sun’s healthcare business model – solutions to bridge healthc - sun - 2009.pdf · sun...

Sun Confidential: Internal Only

Sun HealthCareBusiness Solutions for Health Information Exchange and Interoperable Connectivity

…combining all integration technologies in one easy-to-use environment.

Built on a foundation of integration with unified capabilities for Single Patient View”…

Sun Confidential: Internal Only 2

Health Information Exchange


What is an Health Information Exchange (HIE)?• Electronic Exchange of Healthcare Information between

parties, across institutional boundaries• Similar to a Regional Health Information Organization

(RHIO), but without a Regional Restriction• Precursor to a NHIN – National Health Information

Network• Facilitates access to and retrieval of clinical data to

provide patient centric care


Why an HIE?

• Goal is to provide more accurate information to Health Providers for the Patients Benefit

• Reduce Costs > Reduce duplicate clinical tests

• Provide Patient Centric Clinical Care

> All inclusive view of patients health

> More information should lead to better diagnosis

• Better delivery of clinical results • Research Capabilities

> De-personalize clinical data


National Health Information Network (NHIN)

Health Information ExchangeInteroperability

Regional Health Information OrganizationsElectronic Health Records

Electronic Medical Records

Personal Health Records

Public Health ParticipationPhysician Portals

Patient PortalsPayer Portals


EHR SystemEHR System

Digitization of HealthCareDigitization of HealthCare

`

Composite Applications:

Patients The Underlying Problem - Finding the information


Hospitals

Primary care physician

Specialty physician

Ambulatory center (e.g.

imaging centers)

Payors

Pharmacy

Laboratory

Public health

Current system fragments patient information and creates redundant, inefficient efforts

Pharmacy

Laboratory

Hospitals

Primary care physician

Specialty physician

Ambulatory center (e.g.

imaging centers)

Payors

Public health

HealthInformationExchange

Future system will consolidate information and provide a foundation for unifying efforts

Source: Indiana Health Information Exchange

RHIOs: “Wiring” Healthcare HIE


Realizing the Goals Need Solution

• Digital Information Flow • Management Of Escalating Data • Regulatory Privacy& Access Control

• Health Information Networks – Infrastructure for secure data exchange and access

• Federated IdM and Compliance for data access and audit trails

Administration

• Consumer-directed Healthcare• Long Term Care Management For Higher

Quality And Lower Cost• Single Entity View

• Personal Health Records – Health records for care and cost management

• Disease Management Platforms - Best practice guidelines, treatment plans

Clinicians(Patient-centric)

• Reduce Costs• Genomic Profiling And Pharma Data• Guidance Based On Best Practices• Data Privacy

• Electronic Medical Records – patient centric for cost-effective, specific and real-time guidance

• Identity Management & Security – Regulate, track and audit access

Payers

• Vendor Mergers & Acquisitions • SOA-based Architectures Leverage Legacy

Systems• Image Archiving

• Business Integration & Composite Applications– Enable new business processes without rip and replaceIT Management


Health Care Solutions

• Single Entity View > Provides a secure, real-time & high quality single entity (patient / provider) view

across disparate systems, networks & health services with no common identifier. Delivers matching, duplicate eliminating, and unifying across all records in an Enterprise. Uses all the information available to cleanse & probabilistically evaluate all records in real time and link related records. Leverages eIndex, EMPI & Java CAPS. Success: McKesson, HealthNow, Excellus BCBS

• Health Information Exchange > Connects Applications, Businesses & Caregivers delivering a 360° view of

Patients and Procedures. Enables providers and payers to share more information thereby improving efficiency and quality of care, at the same reducing costs. Leverages eIndex, EMPI, iProvider & Record Locater System. Success: Colorado RHIO, British Columbia PLIS, UK NHS

Sun Confidential: Internal Only 10 10

Without Consistent Master DataThe Problems of Piecemeal Knowledge...

“Through 2011, 70% of SOA projects in complex, heterogeneous environments will fail to yield expected business benefits unless MDM is included.”

- Gartner, Inc. “Predicts 2008: Master Data Management” by Andrew White, John Radcliffe - 25 February 2008

• Medical errors and othernon-optimum results

• Patients feel disenfranchised from their care givers

• Loyalty diminishes

• News of poor customer experiences spreads fast on the Internet

• Fragmented information and poor data quality leads to inefficient business operations.

• More complex process to blend data sets

• Larger systems footprint through duplication

• Higher operational costs and lower efficiency

• Physician retention issues

• Billing and AR Issues

• Tarnished reputation for customer service

• Poor Care

• Lost Patients

Patient Perspective IT Perspective Business Perspective


• No unique identifier exists between the systems Historically healthcare facilities have identified their

patients uniquely per facility eg. MRN on Patient Master Index, DVA, etc

With increasing complexity and the need to provide cross-facility and interdisciplinary services the facility based MRN no longer provides satisfactory identification ie UPI is required to form the basis of the EHR, CMR, etc

Claire Smith

ID: 4444444Medicare: 123-45-6788DOB: 10/07/1954

Clare Smith

ID: 667788Medicare: 123-45-6789DOB: 10/07/1954

System A System B

Same Person, Different ID

How do you link Related Information across Disparate Systems without a Common Identifier?


The Root of the Problem

Enterprise Patient View

Procedure OrdersTest Results

DataRepositories

Laboratory

Radiology

Master Patient Index

Registration


Registration

Pharmacy

Monolithic,IndependentApplications

Multiple EntityViewsDispersed, un-integrated data

Registration


FinanceProvidersPayers ExternalProviders

DataWarehouse Hospitals


Single Entity ViewChallenge

• Link related patient / provider information across disparate systems with a common identifier

● Provide comprehensive management tools to ensure data quality in real-time

● Cross-indexing solution that delivers single customer (patient / provider) view

● Provides real-time automated person matching system

• Sun Master Index • Java CAPS• Open SSO• Service Registry

• McKesson

• Excellus Blue Cross Blue Shield• McKesson• HealthNow

Solution/Benefits

Products

Partners

Success


Other CompositeApplications

Enterprise Patient ViewProcedure OrdersTest Results

DataRepositories FinanceProvidersPayers External

ProvidersDataWarehouse Hospitals

ReusableServices

CompositeApplications

Registration Laboratory Radiology PharmacyMaster

Patient Index

A Smarter Approach

Single Entity View


Health Information ExchangeChallenge • Enable clinicians, public/private health caregivers,

payers & providers to share & access vital health information when & where needed

● Using Sun’s Single Entity View and HIE Framework, caregivers can consolidate and aggregate clinical results from the hospitals and clinics enhancing patient safety & care

• Sun Master Index • Sun Business Process Manager• Java CAPS

• Colorado, USA RHIO• British Columbia, Canada PLIS• United Kingdom NHS

Solution/Benefits

Products

Success


Sun’s 360° Health Information Exchange Network

AcademicMedical Center

PublicHealth

SpecialtyClinic

Hospital

ReferenceLaboratory

MedicalSupplier

Long-TermCare

DiagnosticImaging Center

Finance Researchand Education

EmergencyServices

Physicians

Home Health

PrivateInsurance

GovernmentInsurance

Pharmacy BenefitManagement

Employer

Single-Patient View

Ambulatory Centers

Payers

Pharmacy

ClinicalDocuments

ScreeningRegisters


Health Information Exchange

Enterprise Patient/Provider ViewsElectronic Health Records

Single Entity View

Enterprise Master Patient Index

Primary Care

Hospital Outpatient Care Other

Portal and Presentation Layer

Framework for Security and Identity Management

Transaction Processes

A Single Enterprise Master Patient Record

Patient Record Matching, Cleansing, Merging and Linking

Reliable, Scalable Storage Solutions

Connectivity and Integration Services

GPs, Practice Nurses, Health Visitors

Hospital Clinicians,Regional Specialists

District Nurses, Hospice Staff, Community

Practitioners

Proven, Sustainable Hardware


Claims Lifecycle Manager

`

Challenge• Single entry point to search transactions• Single entity reporting “receipt to completion”

transaction activity

● A transaction monitoring system● Central entity for reporting process errors● Collects data for Search & Reporting● Supports standards based HIPAA transactions

• Sun Patient Master Index • Sun Master Index • Java CAPS

• ServiceSpan

• Caremark• Blue Cross Blue Shields Massachusetts• eMDeon (formerly known as WebMD)

Solution/Benefits

Products

Partners

Success


Claims Lifecycle Manager

Enterprise Patient/Provider ViewsElectronic Health Records

Single Entity View

Enterprise Master Patient Index

Primary Care

Hospital Outpatient Care Other

GPs, Practice Nurses, Health Visitors

Hospital Clinicians,Regional Specialists

District Nurses, Hospice Staff, Community

Practitioners

Single Transactions View

Claims

Diagnosis Codes

HIPAA Transactions

Remittance

Eligibility


Nationwide Health Information Network


Current Challenges in the Federal Healthcare.The secure exchange of interoperable health information within the federal government, and with the public and private sectors, can support agency priorities such as:

• Military: Supporting Wounded Warrior, to enable the continuum of care between public and private healthcare systems for the 30,000 service personnel wounded in Iraq and Afghanistan

• Social Security: Creating electronic records and authorization to ease the backlog in SSA processing of disability and claims applications, now at 755,000 which is up from 311,000 in 2000

• FDA: Ensuring pharmaceutical product safety and efficacy using outcomes data in the real world, a benefit of Post-Market Surveillance of drugs and durable medical goods

• CDC: Federal, state, and local Bio-surveillance efforts to spot disease outbreaks or bioterrorism incidents and to track cases of contagious diseases

• Health IT for Emergency response to Pandemics/Disasters to assist in managing triage systems, evacuation efforts and the health of displaced citizens


Office of the National Coordinator for HealthIT (ONCHIT)● created by executive order in 2004● goal to create a national health IT infrastructure● they initially created Federal Health Architecture

FHA envisions electronic health information to:● improve the quality / efficiency of health care● empower the individual patient● support public health, emergency preparedness, and research

Nationwide Health Information Network (NHIN)


● Part of the ONC is effort is to not only increase the Electronic Health ● Record adoption, but also to ensure connectivity between E.H.R.

Systems. ● NHIN is based on a set of standards and use cases● NHIN has 16 + participating grantees● NHIN CONNECT is the Federal Government version of this initiative

Requires common elements:● minimum set of detailed standards - a shared network “dial tone”● support for consumer / inter-organizational trust● value of exchanging data exceeds the cost

Nationwide Health Information Network (NHIN)


NHIN BenefitsIn describing the importance of Healthcare IT, Secretary Michael Leavitt identified

these benefits, most of which rely in some way on the NHIN: • To the healthcare consumer:

> Higher-quality care > Reduction in medical errors > Fewer duplicate treatments and tests > Decrease in paperwork > Lower health-care costs > Constant access to health information > Expansion of access to affordable care

• To public health: > Early detection of infectious disease outbreaks around the country > Improved tracking of chronic disease management > Ability to gather de-identified data for research purposes > Evaluation of healthcare based on value, enabled by the collection of price and quality

information that can be compared


What is the NHIN-CONNECT Gateway?

• Software for all federal healthcare agencies to “connect” to the National Healthcare Information Network (NHIN)

• Developed in Open Source, Contributed back to Open Source

• Software – Sun Open Source NetBeans Glassfish OpenESB mySQL

Project Mural Project Metro/Tango/WSIT Open SSO Open DS


Health Bank orPHR Support Organization

Community #1

IntegratedDelivery System

Community Health Centers

Community #2

CDC VA

CMS

SSA

FDA

Common “Dial Tone” & “Chain of trust”

The InternetStandards, Specifications and Agreementsfor Secure Connections

Nationwide Health Information Exchange


Sun Open Source SOA Case StudyNationwide Health Information Network - Connect (NHIN-Connect)• Challenge

> Lacking ability to easily share electronic health information between multiple healthcare entities– Social Security, Military

Health,Veterans Admin...• Solution

> Using Sun open source OpenESB, GlassFish, Sun identity mgmt.

> Secure exchange of interoperable health information

> ESB/SOA frameworkSource: Office of the National Coordinator for ITU.S. Dept. of Health & Human ServicesApril 2008

http://events.fcw.com/events/2008/ea/downloads/EA08_2-4_Sankaran.pdf

● The Gateway utilizes an Enterprise Service Bus (JBI/JSR208)

● Developed as open source using open standards


Sun Open Source SOA for NHIN

• Nationwide Health Information Network-Connect> “We wanted to make sure that the vendor was a reputable company that we

could rely on for help and support. We were able to use Sun's entire open source SOA and Identity software infrastructure technology for NHIN.”

> “And last, but not least, we wanted to work with a technology provider that would be a partner as opposed to just a vendor and I am happy to report that Sun has definitely been a partner in helping us to achieve the tremendous success of NHIN."

Craig Miller, Chief Architect, FHA, Vangent


Continuum of Care, integration support

Note: Longer term participationShall include non-Federal Partners


Sun Software Solutions


Sun's strength in HealthCare -

Significant Drivers for Health Information Exchange

77%

60%

44%

37%

29%

21%

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

Providerinefficienciesdue to lack of

data to supportpatient care

Risinghealthcare

costs

Availability ofgrant funding

Increasednational

attention on HITand HIE

Public healthsurveillance

needs

Demand forperformanceinformation

History in Healthcare with Thousands of Clients Worldwide

Prominent Healthcare Clients

Innovation Experience Knowledge


Clients: Sample of our Healthcare Clients

Payer OrganizationsBlueCross BlueShield of LABlueCross BlueShield of MABlueCross BlueShield of NEBlueCross Blue Shield of NCBlue Shield of CAGroup HealthHorizon BCBSUnited Health GroupCoventryCMSThe Regence GroupMagellan Behavioral HealthState of CaliforniaState of North DakotaState of OregonState of South DakotaState of Washington

Healthcare VendorsCernerQuest Diagnostics / MedPlusGE Medical / IDXPointShareMisysMcKesson / Per-sePLIS-Canada

Pharmacy Benefits ManagersCVS / AdvancePCS / CaremarkFirst Health Services Corp.

Hospital Systems and IDN’sNew York Presbyterian HospitalCareGroup, Inc.Children’s Hospital of PhiladelphiaDuke University Health SystemKaleida Health SystemNew England Medical CenterProminaCleveland ClinicSutter HealthTenet Health SystemSisters of Charity

Long Term CareKindred HealthcareGenesis Health VenturesBeverly Enterprises

Regional Health ExchangesPLIS, BC CanadaCORHIO Colorado


• Leader in Back-End Application Integration, Gartner 2008

• Leader in Horizontal Portal Product, Gartner 2007

• Leader in Web Access Management, Gartner 2007

• Fastest Application Platform Server, SPECjAppServer, 2007

• Strong Performer in Customer Hubs, Forrester 2008

• Strong Performer in Application Server Platforms, Forrester 2007

• Visionary in Composite Applications, Gartner 2008

• Visionary in New Service-Oriented Business Applications, Gartner '08

• Visionary in Application Enterprise Servers, Gartner 2008

• Visionary in Data Integration Tools, Gartner 2008

Analysts


The Market has Moved to Open

2/3of Clients Surveyed

Using OSS in Mission-Critical

Applications – June 2008

“Open source adoption initially focused on the operating system and Web server tiers of the application platform stack, but early success widened the focus to include development tools, infrastructure components such as application servers and databases, and higher-level components such as portal servers and content management systems.”

Survey Finds Growing Use of Open-Source Software for Mission-Critical Applications- June 2008 Open Source

Adoption: Notes From The Field

- July 2008

Gartner


Open Source/Community Participation• Why it matters:

> The only major vendor developing production SOA software as open source. Others only leverage open source components and maintain proprietary components

• What:> Sun's open source Open ESB is not a scaled back version of Java

CAPS...all future development takes place in this extended development community

• Benefits:> Lowers customer risk through transparency into future releases> Allows customers to participate in the development


Free Access

Added Value Features

Added Value Enablement

Added Value

SunService

ArchitectureConsulting

PerformanceTuningService

AdvancedMonitoring

SpecializedUpdates

AdvancedBackupEnterpriseManager

24x7Support

HotFixes

CumulativePatches

Sun's Unique Focus:Provide Value to Open Source IP and Communities


Sun Software Portfolio Multi-Platform and Open

Professional Services (PS), Sun Learning Services (SLS), SupportDeveloper Tools and Programs

Java/ClientDatabase

Storage

Virtualization Datacenter

ApplicationInfrastructure

SunxVM

Sun Open StorageZFS


2.2 million employees sold!

•Application Containers•Application Server•Web Server•Message Queue•Mobility Services

•Master Data Management•Single consistent view•Vertical specific solutions•High performance data matching & indexing

•Application Integration & SOA•Enterprise Service Bus•Share/reuse services & processes•Workflow

•Directory Services•Directory services•Virtual directory services•Security/failover services•Data distribution services

•Identity & Compliance •Automated Provisioning•Access Management•Single sign on•Identity Auditing

•User Interaction Platform•Portal, Widgets, Mashups•Communities and Social Graph •Wiki, blogs and Collaboration

Sun's Unique Offering:Comprehensive, Pre-integrated & Open


•Sun's SOA platform lowers TCO and introduces business flexibility for:>1) Integrating customer data>2) Mergers & acquisitions>3) Application consolidation•Leverages legacy application functionality as re-usable services and combines with newly created services to rapidly address new business objectives•Transparency into future releases with open source code base•Rated LEADER by Gartner and Forrester

•Sun ESB Suite•Enterprise Service Bus platform•Integration and process management•Open source and pluggable

•Java CAPS•Comprehensive composite application platform suite•Combines ESB with MDM Suite•Open source and pluggable

• “Sun's Java CAPS product is a rising star in the company's software portfolio”Gartner: 23 April 2007 Paul McGuckin, Daryl Plummer, Jess

Thompson

Sun's Offerings:Application Integration & SOA


Java Composite Application Platform Suite

Infrastructure

Enterprise Service Bus

Business Process Management

Business Activity Monitoring

Portal

Master Data Management Business to Business

ORCHESTRATION

COMPLEX EVENT PROCESSING | BUSINESS DASHBOARDS

MEDIATION | ADAPTERS | ROUTING | TRANSFORMATION

APPLICATIONSERVER

DIRECTORYSERVER

SINGLE SIGN-ON | |

SINGLE ENTITY VIEW MESSAGE EXCHANGE

MESSAGESERVER |

Java CAPS

Open SourceOPEN ESBOPEN SSOOPEN DSMURALNETBEANSGLASSFISHPROJECT METRO

Community Contribution


•Sun's MDM platform addresses the following critical business needs:>1) Multi-channel optimization>2) Increased customer satisfaction>3) Operational efficiency•Integrates disparate customer and other business data into a single comprehensive view to enable customer cross-sell across divisional or geographic boundaries•Improves customer support through automated matching of customer data across different systems

•Sun MDM Suite•Customer data integration•Open source code base•SOA enabled•Community driven

ebizQ, June 12, 2008, Beth Gold-Bernstein, Sun CAPS 6 Has the Right Vision

Suns “integration of MDM is fairly unique, and is ahead of the market in recognizing the central importance of MDM in distributed and federated SOA architectures.”

Sun's Offerings:Master Data Management


Mural - Open Source MDM Community• Master Index Studio – Canvas for

defining model, attributes and services for reference data

• Data Integrator – Provides extract-transform-load (ETL) and supports a wide variety of data sources

• Data Quality – Features matching, standardization, normalization, profiling, and cleansing capabilities

• Data Mashup – Provides server-side data composition and aggregation

• Data Migrator – Provides the ability to migrate database objects across database instances


Sun Solutions● Sun has a Comprehensive Enterprise Solutions Offerings for:

● SOA == Sun Java System Java CAPS● Security == Sun OpenSSO Enterprise● Directory Server == Sun Java System Directory Server EE● Identity Management == Sun Java System Identity Manager/Role Mgr● Presentation == Glassfish Web Space Server● Hosting Application Server == Glassfish Enterprise Server● Hosting Web Container == Sun Java System Web Server

● Sun provides governance frameworks, services, developer tools including:● Sun Center of Excellence (for SOA, Identity Management)● Sun Reference Architectures● SOA Governance == Sun Governance Framework● Java IDE == NetBeans, Studio, Eclipse (Plug-ins)● Training and Certification programs


The SoMI (mostly local) Sun Team• SLG now falls under SunFed• One Nationwide Team – No Regions• Sales, Systems Engineers, Specialists, Service Engrs:

> Heidi Hoyles, Systems & Storage Sales> Andrew Springer, Prof Service Sales> Julie Elsenheimer, Software Sales> Christine Sluman, Services Sales> Danielle Weinberg, Systems SE> Ron Gregory, Software SE> Rhonda Kelly, Services Account Manager> Steve Malesko, Lead Services Engineer> Paul Wickstrom, SW Architect


The SoMI Sun Healthcare Team

• Sales, Systems Engineers, Specialists, Service Engrs:> John Barto, GEH HC Evangelist> Manish Chopra, Solution Architect – Delivery Mgr> Paul Cahill, HC Business Development> Nancy Abell, HC Clinical Solutions Manager> Jean Prater, Gov't Market SW Strategist> Catharine Evans, Civilian HC Business Development Director> Sean Keane, HC SW Architect> Anna Wehberg, HC Marketing Manager


What's Happening in MI - MiHIN• There are 9 HIE's or RHIOs (www.MIHIN.org):

>Capital Area>Upper Peninsula>Southeastern MI>Genesee Area>West MI >Central MI>Northern Lower Peninsula>Southwest MI>South Central MI• There is a MiHIN Program Office>Consists of 9 State of MI Folks from DIT and DCH:

– Ken Theis, CIO & Janet Olszewski, DCH are Executives– Scot Ellsworth, DIT & Beth Nagel are the Tech & Biz Leads


What's Happening in MI – MiHIN cont'd• Project Control Office RFP Issued and Awarded:

>Dewpoint Prime Contractor>S2a Consulting Sub >Currently in Project Planning & Analysis Phase>Will release and RFI ~ a month>Will release an RFP for infrastructure at the end of the calendar year>Looking for grant funding from the ONC• State Goals: >Combination of a Consolidated and Federated System>Central Repository at the State level>Backbone at the State level>Connection hooks at the HIE/RHIO level>Provide the tools and means to connect the 80% small providers, considering they have little to no IT equipment, IT staff, or in many cases – internet connectivity>Works in conjunction with State's Broadband efforts


What's Happening in MI – HIT Commission• The Health Information Technology (HIT) Commission:

>Board Consisting of 13 members: 2 from The State:– Janet Olszewski, Director of DCH– Ken Theis, CIO

>Others representation from non-profit HC corps, pharmacist, pharm mfgs, Dr's, consumers, purchasers and employers, schools of medicine and hospitals • The Big Picture Goals:

> Utilize Technology to improve HC outcomes and clinical workflow> Empower Citizens with access to information

• Framework for Successful Implementation in MI> Leverage the regional collaboration and successes> Refine statewide services that support a statewide HIE> Position MI for resources from the economic stimulus package - ARRA


HIE Implementation Proposed Technology


Software Services and SupportProfessional Services Support Services

Learning Services Managed Services

Migration assistance, workshops architecting identity management

or SOA solutions, and implementation services.

Training and certification courses to help you derive maximum benefits from Sun software.

Plans designed for individual and corporate developers, small, medium-sized and enterprise

environments.

Reduce expensive downtime, minimize risk, conserve internal resources and manage change

Sun Confidential: Internal Only

Thanks

Ron GregorySoftware Technical SpecialistSun Microsystems Inc.


DefinitionsAn Entity refers to functionally independent participants within the health care system, from a single doctor practice up to hospital chains and national organizations, whether public or private. An Entity is any organization, institution or practice; the only parts of the health care system that are not entities are the patients themselves.

A SNO (Sub-Network Organization – a.k.a Regional Healthcare Information Organization [RHIO]) is any group of entities (regionally or non-regionally defined) that agree to communicate clinical data with one another using a single Record Locator Service (RLS), using shared policies and contractual agreements. A SNO has two sets of interfaces, one internal, which binds its member entities together, and one external, which is where traffic to and from other SNOs and outside entities come from.The NHIN (Nationwide Health Information Network) is the sum of all SNOs. It is a network of networks whose participants agree to the Common Framework. The NHIN is not a separately funded entity; it is a framework of cooperation and compliance. If the individual SNO's externally facing interfaces work, the NHIN will work. There are no required “top level” services in the NHIN; at the national level, adherence to standards and policies, however defined and affected, are the key elements. All the actual infrastructure of the network is either hosted within the SNOs or uses the existing internet.


Definitions

• ISB – Inter SNO Bridge• RHIN – Regional Health Information Network• EHR – Electronic Health Record• PHR – Personal Health Record• RLS – Record Locator Service• MPI – Master Patient Index


Continuity of Care Demonstration Scenario


CO RHIO

VA

MHS

NHIN

NHIN

NHIN NHIN

Veteran gets into serious skiing accident in Colorado and needs to go to the Emergency Room


SSA


CO RHIO

VA

MHS

NHIN

NHIN

NHIN NHIN

The emergency room doctors need to quickly review the patient's medical history and the hospital administration needs to verify patient eligibility


SSA


CO RHIO

X12 270/271 FormsVA

MHS

NHIN

NHIN

NHIN NHIN

The patient is a Veteran, so a claim is sent over to the veteran's administration to verify eligibility.

VA responds with verification of benefits.


Payment Lifecycle Management

SSA


CO RHIO

VA

MHS

NHIN

NHIN

NHIN NHIN

ER Doctor needs to access patient information at patient bedside to review patient history. He identifies himself securely and logs onto the CoRHIO using a smartcard, preventing un-authorized access to patient data and providing for Provider Mobility.


Security Solutions - Identity ManagementMobility Solutions (SunRay)RHIO

SSA


CO RHIO

VA

MHS

NHIN

NHIN

NHIN NHIN

All CORHIO patient data is identified using the Master Patient Index and multiple records are transferred inside CORHIO


Master Patient Index (MDM)

SSA


CO RHIO

VA

MHS

NHIN

NHIN

NHIN NHIN

Because patient is a Veteran, the VA and MHS healthcare records are accessed and reviewed via NHIN gateways in all locations. Data is consolidated from several locations prior to leaving the MHS and VA


NHIN

SSA


CO RHIO

VA

MHS

NHIN

NHIN

NHIN NHIN

X-Rays are ordered and viewed via the integration software which connects the Colorodo hospital to the radiology labs.


Java CAPS IntegrationRHIO

SSA


CO RHIO

VA

MHS

NHIN

NHIN

NHIN NHIN

Patient is treated and released. Records are stored as required for the lifetime of the patient.


Open Storage

SSA


CO RHIO

VA

MHS

NHIN

NHIN

NHIN NHIN

Patient injuries make him eligible for disability. Patient makes a disability claim application at the Social Security Administration.


SSA


CO RHIO

VA

MHS

NHIN

NHIN

NHIN NHIN

Social Security Administration contacts Hospital via NHIN and is returned the patient's electronic medical record. With the electronic medical record, Social Security is able to process the disabilities claims in days.


NHIN

SSA