Interoperability

Collaboration with Greater Flint Health Coalition hopes to improve health IT infrastructure, analytics, long-term care coordination goals in the area.

Construction process is revealing more layers of procedure needed to elevate the industry's clinical and business model, experts say.

Other new contributor members include lifeIMAGE, a medical image sharing network, and MediPortal, a developer of patient engagement tools.

(SPONSORED) Learn why the growth of EHRs requires a scalable secure network to support all of the advanced capabilities and interoperability demanded by providers of their EHRs.

Republicans, blasting the proposal as overzealous when it comes to spending, have already shot down the 2017 budget.

More than a year after its implementation, Charles Jaffe, MD, CEO of HL7, is scheduled to return to the HIMSS Annual Conference to update the industry on the accomplishments to date and shed light on developments coming in the near future.  HL7 launched the Argonaut Project in collaboration with healthcare IT vendors and providers to accelerate the adoption of Fast Healthcare Interoperability Resources and, according to Jaffe, there are several exciting developments to discuss. See all of our HIMSS16 previews “First of all, the key that separates FHIR from some of the other standards is that it was created from the start for the implementation community,” Jaffe said. “The focus has been around making their process faster, cheaper and incrementally easier.” One of the most tangible achievements has been the development of a rheumatology app by Geisinger Health System and xG Health Solutions, a company founded by Geisinger, that talks directly with Epic and Cerner EHRs in real-time. [Also: Duke liberates Epic EHR data with Apple HealthKit and FHIR] “This provides data access for everyone in the healthcare continuum,” Jaffe said. “And it works out-of-the-box.” Other continued Argonaut developments, according to Jaffe, are focusing on accessing data, not necessarily writing it. Both Partners HealthCare and Lockheed Martin have recently developed programs to give users access to data across platforms, and Jaffe credits FHIR for much of the progress. The Argonaut Project is also working with EHR providers to speed up the development process. “Within Argonaut we have a series of rapid development protocols we call ‘sprint,’” Jaffe said. Rather than a typical 3-5 month development cycle, they’ve implemented a 2-3 week cycle to come back more quickly with enhancements and improvements. [Like Healthcare IT News on Facebook] “It’s worked extremely well,” Jaffe said. “A lot of the success we’ve had is based on the success of the sprint program.” FHIR is now being utilized on four continents and brings developers together at HL7 meetings, but also smaller groups at events like connectathons that offer unique collaboration opportunities for the implementation community. The session “HL7 Argonaut Project: One Year Later,” is slated for Wednesday, March 3, 2016 from 4:00 – 5:00 pm in the Sands Expo Convention Center Rock of Ages Theater. Twitter: @HealthITNews This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

(SPONSORED) Learn how system interoperability is making the process of sharing patient data simpler than ever been before with substantial benefits.

After facing an unacceptable 70 percent patient matching rate, the San Diego Health Connect health information exchange said it has turned its performance around using identity validation technology to better match patients and in the process clean up its master patient index. Its current patient matching rate is 98 percent. "To a certain degree, we caused the problem ourselves," said Dan Chavez, executive director of San Diego Health Connect. "We use very strict matching criteria. Not every HIE uses the strict matching criteria we do. We require a 100 percent match on six variables to automatically match patients. Other HIEs make the governance decision not to match on such strict criteria. If you loosen the rules in probabilistic and deterministic matching, you can have a higher rate. We want the machine to do as much as possible, but we don’t make it easy because we want the faith and trust that what comes out of the HIE is 100 percent correct." [Also: 'New value propositions' emerge for HIE.] At the 70 percent matching level, San Diego Health Connect had a backlog of requests that had to be manually reviewed. For example, Dan Chavez and Daniel Chavez and Daniel J. Chavez could all be the same person, with different records at different facilities in the San Diego area. Further, when consumers get married or divorced and change names, multiple different records may exist. "There are more than a few Chavez's in San Diego, as you might expect, so my name might go into the exception queue — and I’ve received care at Sharp and Scripps, and maybe my records do not match," he said. "Prior to using Verato, someone from the Sharp medical records department and someone from the Scripps medical records department would have to get together through an e-mail or phone call. If I had additionally been to UCSD, or if someone fat-fingered my Social Security number, the exception would pop up yet again for me, and UCSD would have to get online with Sharps and Scripps. So you see the magnitude of the problem." The exceptions queue grew so large and the backlog so long that medical records departments in the community said this HIE thing was killing them. [Also: New HIE, vendor members for CommonWell.] Verato's Carbon is a cloud-based identity data management system, what the company claims to be the most complete and accurate database of U.S. identities. "We source billions of records including credit agency and telecommunications provider data, along with government and legal data; and we use proprietary technology to produce our view of individual identities," said Joaquim Neto, senior solutions architect at Verato. San Diego Health Connect, for instance, automatically ran its exception queue against the Carbon database and quickly matched 80 percent of the exceptions to their correct records, Chavez said. "Then, with a little bit of examination, we could much more easily deal with the additional 20 percent — associating pediatric patients with parent addresses," Chavez cited as an example. "One of the challenges of patient ID in pediatrics is naming conventions. With the interactions with Carbon, we then could go back to the community and say, 'We all are doing some things incorrectly.' It gave us some guidelines in community-wide naming conventions, so we could go back to participants in the HIE and say, 'If it’s a hyphenated last name, let's place the second name in this field and the first name in that field.'" Improving the patient matching rate earned San Diego Health Connect a higher degree of confidence in the information coming out of the health information exchange among healthcare organizations in San Diego and Imperial County, Chavez said. "People know if the HIE is delivering information for Dan Chavez that there is a 98 percent-plus chance that we in fact have the right Dan Chavez," he said. "That confidence was not there before." [Like Healthcare IT News on Facebook] The HIE declined to share the cost of using the Carbon system from Verato, but the vendor said the ticket could be between $250,000 to $500,000 a year for an organization the size of San Diego Health Connect. "The soft return on investment is the confidence in the HIE as we deal with the medical records in the entire community of 3.2 million people; these providers know when they get patient information from SDHC, it is correct," Chavez said. "The hard ROI comes in no need for medical records departments to call up anyone to check exceptions. They do not have to challenge the data or make 3-5 phone calls to reconcile. Those phone calls at a minimum of 5 minutes a head are expensive." Twitter: @SiwickiHealthIT

Rockford Health System in Rockford, Illinois is using the Health Level 7 data exchange standard to see both the real-time fetal monitoring strip and the patient’s electronic record on the same computer screen. In the past, clinicians had a computer-based patient record in one location and a fetal monitor elsewhere. Using the HL7-based GE Healthcare Centricity Perinatal Connect technology enables Rockford to combine and save documentation from both the EHR and the perinatal systems into its Epic patient record. The most important benefit of the vendor interoperability is increased patient safety, because nurses now can view fetal strips as part of the overall medical record, said Angie Asche-Willoughby, RN, Centricity perinatal system manager at Rockford Health System. [Also: HL7 and ONC launch challenge seeking C-CDA rendering tools for clinicians] “While admitting a patient in the computer system, the fetal monitor is on the other side of the bed; but now, I can visualize the fetal strip on my screen as I am doing a patient assessment, so if a baby is having any sort of distress on their monitor, I literally see it,” Asche-Willoughby said. “But the integration also decreases my time working with technology and charting, and thus increases the time I can spend with my patient. It’s so seamless because anything you document goes into Epic." And that means nurses being able to see both the real-time fetal monitoring strip and the patient’s electronic record on the same computer screen, as opposed to having a computer-based patient record in one location and a fetal monitor elsewhere. Further, the HL7-based Connect technology enables the organization to combine and save documentation from both the EHR and the perinatal systems into the Epic patient record. The No. 1 benefit of the vendor interoperability is increased patient safety, because nurses now can view fetal strips as part of the overall medical record, said Angie Asche-Willoughby, RN, Centricity perinatal system manager at Rockford Health System. “While admitting a patient in the computer system, the fetal monitor is on the other side of the bed; but now, I can visualize the fetal strip on my screen as I am doing a patient assessment, so if a baby is having any sort of distress on their monitor, I literally see it,” Asche-Willoughby said. “But the integration also decreases my time working with technology and charting, and thus increases the time I can spend with my patient. It’s so seamless because anything you document goes into Epic.” In addition to reducing the anxiety for nurses who no longer have to worry about what is going on between two different screens, the interoperability actually can reduce the anxiety of mothers during childbirth, Asche-Willoughby said. “This set-up gives a nurse more time with her patient, so the patient isn’t thinking that all the nurse is doing is computer work,” she explained. “It provides a patient with a greater sense of comfort because a nurse is not as worried about her documentation. As a nurse, you don’t want a patient feeling like the only thing a nurse is doing is working on a computer; you want your patient to know you are taking care of her.” The GE Healthcare Centricity Perinatal Connect systems integration module uses the HL7 2.x protocol, with ORU-type message specification exchanges. It can translate between HL7 2.3, 2.4 and 2.5, back and forth. And it can work with any EHR system, GE Healthcare said. GE Healthcare and Rockford Health System declined to reveal the cost of the interoperability module. However, the vendor said a provider organization can measure return on investment through increased productivity, among other improvements. Twitter: @SiwickiHealthIT

Don't miss the HIMSS Awards & Recognition Gala at HIMSS16! Join us for an evening honoring the brightest stars in health IT at the vibrant Wynn Hotel in Las Vegas. March 3, 2016 — 06:30PM - 09:00PM PT Wynn Hotel | Latour Ballroom Click here for more information