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DisclaimerThis webinar may be recorded. This webinar presents a sampling of best practices and overviews, generalities, and some laws. This should not be used as legal advice. Itentive recognizes that there is not a “one size fits

all” solution for the ideas expressed in this webinar; we invite you to follow up directly with us for more personalized information as it pertains

to your specific practice and issues.

Thank you, and enjoy the webinar.

About UsOur passion is to provide solutions for our healthcare provider partners which help them improve patient care, enhance the patient experience and maintain a financially healthy practice.

Since 2003 we have specialized in NextGen Healthcare services including:

• Consulting

• Hosting

• Customization

• And productivity tools such as ChartGuard® and RefundManager®

Upcoming Webinars:

• The Steps to a Patients Centered Medical Home Wednesday, March 16, 2016

• Quality Care Program Reporting: So Many Choices, So Little Time Wednesday, April 13, 2016

Using NextGen Share in the Real

World

Introductions

Mary Hart

Client Relationship Manager

Cindi Kincade

Vice President, Consulting Solutions

Lindsey Lanning

Healthcare Informatics Coordinator

Billy Lawson

Product Specialist

Using NextGen Share in the Real

World

Today’s Webinar

• Introduction to Interoperability• NextGen Share

What is it?

Why use it?

• NextGen Share and Direct• NextGen Share Set-Up• NextGen Share Functionality • NextGen Share: A Client’s Perspective• What’s Next

Interoperability

HIMSS

AHIMA

Interoperability describes the extent to which systems and devices can exchange data, and interpret that shared data. For two systems to be interoperable, they must be able to exchange data and subsequently present that data such that it can be understood by a user.

Interoperability is the ability of different information technology systems and software applications to communicate, to exchange data accurately, effectively, and consistently, and to use the information that has been exchanged.

Why is Interoperability Important?EHR system interoperability is a necessary step toward transforming healthcare into a system that can achieve goals of improved quality, efficiency, and patient safety. For example, use of interoperable EHR systems could better enable healthcare providers to:

• view results collected by other providers to avoid duplication;

• evaluate test results and treatment outcomes over time regardless of where the care was provided to better understand a patient’s medical history;

• share a basic set of patient information with specialists during referrals and receive updated information after the patient’s visit with the specialist to improve care coordination; and

• view complete medication lists to reduce the chance of duplicate therapy, drug interactions, medication abuse, and other adverse drug events.

Key Challenges Related to Interoperability

1. A lack of mandated health data standards

2. Differing state privacy rules3. Accurately matching patients’ health

records4. Costs associated with Interoperability 5. Need for governance and trust among

entities 6. Information blocking

NextGen Share

What is NextGen Share?

According to NextGen: NextGen Share is a nationwide network connecting providers to support secure clinical data exchange.

NextGen Share allows clients to discover and connect with external providers. It allows users to find connected providers and organizations; compose and exchange a referral with clinical documents; and count such transactions towards their meaningful use attestation. This dramatically simplifies today’s manual referral workflows which require faxing or paper shuffling.

NextGen Share

• NextGen Share was built using NextGen and Mirth integration and provides secure connectivity between both NextGen Healthcare and non-NextGen Healthcare providers.

• NextGen Share supports interoperability across all certified EHR vendors to enable the exchange of clinical information.

• It includes a searchable provider directory and message translation between supported formats. Providers can exchange clinical data files such as C-CDA files and attachments, referral request letters, and intake notes.

• Access to these patient files and the ability to share them will improve patient safety and patient health outcomes across the network.

Why Use NextGen Share?

• Meaningful Use Modified Stage 2 requirements

Interoperability Objectives

• Supports secure sharing of EHR documents and C-CDAs

• Better communication between physicians which means increased care coordination for patients

Find a Provider

Create/Send Referral

• Decrease in in manual data entry


Objective 10: The EP is actively engaged with a PHA or CDR to submit electronic public health data in a meaningful way using CEHRT, except where prohibited, and in accordance with applicable law and practice.

• NextGen Clinical Registry Service

Clients may register intent with these registries for 2015 MU Reporting by 2/29/2016

Pricing is based on what each registry charges


Objective 5: The EP who transitions their patient to another setting of care or provider of care or refers their patient to another provider of care provides a summary care record for each transition of care or referral. • Setup NextGen Share so it is integrated into the

EHR in the referral template and medical summary utility

NextGen Share and Direct

The Direct Project

The Direct Project establishes standards and documentation to support simple scenarios of pushing data from where it is to where it's needed, in a way that will support more sophisticated interoperability in the future.

The Direct Project specifies a simple, secure, scalable, standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet.

How it Works

A HISP is a Health Information Service Provider. A HISP

securely transfers encrypted health information in a

standardized format between healthcare providers.

What is a HISP???

NextGen Share is now DTAAP Certified

The Direct Trust Agent Accreditation Program (DTAAP) validates and supports compliance with the technical, security, trust, and business practices required for Direct messaging. This certification ensures NextGen Share is meeting the highest data privacy and security standards.

Other HISPs in Direct Trust

What is a Direct Message?

• Secure SMTP (simple mail transfer protocol) [email protected]

• Not the same thing as an email address

• What is used to exchange health information through NextGen Share

NextGen Share Set-up

Environments

You may choose to install NextGen Share into either your test environment or your production environment

• The test environment referred to as “Staging” can be connected to your NextGen test database

• The prod environment referred to as “Production” is a live system connected to your NG production database

Onboarding Process

• Navigate to the NextGen website and under ‘Product/Services’ click on the ‘NextGen Share’ link located in the Interoperability section.

• Scroll to the bottom of the NextGen Share Page and click the www.nextgenshare.com link to log-in and begin

To begin the onboarding process for NextGen Share:

NextGen Share Enrollment

• Create a Share Profile

NextGen does prepopulate some information on file

Must pick specialty

• There is an option for multi- specialty

Pick sub-domain

• Unique to practice will show up in direct address as providername@direct.(chosen sub-domain).nextgenshare.com

• Example: [email protected]

NextGen Share Enrollment Cont.• Connect to the Share Network

Enter the email of user performing installation and it will send a license key and install instructions to them

Download NextGen Share installation kit on the Rosetta Server

Run the installation wizard

Once installation is successful, you will run a NextGen Share Network Connectivity test

Once the connectivity test signals success, enter the license key and then wait for a registration success notification

The NextGen Share Installation Complete page will appear where you can click finish and navigate back to the portal.

NextGen Share Portal will confirm installation was successful

NextGen Share Enrollment Cont.• Core Service Section will show you the status of connection to

your EHR environment

NextGen Share Enrollment Cont.• Activate Messaging

Check Prerequisites

Verify Identity with DigiCert

• Government issued ID and a notary required

Enable Direct for providers

• Messaging Service will connect to EHR to retrieve provider and practice information and automatically create direct addresses

• Once this is complete, the section will update to show number of active practices and providers retrieved from your EHR databases

NextGen Share Portal

Add External Providers The NextGen Share directory is comprised of data from a variety of sources, including:

• NextGen EHR customers

• 3rd Party HISPs who have signed directory sharing agreements with NextGen Share

• The Direct Trust Directory Services program

• User-submissions to the directory

As long as a provider has a Direct address they can be added to the NextGen Share directory

If you add a single provider to the directory with a trusted address they will immediately be available in the directory.

Viewing Providers in a Practice• You can search for a provider using the ‘Find Provider’ tool

• You are able to change their unique direct address by clicking the existing address, making your changes and then saving by clicking the checkmark

• You can also turn on or off direct messaging for a provider (or whole practice) by sliding the status bar from on to off

Note: If you do slide to off it will remove them from the directory

NextGen Share Functionality

Outgoing Referral Workflow

Patient Chart

Referral Template

NextGen Share

Medical Summary Utility

Outgoing Referral Using Medical Summary Utility

Create Referral Order

•Do this in the KBM

Open MSU & Find Provider

•Open MSU from Utilities Menu Bar

•Search in directory for provider to receive referral

Associate Provider with Referral

•Locate and select appropriate referral

Send Referral

Benefits of Using MSU:• Allows users to choose the

clinical content• Supports attachment of

images Including ICS• The referral template does not,

but you are able to open a ticket with NextGen and have this enabled for the referral template.

• Includes the same NextGen Share directory search

• Allows a preview of the content before transmission

Referral Creation UsingReferral Template

• Find provider

Utilizing NextGen Share search window

• Compose Referral

Can attach multiple EHR documents and images

• Send Referral via NG Share

• MU calculations automatic

• Cover Letter will be included to recipient

• Date/Time of when C-CDA was sent can be seen on the referral template or in orders management

Outgoing Referral Using Referral Template

Search and Select a

Provider in directory

Create Referral Send Referral


• Open the Referral Template

• Select the NextGen Share icon to launch the NG Share window


• Notice ‘My EHR’ and ‘Share’ are both checked• This will allow the user to search both the NextGen database and the NextGen

Share database for providers


• With the NextGen Share search window open you can search by a providers last name, organization, specialty, or location

• After entering search criteria, the user can locate and select the correct provider• The different symbols you see next to the directory are:

• Blue Badge icon- Stands for an organization or practice

• Red balloon icon -Stands for a provider from your EHR directory

• Small physician face-Stands for a provider from the NextGen Share directory


• After selecting the provider, the specialty box will auto-populate with the provider’s specialty

• Add referral diagnosis and clinical indications as normal

• Attach documents if you would like by clicking details


After clicking the ‘details’ button the referral attachment window will open and EHR documents and images can be attached


• Check ‘Continuity of Care Document Sent’ checkbox Click ‘Add’ to place order

• Highlight the order and click ‘Share’ to send the C-CDA


Ways to verify the referral went through:• Referral Order Grid• Orders Management Template

Click on the order to open the order details and in the clinical information comments section you can find confirmation that the CCDA was sent and delivered

Receiving a Referral from NextGen Share

• Incoming messages go into the inbox for the assigned recipient and create a task These tasks can be received by

multiple people depending on the routing rules you’ve established for tasking and task groups

Provider notifications CAN be turned off, but you need to open a NG ticket in order to do so

• A provider/ clinical staff will open the task and accept

Note: Incoming documents can be setup to go to a provider's PAQ

Receiving a Referral from NextGen Share

After accepting the task and clicking ‘chart’ you can access the incoming C-CDA cover page and attachments in the categories view

Note: For Referrals SENT, it saves the sent information in the Categories tab of the chart as well

Cover Letter

If you wanted to add a custom cover letter/ attachment you would need to create them as a document and then attach those documents to your NextGen Share messages. These will be sent as attachments to go along with the Direct message.

Referral Attachment

Setting Up Notifications When C-CDA is Received

To assign other users besides the default provider to receive incoming referrals they would open file maintence, select ‘order result notifications’, click ‘new’, make sure external system ID is NextGen share, select provider, and designate user to receive referrals.

Important Notes

• The directory will not have ALL providers; only ones that use a Direct Trust HISP

• If a referral is unsuccessful an alert will be sent to the referral sender in their inbox

• If patient is not an exact match, the referral is sent to the Rosetta Holding Tank to be matched

• C-CDA's can be received or sent to any provider registered to a Direct Trust accredited HISP regardless of their EHR product

• You can add providers if you know their “Direct Address”

NextGen Share: The Real World

What Does it Cost?

• NextGen Share is free to all clients who have met the prerequisites

No cost to purchase

No cost to maintain

No cost to install

No need to purchase new hardware

No per transaction fee

• NextGen Share does not require the purchase of the Direct interface

Free Isn’t Always Free.. Don’t forget the soft costs

Minimum RequirementsItems to take care of prior to testing, the must- haves to install:• Must have 5.8 UD1 hotfix 69 or greater installed

• Minimum of KBM 8.3.3 or greater

• Share KBM Templates must be installed

• NextGen application installed on Rosetta server

• A minimum of Power Shell 2.0

• A minimum of ASP.net MVC 3

• A minimum of .Net 4.5.1

Other Considerations

• Installation

• Training

• Set-Up

• Testing

Problems Clients Are Facing

• Not all doctors or practices are in NextGen Share

• Many providers are not ready for automated referrals at this time

• Everyone is not in the directory

• Not all providers are on a Direct Trust HISP

• Not all providers are using an EHR

• Many times referrals simply go unread

Client Benefits of NextGen Share• Drops complete C-CDA and cover

page into EHR automatically

• Workflow is extremely easy

• No longer need to print and fax documents everything is electronic

• Automatically tracks MU compliance for interoperability objectives

• Users are able to import patient clinical data from the C-CDA into the patient chart utilizing the clinical reconciliation function Medications

Allergies

Problems

Diagnosis Codes

Procedures

Client Experiences“We receive the C-CDA from 2 commercial pharmacies, CVS and Walgreens when a patient receives a vaccine. It’s nice that the vaccine information is available to view. When NextGen generates a C-CDA, all outside lab results from Orders Module and all vital signs from all encounters appear, which is nice.”

“The actual C-CDA document can be extremely long, since it includes all sorts of information that may not be relevant to a particular referral (“junky” information as my providers put it).”

What’s Next for NextGen Share

Changes to Come

The Surescripts HISP interface will be discontinued on July 1, 2016

• Only applies to clients who have a Direct interface to Surescripts HISP

UD 2 features:

• An increased number of providers will now show in the provider search window (more than 4)

• There will now be a favorites list and a most recently used list

• The "type ahead” feature will be enabled, so results for letters or partial names will appear and the entire name is not required

Example: User will be able to search “Gor” to find the provider “Gordon”

NextGen Clinical Registry Update• What can I expect on Monday 2/22 if I am on UD2 in a production environment?

Log into NextGen Share and on-board to the service! The title for the Clinical Registry Service will be visible for clients starting over the weekend.

NOTE: Clients will need to reselect the same enrolled providers they submitted via the Provider Extract Utility during the setup process.

• But I already submitted my provider list? I have to do it again? Unfortunately, yes. This information was only used to generate attestation letters and not used to build the setup as the service was not available at that time.

• Providers changes made in the portal from this point forward will be fully automated and updated with CECity on a weekly basis. (Sunday nights)

• What can I expect on Monday 2/22 if I am on UD1 in a production environment?

You will not be able to install the service because you will fail the prerequisite checks for UD2

Provider changes and additions remain manual and will need to continue use of the Provider Extract Utility until you are on UD2.

• The letters will come from the registry on or about 4/1/2016 and the enrollment date will be the SOF date or 2/29/2016.

Uncertain Where Your Practice Stands?

Let Itentive help:• By assessing your current readiness

• Providing recommendations

• Implementation of new processes and procedures

Next Steps

• Visit us Itentive.com

• Sign-up for our informative webinars and blog

• Consider our 3-day, fixed price on-site consultations:

Clinical Workflow

Revenue Cycle and Front Office

Technology and Performance

• Test Drive our Products

Questions• Mary Hart

Client Advocate [email protected] 224-220-5581

• Lindsey Lanning Healthcare Informatics Coordinator [email protected] 224-220-5621

• Cindi Kincade Vice President, Client Solutions [email protected] 224-220-5575

Thank you

disclaimer this webinar may be recorded. this webinar ... · nextgen share portal will confirm...

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