Using HIE to Improve Data Integration and Patient Care

Delivery

Tonya La Lande & Jonathan ShermanCarolinas HealthCare System

9/11/2017

public, not-for-profit healthcare system in the nation

Second largest

team members60,000+

in revenues$9 billion

in community benefit$1.65 billion More than 40 hospitals

900+ care locationspatient encounters12.5 million

ABOUT CAROLINAS HEALTHCARE SYSTEM

2

To be the first andbest choice for care.

V I S I O N

M I S S I O N HealthHope Healing

To improveelevate

and advance - for all

3

4

CHS Information & Analytics Services

Revenue Cycle Clinical Analytics

Patient Portal/HIE

Key

5

Supplementary Solutions

CHS Population Health Strategy – Cerner HealtheIntent Platform

6

Workflow Tools

MyCarolinas Pt. submitted data

Device dataCare plan mgmt

Community Referrals

Aunt Bertha, EDIE

Outreach CapabilitiesEmmi, West,

etc

Analytics Engines

Data ManagementCost

Accounting Data Mart

Data MgmtIBM,

Informatica

Application Programming Interface (API)

MgmtAkana, Mulesoft

Data Replication Infrastructure

Artificial Intelligence

Watson, Jvion

Advanced ReportingPowerBI

Care Team Communication

Doc Halo

Platform

• Care Mgmt• Registries• Point of Care

Integration• XG Care Plans

• Data normalization

• Person Mgmt• Data

Warehouse

• Milliman Risk Adjusters

• HCC, 3M, Truven• Measures• Dashboards• MIPS/ACO/GPRO

• Message Center/ Direct

• Physician MetricsNetwork Mgmt

Post Acute Decision Support

NaviHealth

Referral Management

TBD

Decision SupportStanson,

NDSC

Italics indicated example solution

Advanced Analytics

RowdMap, TBD

Employer Group Management

Cerner Pure Wellness

Interoperability Defined

• ONC adopted IEEE’s definition:• Ability of two or more systems to exchange information• Ability of the systems to use the information that’s been exchanged without

special effort on behalf of the user

• Three key components• Technical ability• Active use• Without any special effort on behalf of the user

7

CHS CareConnect HIE Overview

• CHS CareConnect, our Health Information Exchange (HIE), provides standards based, secure sharing of patient information between health care organizations

• CareConnect integrates and provides access to clinical information not available in existing CHS systems

• CareConnect connects 19 CHS hospitals with over 250 affiliated and independent physician practice networks in the Charlotte metro area

• Across the Carolinas, connects 3 regional CHS hospitals, affiliated physician networks, 4 independent health systems, and 3 independent HIEs

• Expansion includes both CHS-affiliated and independent hospitals and physician practices, regional IDNs and HIEs, public health agencies, and post-acute networks across the region

• Current repository has over 6 million unique patient records

Entity: Carolinas HealthCare Information Exchange, LLC d/b/a Carolinas HealthCare System CareConnect

Production Date: April 1, 2011

Primary vendor: Medicity via an application service provider model, migrating to Cerner HIE application

8

CHS CareConnect Timeline

2010•Created CHS

CareConnect, LLC• Selected Medicity

as HIE VOC

2011-12•CHS data

populated in HIE, April, 2011

•1st portal customers

2013-14•Elected not to charge in Charlotte metro •Connected to Coastal Connect•Exceed 3M unique records

2015-16• eHealth

Exchange certification

• Access to portal via native EMR

2017•Converted to

Cerner HIE•New Q&R

connections

9

CHS CareConnect Diagram

(HIE Repository)

CaroMontVA CVMCUNCH

(CHS Record Repository)

eHealth Exchange

Independent Community

PracticesNovant Health Mission

HIE

CHS PracticesH

H

Independent and Regional

CHS

Connections In Progress

Q&R connections

10

CHS CareConnect Footprint

11 11

CHS CareConnect HIE Benefits

• Quick access to clinical information via multiple provider data sources within existing EMR workflow

• Labs, Cardiology, Pathology, & Radiology Reports• Transcribed Documents• Allergies, Problems, Medications• Patient Demographics• Family & Social History

• Promotes care coordination• Reduces time to access clinical information

• Eliminates/reduces faxing from HIM departments• Puts information in the hands of clinicians at the time of care

12

Cerner HIE Connection & Rollout Progress

• CHS Interfaces – 2/15/17

• Mission Connect • CCD Query & Retrieve:

2/21/17

• Coastal Connect• CCD Query & Retrieve:

2/28/17

• Novant Health • CCD Query & Retrieve:

6/13/17

• CHS End Users• Access CareConnect via

Cerner Millennium –6/21/17

• Next up• UNCH• CHS Ambulatory Surgery• VA• Caromont

13

0

1

2

3

4

5

6

0 1 2 3 4 5 6

Clin

ical

Val

ue

Readiness

Participant Connection Matrix

Highest Value & Readiness

CHS Ambulatory Surgery Center

CHS Powerchart ECG

CHS HCHB

Lowest Value& Readiness

Complete

14

CareConnect Training & Communication Plan

15

Training Objectives

1. To communicate the new CareConnect Outside Records mPage to Canopy users and the new CareConnect Community Health Record (CHR) to external customers

2. To train the CHS Support Center staff on password reset for external customers

Audience

Canopy Users: Acute Providers, ED Providers, Acute Nurses and Clinicians and Ambulatory Providers and staff

Non Canopy Users: External endusers

CHS Support Center: CHS Support Team staff members

Training Strategy:

Types of Training Materials: Job Aid Interactive Video (less than 5 mins)

Location of Training Materials:Canopy Users Education Repository mPages – Canopy EDU,

Clinician EDU PeopleLink – Learning Section PeopleConnect – Canopy Education PageNon-CHS Users (External) CHS Website – outside of firewall, hidden link

for users to accessCHS Support Center Knowledge Base Repository

Training Material Communication:Canopy Users Canopy Monthly Release Canopy Pop-up Alert YammerNon-CHS Users (External) Onsite training Skype virtual web training sessions Email communicationCHS Support Center Email Communication

Roles & ResponsibilitiesCAST Team Assist with communication and onsite training Acute and ED providers

E-Learning Team Create web based training video and job aide.

Clinical Informatics Coordinator

Assist with communication and training acute nurses and ancillary clinicians

CareConnect Team Create & deliver communication, and train non CHS end usersTrain Support Center Staff on password reset

Ambulatory CAST Team Assist with communication to Practice Managers and assist with training Ambulatory Providers and Clinicians

Physician Liaison Assist with communication to Ambulatory Providers

15

HIE Impact on Patient Care

• Implemented new HIE application on 6/21/17

• Dr. Geoffrey Rose, Cardiologist at Sanger Heart & Vascular Institute immediately saw the value

• Accessed CareConnect when treating a patient from Novant Health

• Saw the patient had undergone several cardiac tests prior to seeing him at Sanger

• Was able to avoid retesting the patient• “Easy to see how CareConnect will lead to

care that is better coordinated, more efficient, and ultimately, more effective.”

16

CareConnect Success Stories

• Nurse confirmed patient seeking opioids

• Pharmacist confirmed patient med list to contraindication for med prescribed elsewhere

• HIM worker reports decrease in calls for fax reports

• Skilled Nursing Facilities have quick access to info

• Pediatrician accessed recent records from nearby Novant Urgent Care facility and adjust treatment

17

CareConnect Portal Use via CHS EMR

5,319 unique users of CareConnect portal via Canopy EMR (exceeded goal of 4,271)

30,045 total patient searches since inception18

Other CareConnect Plans

19

QUESTIONS?

Contact Information:

Tonya La Lande704-446-6243

tonya.lalande@carolinashealthcareconnect.org

Jonathan Sherman704-355-0382

jonathan.Sherman@carolinashealthcare.org

20