct Secure Messaging as a transport tool

Examples of automation using e-mail

• Purchase/transportation of orders… – An e-mail confirmation is sent.

– Notice that the package has shipped.

– E-mail each stop that the package has taken.

• Invoicing and statement reminders (all utilities, cable, cell phone, etc.)

• Appointment reminders

• Social tool messages based on triggers.

• Many, many more

The IHIN Uses the Clinical Document Architecture format called the Continuity of Care Document (CCD) for Patient Information Query

Stage 2 MU moves from the CCD to the Consolidated - Clinical Document Architecture or C-CDA

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Health Level 7 (HL7) American Society for Testing and Materials (ASTM)

2.0

2.3.1

2.4

3.0

2.5.1

Continuity of Care Record (CCR)

Continuity of Care Document (CCD)

HITSP C32 CCD

2.x

Clinical Document Architecture (CDA)

Consolidated Clinical Document Architecture (C‐CDA)

Other International Standards

Patient Matching

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► Patients are matched in real-time as they are inserted into the registry

• This approach significantly improves performance compared to the previous method.

• Allows for large scale patient matching in real-time

► Two phase match process

• Candidate phase matches on primary fields

• Agreement phase matches on an expanded number of secondary fields

• Approach allows for the expansion of secondary match fields over time without performance degradation

► New approach provides a more consistent handling of overmatch scenarios and incorporates future plans for administrative matching/override capabilities

Patient Matching Fields

Candidate Phase Fields…

• Family Name

• Given Name

• Date of Birth

• Gender

15Informatics Corporation of America - Proprietary and Confidential Information

Agreement Phase Fields (as available)…

• Social Security Number

• Medicare Number

• Driver License Number

• Postal Code

• Phone Numbers

• Email Address

• Place of Birth

• Mother's Maiden Name

• Death Date (if relevant)

• Multiple Birth Order (if relevant)

Jaro-Winkler and Levenshtein algorithms to allow for inconsistency in data entry and name variation when applicable

A collection of repositories that can contain both clinical and claims data

Each repository has role based security enabling everything from global access down to specific views.

Push CCDs to the Iowa Medicaid Health Home repository

Public Health reporting included for ELR of reportable diseases and bi-directional immunization connectivity.

IHIN participation is needed for Iowa Public Health electronic data exchange and Iowa Medicaid Health Home participation

Scalable with limited state personnel Partial control by the participant Reusable for numbers other data feeds such

as lead reporting, vital records, etc.

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We believe in providing the patient with access to their health information.

That information should be available anytime, anywhere.

We believe in providing them tools to help them manage their health.

We believe in helping them connect approved devices to that environment.

The IHIN has a Patient Engagement component and we are working with our vendor to deliver

Personal Health Record (PHR) like access available for every Iowa Citizens

Includes alerts and recommendations Patient Forms faxed or e-mailed to providers Receive and send structured data Track and graph health goals Keep health information in one place Ability to grant access to care coordinators,

health coaches, or family members, etc. Access through any web based device

IHIN load through Query Blue Button

Receive standard patient forms prior to visit. Patient forms filled out accurately and legibly. IHIN connected providers to be able to meet

Stage 2 MU Objective for the patient to View/Download/Transmit their information

CMS has approved a shared approach We must provide CMS and Medicaid approved

reports for VDT to accomplish that

Preparing Healtheway Application. Our surrounding states have also agreed to join e-Health Exchange

Will look at HISP to HISP for Direct if more immediate needs exist

Estimating the Direct HISP to HISP in Q3 and possibly see e-Health Exchange in Q4

General information for the public Provider Welcome Kits◦ Opt Out information◦ Provider posters etc.◦ Patient posters

Other materials shown below

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www.iowaehealth.org/provider