Delaware Health Information Network



Delaware Health Information NetworkTown Hall Wednesday, September 11, 201310:00 a.m. – 11:00 a.m.Conference Room 107 Wolf Creek BoulevardSuite 2Dover, DE 19901 Meeting MinutesPurposeTo keep our public informed.AgendaWhat we are doingWhat we will be doingWhat should we be doing (public feedback)?CURRENT Activities UpdateDHIN is working with Med Labs Diagnostic and Mercy Diagnostic. Med Labs is currently in testing and we expect to be in production by the end of September. Mercy Diagnostic is not quite as far along; they will begin certification testing by the middle of October and should be in production by mid to late November.Electronic Lab ReportingBeebe and BayHealth are in full production and sending their reportable labs into Public Health. Nanticoke is currently in the process of on boarding and will be in full production later this month.St. Francis initially had the wrong specs for content testing and now have been provided the proper information; they are scheduled to go back for additional testing this HS will be following St. Francis, and Nemours will do a system upgrade on their end before starting Electronic Lab Reporting through DHIN.Public HealthDHIN continues working to onboard Public Health Lab as a new data sender. We have received the sample messages that are required to begin the work on the interface and those sample messages have been provided to Medicity. DHIN’s portion has been completed and we are waiting for Medicity to slot the work for interface development. We are targeting late January to go into production.New Born Screening Phase one of the new born screening project is working with the hospitals and the birthing centers regarding their equipment for hearing testing. We need to ensure that the equipment is capable of generating an HL7 message. We have a contract in place with the vendor that works with the state on newborn screening to do the technology assessment for both hospitals and birthing centers. All six hospitals have completed the assessment and we are waiting for results.The first phase we are working on is the hearing screening. We will not be able to use the cooperative agreement for the entire project; however, Public Health has some grant funding to contribute and we will be able to continue the project after the cooperative agreement money has been spent.The New Born Screening project will take place in multiple phases. The total NBS project will involve combining the results of the hearing screening with the results of metabolic screening into a single report. The consolidated NBS report will be going into the DHIN community health record, as well as being delivered to the ordering providers. ImmunizationsDHIN continues to make progress with Immunization Reporting and in August 46% of all entries into the DelVAX system were VXU messages submitted through DHIN. The challenge now is the upcoming flu season since a majority of patients receive their shots at their local pharmacies. We currently have five CVS Caremark pharmacies submitting VXUs electronically and DHIN is working to get other pharmacies to submit their immunizations electronically. If we can get ahead, it will be the first time in history that the Immunization Registry in Public Health will not need to hire additional staff to enter submissions to the registry.DHIN is receiving VXQ messages thru Cerner which is the one EMR that we have certified bidirectional exchange. In the past three months, since activated, we have ranged from 1200 to 2500 VXQ messages coming through each month.The web service has deployed; however, we ran into problems and are working with the state to clear the firewall issues. Once in place, there are a number of practices ready to use web service for production and testing. DHIN expects a lot of action once it is in place and operational. Transcribed ReportsDHIN is currently working with Nanticoke on submitting transcribed reports and is expected to be in cert by the mid October and in production by late November. Transcribed reports allow us to obtain discharge summaries, operative reports and essentially anything that can be dictated. Transcribed reports represent a large amount of useful clinical information. DHIN is currently getting transcribed reports from Beebe, BayHealth, CCHS and St. Francis. Nanticoke is next, only leaving Nemours which is not currently submitting transcribed/dictated documents into DHIN.Image ViewingDHIN is currently in a pilot with two hospitals, BayHealth and Nanticoke. We have had a few setbacks with the BayHealth project and expected to be in production next week. Yet, there may be a few additional delays, we are working on the defects that we identified in the system that have prevented us from moving into production. As for Nanticoke, if all continues to go well, we are expecting Nanticoke to move into production by late September or early October. DHIN is breaking new ground on many new initiatives and it should be expected to have a few setbacks; however we are determined to find the right technical solutions and continue to work hard on D ExchangeCCD Exchange is also a new initiative and DHIN has been working on a pilot with Delaware Health Net. Delaware Health Net uses Allscripts as their EHR to integrate the production of Continuity of Care Documents sent into DHIN for a searchable part of the community health records. Care Summary Exchange is a required component of Meaningful Use Stage 2 and the benefit to the health care community is greatest if Care Summary Documents become a searchable part in the community health records. Event Notification System DHIN expects the Event Notification System to go into production this week with one of the Medicaid MCOs and at least one hospital. We will be able to utilize the Admission Discharge Transfer (ADTs) feeds coming to DHIN from the hospitals when there is a visit to the emergency department or an admission/discharge from the patient side. They will then be matched to the eligibility files provided by the health plan. When an ADT feed coming from the hospital matches a member of that health plan, it will send an alert that one of their members has been discharged from the emergency department. The ENS will allow case managers to quickly get on top of case management and care coordination and will result in fewer re-admissions. If we can engage care management early it will help assist patients in complying with their discharge instructions. DHIN is actively working to expand ENS outside of the pilot program to other health plans which will include Highmark and AETNA, both of which are the health plans that currently support the state employee benefits for both current and retired employees. DHIN has had kickoff meetings with both Highmark and AETNA and are working together on a solid project plan.DHIN is also working on getting the ENS out to practices. Practices will supply us with a patient list of who they would like to receive alerts on; when an ADT comes in it will be bounced against membership files to determine if patient matches the list provided by practices.Planned Activities UpdateOut of StateAtlantic General Hospital is in production and actively sending data into DHIN. DHIN has an executed MOA with Union Hospital in Elkton, Maryland; and continue to work on recruiting Peninsula Regional.DHIN also has an executed agreement with Maryland HIE, CRISP and will begin scheduling work. EHR IntegrationsDHIN continues to work with EHR integrations and currently has thirteen different EHRs that have a certified results delivery interface. Those thirteen EHRs represent 68% of all DHIN practices that use an EHR. DHIN also has a number of additional vendors that we have executed contracts for and are actively in the process of beta testing. Grant/FundingDHIN and DMMA are working together to apply for a grant from CMMS to fund the development of electronic reporting of the clinical quality measures for Meaningful Use Stage 2. It has been a good collaborative effort between both DHIN and DMMA; changes have been submitted and are in the process of being reviewed which may take up to sixty days. DHIN is on the downhill side of the state HIE Cooperative Agreement Grant which ends in January 2014. We are actively exploring grant opportunities to continue to grow our functionality and the value proposition that DHIN provides to Delaware.Two options of additional funding: CMS Grant is one opportunity that we are working with DMMA. State Innovations Planning Grant Part of the requirement for the SIM Grant is to demonstrate that we leverage capabilities that the state of Delaware already has - and a key asset is DHIN. Any technology components that the State Innovation Model design has would need to feature DHIN as a key piece.Later today, DHIN is meeting with consultants to explore the technical options for how we could expand our provider portal, ProAccess, which is the web access to DHIN’s community health records. Our intent is to expand the portal to become one feature of the portal that also allows bidirectional communication between the providers and all health plans in Delaware. Bettina Riveros is actively seeking resources to obtain the capital to begin the project while we wait to hear if we will receive the testing grant. There is no solid time line and we do not want to lose the momentum.The second draft of the State Innovation Model Design is out for public comment. On September 17th, a sequence of public meetings will be held in each county that will allow the opportunity for direct face-to-face public comment. The Health Care Commission has also applied for the second round of the CMMI Grant naming DHIN as partner. This CMMI Grant will be specifically around Consumer Engagement with iTriage being the center piece; but the entire initiative will revolve around informing, educating and engaging patients in their health and their health care.DHIN has also engaged legal counsel to begin looking at all payers claim data base and will be a part of the SIM planning process. Also to review the legal frameworks governance structure for the Innovation Model and looking at truly transforming healthcare in Delaware in ways that will live beyond the closeout of the grant. It is very important that the people affected by the plan have a voice in how it gets implemented. Choose Health DelawareOctober 1st begins the open enrollment for Health Benefit Marketplace and we are finding that many Delawareans are not aware. Please spread the word in your circle of friends and family to ensure that people are aware there is a legal requirement for everyone to have health insurance by January 1st. If Delawareans are not able to get insurance through their employer, they can go through the Health Benefit Marketplace. Once Delawareans have applied for coverage, their application will be sorted out to confirm whether they qualify for Medicaid expansion or a commercial plan. The website: Public_Comment C: Mary Nordenson: I am pursuing the need of functionality to download lab data from hospitals labs. I have a meeting scheduled with DHIN and Medicity to work on this situationC: Health plans have legal right to see the clinical data we should be facilitating.Q: Mary Nordenson: Is it true that physicians now get alerts regarding EDA: That functionality is not in place. We have a pilot working with MCOs and soon to roll the same functionality out to practices. Next Town Hall Meeting is scheduled for October 9th at 10:00 am ................
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