why initiate: the foundation for healthcare interoperability lorraine fernandes, rhia senior vice...
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Why Initiate:The foundation for healthcare interoperability
Lorraine Fernandes, RHIASenior Vice President, Healthcare Practice
Bill KlaverProduct Manager
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About Initiate Systems and interoperability
Over 2 billionrecords analyzed
1,400 healthcare facilities use Initiate technology
Typically discover duplication rates of 15-30% in “clean” files
Installations from500K to 500M+ records
Search and link across 150M records in sub second
Offices Chicago, CA,TX, AZ, Australia,UK, Canada
… Establish patient identity
… Provide meds history profile
… Create national prototype
… Determine a member
… Access clinical info on demand
… Enable complete 360° Rx view
… Advanceinteroperability
… Share data securely
… Create a national EHR
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The healthcare reality
Volume of patient data increasing exponentially
Quality of patient data declining
Fragmented, duplicate and conflicting patient information within and across databases andtouch points
Regulatory and safety issues drivenew requirements
ADTRob Johnson
1000 Main St.
ADTRob Johnson
1000 Main St.
PACSBob Johnson
(555) 123-4567
PACSBob Johnson
(555) 123-4567
LabRobert Johnsonrobj@aol.com
BillingBobby M. Johnsoncredit card# 5555-55-1234
BillingBobby M. Johnsoncredit card# 5555-55-1234
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Patient identification enables the interoperability of tomorrow’s virtual health record
EHRs, RHIOs and NHIN EHRs, RHIOs and NHIN
Improve patient care and reduce medical risks
Improve efficiencyby reducing redundant care activities
Support consumer directed health information management
Comply with regulations
Enhance operational productivity and efficiency
ROI
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Interoperability challenges in healthcare ecosystem
Clinics, Labs, Imaging
Hospital1
Hospital1
Hospital2
Hospital2 Hospital
3Hospital
3
Physicians Network
Physicians Network
ClinicalSystemClinicalSystem
Pharmacy&
Pharmacy Benefits Mgmt.
Pharmacy&
Pharmacy Benefits Mgmt.
Hospitals(for Inpatients & Outpatients)
Hospitals(for Inpatients & Outpatients)
Labs & ImagingLabs & Imaging
Lab SystemsLab Systems PhysicianPhysician
Public HealthPublic Health
CountyGeneralCounty
General
GeneralGeneral
Real-t
ime
Query
API
Nightly U
pdate
XML
Real-timeQuery
API
Real-timeUpdates
SOAP
SearchFlat File
Real-tim
e
Updates
HL7
NCPDP
Real-timeQuery
IdentityIdentity
IdentityIdentityIdentityIdentity
IdentityIdentity
IdentityIdentity
IdentityIdentity
IdentityIdentityEHR,RHIO, NHIN
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Interoperability with Initiate starts with the Identity Hub
P&C policyholder dataP&C policyholder data
Claims and billing dataClaims and billing data
Debbie BeckerNULL5555-55-1234
Local identifierDBECKER1234
Commercial policyholder dataCommercial policyholder data
Debbie Becker9146 E VILLA DEL SOLNETOWN, CA 45885
Local identifierHOSPABC98765
Store #3908, Zip =
Debbie Dozier -Becker9146 E VIA DEL SOLNETOWN, CA 45883
Local identifier12/19/61 – 727
Debbie DozierNEED INFO5555-55-1234
Local identifier12345ABCDE
Web self service dataWeb self service data
Debbie Becker9146 VIA DEL SOL480-473-3486
Local identifierBECKER4804733486
InitiateIdentity Hub™ software
1. Derives & standardizes data for efficiency2. Finds all potential matches3. Use sophisticated probabilistic statistics to
compare many attributes & score records4. Puts results in 3 buckets – link, don’t link,
needs manual review
Trusted systemof record
Trusted systemof record
1: 12/19/61 – 7272: DBECKER12343: 12345ABCDE4: HOSPABC987655: BECKER4807343486
Debbie Becker9146 VIA DEL SOLNETOWN, CA 45883480-473-34865555-55-1234
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By answering these questionsDo I know this person? Query (IHE PIX Manager) By ID information from both source and generated at the PIX Manager By demographics enhanced by multiple sources contained in the PIX Manager (PDQ
capabilities)
Where do I know this person from? Source demographics (IHE PIX & PDQ functionality)
Source identity information is never lost from within and across sources
What do I know about this person? Event demographics (IHE PDQ functionality) Information about events (i.e. patient chart, diagnosis, etc.) that have triggered a
patient record
How do I know this person? Linkage summary (IHE PIX Manager) Record of truth view across sources including the most current attributes
Is there anything else I know about this person? Household information (Extended IHE PIX Manager)
Information on patient relationships either household information within source across sources
What can I do with this information? HL7 message integration (IHE Interoperability)
Send, received, and updated via HL7 messaging
How Initiate fits in with IHE?
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EMPI questions that drive interoperability
What “View” of the patientare you allowed to see?
What other information do we know about the patient?
What can we do with this patient information?
Do we know the patient?
Is this the correct patient?
How do we keep the patient information in-sync?
How do we get to the other information about the patient?
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EHR
Healthcare ecosystem – interoperability applications
Laboratory management
Laboratory management Radiology
management Medication
management
Patient financial management
Medication management
Medicalmanagement
Medical management
Patient portal
On ramp to RHIO
Patient financial management Composite
public data
On ramp to RHIO
Medical management
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Healthcare expectations that drive interoperability
CustomerPortal
Specific views – Create common view of “customer” per organization’s objectives and marketing requirements. May address consumer, member, patient portal.
Public Health
EHR - Create virtual EHR of public databases such as immunization, disease-specific, biosurveillance, - with option to be payer specific for state funded healthcare.
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Billing
Care delivery Purchasing
Research
Diagnosis Treatment
Scheduling
Communications
The invocation of the necessary
services to provide the most accurate information to the right place at the
right time
Registration
ProcessProcessProcessProcess
Interoperability defined
PatientPatient PayorPayor ProviderProvider PBMPBM SupplierSupplier PharmacyPharmacy PublicHealthPublicHealth
RadiologyRadiology RHIORHIO
PeoplePeoplePeoplePeople
PhysicianPhysician Etc.Etc.
ERPERP ClinicalClinical RxRx ResourceResource FormularyFormularyFinancialFinancial ResearchResearch
DataDataDIDIPatientPatient 3rd party/
Ref. data3rd party/Ref. data
Etc.Etc.ProviderProvider
Pri
vacy,
Secu
rity
, S
tan
dard
s,
Reg
ula
tory
Com
plian
ce
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Solution
Reference architectureLabmgt
EMPIEMPI HISHIS ClinicalClinical FinancialFinancial ProviderProvider 3rd party3rd party
Radiologymgt
Customerportal
Business
Integration
Hosting
Medicalmgt
Medicationmgt
Sticky applications
On rampto RHIO
Business Logic
Infrastructure
Application ServicesApplication Services
Core Business ServicesCore Business Services
Messaging Services and Source AdaptersMessaging Services and Source Adapters
Data ServicesData Services
Identity ServicesIdentity Services
Con
su
lting
Data ServicesData Services
Security ServicesSecurity ServicesInitiate
Sta
nd
ard
s
Service
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