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Robert Harmon, MD, MPHDirector, Duval County Health Dept./FL Dept. of Health
Chair, FL DOH HMS EHR Exec. Steering Comm. Chair, NE FL Health Informatics Consortium
Chair, NACCHO Public Health Informatics Work Group
Presented to APHA Annual Conference, Washington, DC
October 31, 2011
Creating a Broader Vision for Public Health in the Nationwide Health
Information Network
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OverviewOverview
Duval CHD and its Institute for PH Informatics & Research
HIE projectsEHR projects, including RECStatewide HIT projects
Note: I have no business relationships to disclose
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“Metro” CHD serving population of >864,000Part of Florida Dept. of Health~670 state employees (down from 946 in
2008)Revenue of $48.5 M (down from $61 M in
2008)Academic, full-service public health agency19 clinic sites (including 6 mobile)Largest provider of Medicaid services of all
CHDs in FL
Duval CHD Facts
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Duval CHD Institute for PH Informatics and Research
(IPHIR)Administrator, Thomas Bryant, reports to
DCHD DirectorContains Research & Evaluation, Health
IT, and Quality Improvement unitsFY 2010-11: FTE ~ 22; budget ~$2.0 MOversees ~ 24 research, demo & eval
projects/yr: budget ~ $700KWrites proposals for and staffs PH
informatics projects
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Duval CHD/IPHIR Projects
Staffs NE FL Health Informatics Consortium (I’m the chair)
Provides data and manages the NE FL HIE/JHIN (I’m on the Board)
Conducts QI studies on NE FL HIE Recruits participants for N&SW FL REC
project Oversees EHR pilots such as eRx Writes reports and articles Coordinates categorical HIT projects such
as ESSENCE syndromic surveillance
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Florida DOH HMS Interfaces
CHD HMS Instance (67)
HMS Core Components
Care Coordination
Registration
Eligibility
Scheduling
Encounter/ Services
Unified Service
Reporting
Billing
TB HIV/AIDS
Dental
Healthy Start
Data Warehouse
Florida SHOTS
Vital Statistics
LabWare
Quest
LabcorpMedicaid
MedicareCommercial Insurance
RW CareWare
Healthy Start Prenatal
AIMS
Emdeon Clearinghouse
CHD Contract Mgt
Sys
HMS Statewide Reporting
EMPI Clinical Data Repository
Commercial Pharmacies
Central Pharmacy
Integration Services
CDC
Clin
ical
En
cou
nte
rC
linic
al E
nco
un
ter*
E Prescribing
eLabs
E Radiology
EOHR
CHD HMS Instance (01)
DOH HIE
Merlin
ESSENCE
Florida HIE
Integration Services
Integration Services
Integration Services
Integration Services
Integration Services
*Clinical Encounter Functionality:
ü Demographicsü Medical Historyü Vitals and Measuresü Chief Complaintü History of Present Illnessü Review of Systemsü Progress Notesü Physical Exam
The following are in development:
· Problem List · Assessment and Plan· Clinical Communication
Framework· Patient Snapshot· History: Birth, Prenatal,
Natal, Neonatal· Percentile Graphs· Developmental
Assessment· Nutrition Assessment
Other FDOH Systems
Other Public Systems
Private Sector Systems
HMS Modules
HMS Core Components
Existing interface or system
Planned interface or system
Integration Services
Data translation/transport services provided by Integration Broker tools
Diagram Legend
· AIMS – AIDS Information Management
System
· CDC – Centers for Disease Control
· EMPI – Enterprise Master Patient Index
· EOHR – Electronic Oral Health Record
· ESSENCE - Electronic Surveillance
System for the Early Notification of Community-based Epidemics
· HIE – Health Information Exchange
· RW – Ryan White
· TB - Tuberculosis
Diagram Shapes and Symbols
Diagram Acronyms
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DOH Electronic Health Record Development Timeline
2010 2011 20132012
Diagram Legend: CompleteComplete In ProcessIn Process Not StartedNot Started
Privacy and Security – Incorporated Throughout Development ActivitiesPrivacy and Security – Incorporated Throughout Development Activities
INFANT & CHILD Core ContentINFANT & CHILD Core Content PilotLaunch Infant/Child
Primary Care
ADULT Core ContentADULT Core Content PilotLaunch Adult Primary Care
Patient EducationPatient Education Pilot Launch Education
Certification SpecificSummaries, Lists and RemindersCertification Specific Summaries, Lists and Reminders
Core Clinical Content
Core Clinical Content
Program TemplatesProgram Templates PilotLaunch Program
Templates
Electronic Orders
Electronic Orders
E-LabsE-Labs E-Radiology E-Radiology Pilot Launch E-Radiology
Electronic Access to Clinical InformationElectronic Access to Clinical Information
Health Information
Exchange (HIE)
Health Information
Exchange (HIE)
Support EHR RolloutSupport EHR Rollout
E-Prescribing (eRx)E-Prescribing (eRx) PilotLaunch eRx
Health Information ExchangeHealth Information Exchange Pilot Launch HIE
Pilo
t Launch eLabs
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NEFHIC Facts Founded in 2007 Covers 6 counties in NE Florida: Baker, Clay,
Duval, Nassau, Putnam, St. Johns Involves large group of partners (see org chart) Successful: won FHIN grant from AHCA ($407K)
and demo project grant from CMS ($12M) Includes operational exchange project
(NEFHIE/JHIN powered by Cerner)) Partner in $10 M, 4-year REC project for 41
counties Applicant for Beacon award
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Northeast FL Health Informatics
Consortium (NEFHIC)Officers
Duval County Medical Society NE FL Regional Health Org.
NE FL Health Information Exchange Duval County Health Dept.
Advisory Committee Tech Committee
Univ. of FL College of Medicine- Jax Univ. of North Florida
St. Johns River Rural Health Network NE FL Area Health Education Center
Veteran’s Health System Naval Hospital Jax
United Way
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NEFHIC Activities Coordinates proposals for HIT grant
funding, such as AHCA FHIN, REC, Beacon Promotes EHR and HIE utilization Shares best practices Hosts vendor presentations Serves as regional health information
organization (RHIO) and advisory council to NE FL HIE
Promotes HIT educational conferences
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NE FL Health Information Exchange(NEFHIE)
Formerly JaxCareNew Board composed of six hospital CEOs plus
Dean of UF COM/Jax, EVP of DCMS and Director of Duval CHD
Oversees HIE for NE FL (JHIN) and vendor (Cerner)
Pursuing upgrade and linkage to FL HIE
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Florida HIT Regional Extension Centers
Walton
Holmes
Washington
Wakulla
MadisonLeonGadsden
Jackson
Bay
Escam
bia
Santa Rosa
OkaloosaCalhoun
Liberty
Gulf Franklin
Jeffe
rson
Taylor
Lafayette
HamiltonSuwannee
Col
umbi
a
Baker
Nassau
DuvalSt. Johns
Union
Bradford
FlaglerPutnam
Clay
DixieGilchrist
Alachua
LevyMarion
VolusiaCitrus Lake
Sumter
Orange
Seminole
Hernando Brevard
Indian River
OsceolaPolk
PascoHillsborough
Pinellas
Manatee Hardee
Highlands St. Lucie
Sarasota De Soto
Charlotte GladesMartin
LeeHendry Palm Beach
CollierBroward
Monroe Miami –
Dade
Okeechobee
The Center for the Advancement of Health IT (Community Health Centers Alliance, Inc.)
PaperFree Florida (University of South Florida)
South Florida Regional Extension Center
University of Central Florida College of Medicine
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Florida HIE Key Concepts Oversight by FL Agency for Healthcare
Administration (Medicaid agency) and HIE Coordinating Council. I’m a member.
Vendor is Harris Corp (www.harris.com) Federated model Initial priorities to be direct secure
messaging, patient record lookup, and public health reporting
FL DOH and 67 CHDs to be early participants
Just getting started this year
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References & Links
www.dchd.net
www.nefhic.org
www.fhin.net
www.florida-hie.net
www.healthit.hhs.gov
