HPC CHART Phase 2 RFP Mass HIway: Use Cases, Workflow Implications, Best Practices

HPC CHART Phase 2 RFP

Mass HIway: Use Cases, Workflow

Implications, Best Practices

Meet the speakers

Margaret Senese

Program Manager for Strategic Investment

Health Policy Commission, Commonwealth of Massachusetts

Sean Kennedy, MPH, MS, PMP

Health Information Exchange Director

Massachusetts eHealth Institute at the Massachusetts Technology

Collaborative

Massachusetts eHealth Institute

Learning objectives



Communicate the value of HIE



Describe how to get started with The HIway



Generate a use case



Find a trading partner and describe best practices to engaging



Use presented use cases and related tools to initiate your HIE

efforts

3 Massachusetts eHealth Institute

The inclusion of specific examples does not imply

endorsement by the HPC for CHART Phase 2 funding

Agenda



Value of HIE



Getting started with HIE & use case overview



Find a trading partner and best practices to engaging



Using the HIway – examples of “real-world” uses



Resources



Key Takeaways



Questions & discussion

5

Value of HIE



Improves & streamlines care coordination



Improves patient safety - fewer medical errors



Reduces duplication of tests



Supports achieving Meaningful Use



Eases & improves public health reporting & analytics



Enables inter-and intra-organizational exchange



Serves as a foundation for Accountable Care

Getting started with HIE &

Use case overview

8

Getting Started with HIE

A key milestone on the

HIway connection path

Use Case Introduction



What is a Use Case?

–

A use case is an easy to understand description detailing the

interaction between an actor (human, organization, system) and

a system under consideration.

–

For HIway purposes, it identifies a set of ‘trading partners’ and

source and destination systems and describes how they intend

to use the Mass HIway.



Why do we use them?

–

Use cases are developed with the goal in mind, which makes

them a valuable planning tool.

–

A well-crafted use case communicates the functional

requirements that may then inform technical planning.

–

Having them available prior to technical discussions helps scope

the technical solution and accelerates the technical evaluation

process.

Use Case Introduction (cont.)



How they should help you?

–

Use case development requires an understanding of the

business need – the issue you seek to resolve or opportunity on

which you intend to capitalize.

–

Defining your need early in the process will accelerate later

development efforts and provide a basis for evaluating success.

•

Examples:

–

“I need to join the HIway”

»

Way too ambiguous

–

“Our Practice needs to generate and securely send summary of

care records to my patients’ specialists to meet MU2, Transition

of Care criteria.”

»

Provides initial needed details to guide plan development,

scope the effort and establish priorities

“

Our Practice

needs to

generate and securely send summary of

care records

to my patients’ specialists to

meet MU2, Transition

of Care criteria

.”

Use Case Elements



Use case name



Goal



Story



Trading partners and systems



Data to exchange

Use Case Benefits



Identifies the clinical / business need before solution

development…mitigating rework and delays



Facilitates initial scoping, project planning and effort

prioritization



Supports ‘selling’ your request to management – you have

done your due diligence to articulate value, not just

functionality



Supports identifying the project team / stakeholders

13

14

Implementing your use case



There are (2) parts to exchanging via the HIway:

–

From the EHR to the HIway gateway

–

From the HIway gateway to the intended recipient



Your implementation approach will establish priority

Finding a Trading Partner &

Best Practices to Engaging

Best Practices to Engaging



Plan your use of an HIE – Mass HIway or other

Use Case Library



Work in progress



Intended to accelerate

connections by sharing

use case details



Current Library

Categories

–

Transitions of Care

–

Lab Data Exchange

–

Public Health Reporting

–

More to come

Determine Your Use Case

18

Key questions:

1. Why are you connecting to the

HIway?

2. What is the scenario?

3. Who is your trading partner(s)?

4. What systems/data sources are

involved?

5. What data is being exchanged?

6. Are you sending or receiving or

both?

•

If sending, can you create the

data set?

•

If receiving, can you “digest”

the data set?

Best Practices to Engaging



Plan your use of an HIE – HIway or other



Review existing referral and care coordination patterns



If using the HIway, determine the status of your trading

partner:

–

View the HIway Status map to identify trading partners and

check status,

http://mehi.masstech.org/mass-hiway-participants

–

If your trading partner has not yet started their HIway connection,

refer them to EOHHS/HIway Ops to get

connected,

http://www.masshiway.net/contactus.jsp

Finding a trading partner – HIway Status Map

20

as of June 2014

Organization Name:

Milford Regional Medical Center

HIway Status:

Transacting

Billing City:

MILFORD

Billing Street:

14 PROSPECT ST

Use Cases:

Discharge summaries from acute

care to skilled nursing facility and

home health in the form of a CCDA

Best Practices to Engaging



Plan your use of an HIE – HIway or other



Review existing referral and care coordination patterns



If using the HIway, determine the status of your trading

partner:

–

View the HIway Status map to identify trading partners and

check status,

http://mehi.masstech.org/mass-hiway-participants

–

If your trading partner has not yet started their HIway connection,

refer them to EOHHS/HIway Ops to get

connected,

http://www.masshiway.net/contactus.jsp



Exchange etiquette – send messages only with prior

coordination



The HIway also needs “receivers” and a greater diversity of

participating organizations

Berkshire Health Systems (BHS) will enable health information exchange among its providers, its Electronic Health Record (EHR) systems and with its trading partners. BHS and their trading partners will bidirectionally exchange health information for critical patients, including cardiac patients in the midst of an acute MI who need urgent surgical intervention. These cases call for immediate, comprehensive, compatible, and accurate data sharing. BHS, Suburban Medical and Berkshire OB/GYN will each capture consent at the check-in. Upon seeing the patient, the provider will record the clinical encounter in the respective EHR, then - using webmail - will send health information supporting the referral to Baystate Medical Center. Once care is completed, they will then receive information back from Baystate as the patients are returned to them for continued care.

STORY

• Berkshire Health System > planned: MEDITECH (via LAND) & Allscripts (via MedAllies HISP); current: HIway Webmail

• Suburban Internal Medicine > planned: Allscripts (via MedAllies HISP); current: HIway Webmail

• Baystate Medical Center > planned: Cerner (via PVIX from/to the HIway); current: HIway Webmail

1) Reduction of diagnostic tests (e.g., blood work) - with an HIE connection, we can avoid situations where current test results exist but are unavailable; 2) Increase the number of patient files transferred

electronically

TRADING PARTNERS AND SYSTEMS GOAL

DATA TO EXCHANGE

CCD - summary of care

ORGANIZATION

FACILITATING PATIENT REFERRALS FROM A COMMUNITY HOSPITAL

TO A HIGHER ACUITY MEDICAL CENTER

Berkshire Health System Suburban Internal Medicine Baystate Medical Center

BAYSTATE MEDICAL

CENTER

FACILITATING PATIENT REFERRALS FROM A COMMUNITY HOSPITAL

TO A HIGHER ACUITY MEDICAL CENTER

BERKSHIRE HEALTH SYSTEM

SUBURBAN INTERNAL MEDICINE

BAYSTATE MEDICAL CENTER

1) Reduction of diagnostic tests (e.g., blood work) - with an HIE connection, we can avoid situations where

current test results exist but are unavailable;

2) Increase the number of patient files transferred electronically

GOAL

SUBURBAN INTERNAL

MEDICINE

BERKSHIRE MEDICAL

CENTER

Massachusetts eHealth Institute 29

Massachusetts eHealth Institute 31

Massachusetts eHealth Institute 32

A provider administers an immunization to a patient and this data is entered into the patient’s record within the practice’s EHR. The EHR then sends this information as an HL7 2.5.1 VXU message to the

Massachusetts Immunization Information System (MIIS) at the Massachusetts Department of Public Health via the Mass HIway. The message is sent to MIIS’s Mass HIway Direct address.

MIIS processes the message and determines it was received successfully. At this point an HL7 2.5.1 ACK message is generated and sent back to the ambulatory practice’s EHR to confirm successful receipt of the original message.

STORY

Organization A - ambulatory practice, using EHR interface to submit immunization data to MIIS via the Mass HIway

Organization B – Mass Department of Public Health using MIIS To achieve Meaningful Use 2 objective- submission of electronic data to immunization registry and to meet

M.G.L. c. 111, s.24M, which requires all licensed health care providers who administer immunizations to report all

immunization data to the Massachusetts Immunization Information System (MIIS)

TRADING PARTNERS AND SYSTEMS GOAL

DATA TO EXCHANGE

HL7 2.5.1 VXU message from ambulatory practice to Mass DPH HL7 2.5.1 ACK message from Mass DPH to ambulatory Practice

ORGANIZATION(s)

Ambulatory Practice and the Massachusetts Department of Public Health

Immunization Data from Ambulatory

Practice to Public Health Department

HL7 2.5.1 VXU message

HL7 2.5.1 Acknowledgement

Message (ACK)

Immunization Data from Primary Care Physician to

Massachusetts Department of Public Health’s

Massachusetts Immunization Information System (MIIS)

To achieve Meaningful Use 2 objective- submission of electronic data to immunization registry and to meet

M.G.L. c. 111, s.24M, which requires all licensed health care providers who administer immunizations to

report all immunization data to the Massachusetts Immunization Information System (MIIS)

Resources



MeHI Use Case website

–

http://mehi.masstech.org/health-information-exchange-0/mass-hiway/develop-hiway-use-case



MeHI Use Case Library

–

http://mehi.masstech.org/use-case-library



MeHI HIE Case Studies

–

http://mehi.masstech.org/hie-case-studies



MeHI Use Case Development

–

Guide -

http://mehi.masstech.org/sites/mehi/files/documents/Use_Cases/Tools/MassHIway_UseCaseGuide_070720

14.pdf

–

Form -

http://mehi.masstech.org/sites/mehi/files/documents/Use_Cases/Tools/MassHIway_UseCaseDevelopment%

20Form_07072014.pdf



HIway Implementation Grant

–

Press Release with user story descriptions

•

http://mehi.masstech.org/press-releases/massachusetts-ehealth-institute-masstech-awards-235-million-grants-accelerate



HIway Interface [Vendor] Grantees

–

Press Release -

http://mehi.masstech.org/news/massachusetts-ehealth-institute-awards-vendor-grants-advance-accelerate-health-information

Key Takeaways



HIEs enable inter-and intra-organizational exchange



To get started, review existing referral and care coordination

patterns



Use case generation facilitates initial scoping, project planning and

effort prioritization. Further, they identify the clinical / business need

before solution development …mitigating rework and delays



Elements of a use case include:

1.

Use case name, goal, trading partners

2.

Story, systems, data to exchange



Engage your clinical and business leaders early…discovering what

you want to do takes time, pulling the team together takes longer.

Discussion & Questions

Massachusetts eHealth Institute

37

Margaret Senese

Program Manager for Strategic Investment

Health Policy Commission, Commonwealth of Massachusetts

Sean Kennedy, MPH, MS, PMP

Health Information Exchange Director

Massachusetts eHealth Institute at the Massachusetts Technology

Collaborative

617-371-3999

[email protected]

@MassEHealth