Delaware Health Information Network



Delaware Health Information NetworkTown Hall Wednesday, July10, 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 currently receiving ADTs and lab results from Atlantic General Hospital. AGH is DHINs first out of state data sender in production. DHIN is currently engaged with colleagues from the Hawaii HIE. The HHIE has adopted the same technology solution as in Delaware and they are currently visiting to see how DHIN onboard practices, as well as how policies are addressed.The link in ProAccess to the Delaware Prescription Monitoring Program has moved into production. We do not yet have a single sign on solution, so you will have to use a separate login for now, but you can link directly to the Monitoring Program login page from ProAccess. We still intend to pursue single sign on, but it will take a bit longer.ProAccess users will now see links to both DelVAX Immunization Registry and Delaware Prescription Monitoring Program in the “My Links” section of ProAccess. DHIN continues to explore other levels of integration.DHIN has moved Accu Reference Lab into production; which makes our 18th data sending organization. Delaware Health Nets CCD Exchange is now in cert (testing environment). CCD is a method of capturing data in ambulatory EHR and captures critical elements of information that exist inside the EHR and packaging it into a standard format which will then sent into DHIN. Information will then be stored in the community health record and available for discovery. This will be DHINs first experience with pulling data from the ambulatory practices into community health record. This is a summary of care which qualifies for Meaningful Use Stage 2 requirement.Public HealthDHN continues to make progress with Public Health on immunization updates. DHIN currently has 28 organizations in production sending immunization updates electronically into the Public Health Registry.Twenty more organizations are in active testing and several more have expressed an interest/intent in exploring with their EHR vendor for what will be the next step requirement. DHIN does not have the June figures on the total number of immunizations that have been captured in DelVAX; however, given that CCHS has gone into production, DHIN believes those numbers have gone up substantially.DHIN also continues working with Public Health in bringing their labs into DHIN as data senders and becoming part of the community health records.DHIN also continues to work with Public Health on Newborn Screening which will be a multi phase project. During the first phase, DHIN will ensure that all hearing testing equipment in each birthing hospital is up to a version that is capable of sending the information electronically. Initial work will take place as we physically go to each hospital and if necessary update their hardware and software. Once everyone is on board, we will begin taking hearing and metabolic screening and combining each testing into one newborn screening report which can be served in the community health records through DHINElectronic Lab Reporting Both Beebe and Bayhealth are in full production and sending notifiable conditions to Public Health electronically through DHIN. St. Francis and Christiana are in the final stages of content verification. Interfaces are working and technically sending messages and state epidemiologist are in the process of verifying the content that they are receiving is correct.DHIN is currently in discussion with Nanticoke and Nemours regarding sending labs into DHIN. Event Notification SystemDHIN continues to work with piloting two hospitals and two MCOs on the Event Notification System. Our anticipated date to complete the pilot is mid August; at that time, we will move to all payers/practices who would like to subscribe to the Event Notification System.DHINs Provider Relations Team will be visiting and educating practices interested in the Event Notification System and explaining how it works, what is involved and how it can benefit them.Planned Activities UpdateImage ViewingImage viewing is a Meaningful Use Stage 2 menu objective for both hospitals and practices. We are engaged in a pilot with Nanticoke and expect completion by mid August. In the radiology report that you receive through DHIN, there will be a link (URL) embedded in the report that the end user can click-on and it will take them directly to the image. Providers will be able to view the image and review the report on their computers. The image will not be stored in the DHIN repository. Out of StateDHINs connection with CRISP, Maryland State HIE, continues as we begin receiving ADTs from CRISP that will allow us to feed the Event Notification System. This will include all Maryland hospitals, including Johns Hopkins, Univ of Maryland, and the border hospitals, which all get a lot of Delaware patients. We will be getting all their ADTs feeds into the Event Notification System, which will allow us to notify their health plans and primary care providers that they have been discharged from the ED or the hospital. Once integration is complete with the community health record, notifications will also show up in ProAccess. DHIN is in negotiations with a number of out of state potential data senders. Several Philadelphia hospitals and also a few additional Maryland border hospitals have expressed their interest in participating in DHIN. DHIN is also exploring technical feasibility as well as business viability of a number of additional of new types of projects. As well as expanding our reach beyond state borders, we are also expanding on traditional types of data exchange that DHIN has been involved in the past. We are beginning to branch out on new lines of service that could offer leveraging the fundamental technology infrastructure that we have already established through DHIN.State Innovation Model Planning GrantThe state of Delaware has received a planning grant to look at innovations in care delivery models and payment models. One of the items that we are looking at is how new delivery models and payment models will leverage health information technology infrastructure that is already in place. Delaware is very fortunate to have a mature statewide HIE. All Delaware hospitals and 98% of Delaware providers are in DHIN. Delaware has a technology infrastructure that most states do not have; there is an opportunity for Delaware to leverage what we already have and build on it in a way that would benefit the entire state. The planning grant will end by mid October. The assumption would be that once we turn in the plan, we will then apply for the testing grant which will be a duration of approximately three years to build out the model. As a result of the testing grant, DHIN hopes to leverage the web portal that we currently have for clinical results (ProAccess) and create a common portal used by all payers so that the providers do not have to go to a different website for each payer or to a different website to do eligibility checking for each payer. DHIN would also like to expand by bringing ambulatory data into the community health record. Pulling in ambulatory data will give us a far richer conjoined data set that will support point of care clinical decision making and also analytics. Practices/providers that have elected to participate in new payment and care models would need to be prepared to contribute their ambulatory data into DHIN.An aggressive state wide marketing of Consumer Engagement Tools; all eligible hospitals and professionals under Meaningful Use Stage 2 must give their patients the ability to view on-line, download and transmit their own health data with the ability to do secure messaging between provider and patient. DHIN will offer iTriage to meet the requirements for Meaningful Use Stage 2. iTriage is a free mobile application that can be downloaded to an iPhone, iPad or android platform and is also available as a web browser tool. The iTriage application is a 24/7 guidance on symptom recognition (“what might I have?”), most appropriate care setting to have it addressed (“where should I go?”), as well as providing information about medication side effects, explanation of what is involved in various medical procedures, and a “personal” space that allows the individual to record and track some of their personal health data. DHIN is working with iTriage and Medicity to create a linkage between the DHIN community health record and iTriage which will allow clinical data going into DHIN to be pushed out securely to a clinical inbox inside the iTriage application. Part of the functionality will be secure messaging between provider and patients. DHIN is already committed to offering this functionality to providers and hospitals in Delaware as a MU2 solution for the consumer engagement objectives. Under the proposed innovation grant, we would aggressively market this tool directly to consumers, with the goal of getting all Delawareans engaged in their own care and managing their own health data. The letter of intent to apply for the second round of the CMMI Grant, specifically around consumer engagement in Delaware has been filed by the Delaware Health Commission and has named DHIN, CCHS, Highmark and Astra Zeneca as partners. Public CommentsQ: How much will be charged per office/per provider for the secure messaging that will be offered to patients with the ability to view clinical summaries? A: The cost per provider will be approximately $165 per year. Exact pricing is still being evaluated to make sure DHIN can cover its costs.C: (Tracy Okubo, ONC): Congratulations! DHIN is the first to hit and exceed their projected target spend rate for the month. Next Town Hall Meeting is scheduled for August 14th at 10:00 a.m. ................
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