What are three factors that are realonsible for hospital downsizing?
What are three factors that are realonsible for hospital downsizing?
Interoperability ISEM 542 Interoperability “In healthcare, interoperability is the ability of different information technology systems and software applications to communicate, exchange data, and use the information that has been exchanged”. 1 Quoted 10/31/2018 from HIMSS article (c) 2018 BL Boyer, Harrisburg University 2 The healthcare reality Volume of patient data increasing exponentially Quality of patient data declining Fragmented, duplicate and conflicting patient information within and across databases and touch points Regulatory and safety issues drive new requirements ADT Rob Johnson 1000 Main St. PACS Bob Johnson (555) 123-4567 Lab Robert Johnson robj@aol.com Billing Bobby M. Johnson credit card# 5555-55-1234 Patient identification enables the interoperability of tomorrow’s virtual health record EHRs, RHIOs and NHIN Improve patient care and reduce medical risks Improve Support efficiency consumer by reducing directed health redundant care informatio
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n activities management ROI Comply with regulations Enhance operational productivity and efficiency Interoperability challenges in healthcare ecosystem Public Health Hospital 2 Hospital 1 County General Hospital 3 Identity General Identity Clinics, Labs, Imaging Real-time Query Hospitals Identity (for Inpatients & Outpatients) Identity API EHR, RHIO, NHIN Identity NCPDP Pharmacy & Pharmacy Benefits Mgmt. Real-time Updates Clinical System Physicians Network Real-time Query Identity Identity Lab Systems Labs & Imaging Physician Interoperability with Initiate starts with the Identity Hub P&C policyholder data Debbie Dozier -Becker 9146 E VIA DEL SOL NETOWN, CA 45883 Local identifier 12/19/61 – 727 Trusted system of record Claims and billing data Debbie Becker NULL 5555-55-1234 Debbie Dozier NEED INFO 5555-55-1234 Debbie Becker Local identifier DBECKER1234 9146 VIA DEL SOL NETOWN, CA 45883 480-473-3486 5555-55-1234 Local identifier 12345ABCDE Commercial policyholder data Debbie Becker 9146 E VILLA DEL SOL NETOWN, CA 45885 Web self service data Store #3908, Zip = Debbie Becker 9146 VIA DEL SOL 480-473-3486 Local identifier HOSPABC98765 Local identifier BECKER4804733486 Initiate Identity Hub™ software 1: 12/19/61 – 727 2: DBECKER1234 3: 12345ABCDE 4: HOSPABC98765 5: BECKER4807343486 1. Derives & standardizes data for efficiency 2. Finds all potential matches 3. Use sophisticated probabilistic statistics to compare many attributes & score records 4. Puts results in 3 buckets – link, don’t link, needs manual review Interoperability HIMSS describes three levels of Information Technology Interoperatiblity: 1 • Foundational • Structural • Semantic What is Interoperability? 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 7 Interoperability Foundational 1 Simple information exchange that does not require interpretation by receiving system. What is Interoperability? 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 8 Interoperability Structural 1 Structure and format of data is well defined. What is Interoperability? 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 9 Interoperability Two or more systems have complete exchange capabilities. Semantic 1 • Uses structure and codification of data • Used to connect disparate systems • Sometimes referred to as “true HIE” What is Interoperability? 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 10 Interoperability For data to be exchanged a standard format for the data structure is required HL7 is the Healthcare data format 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 11 HL7 1 – Video What is HL7 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 12 HL 7 – Video part 2 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 13 HL 7 – Video part 3 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 14 Health Exchange2 HIS – is a generic abbreviation for Health Information Exchange. • They can be Regional Health Information Organizations (RHIO) • Qualtiy Information Organizations (QIO) • … and more locally or privately funded. 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 15 Health Exchange2 Types 10/31/2018 •State •Private •Hybrid •Regional (c) 2018 BL Boyer, Harrisburg University 16 Health Exchange2 State These are operated by the local state government or by some state contracted entity. 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 17 Health Exchange2 Private Usually centered around a single community or network, many times based in a single healthcare unit (probably hospital) 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 18 Health Exchange2 Hybrid Usually a result of a vendor combining forces with a state or regional system. 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 19 Health Exchange2 Regional Typically a non-profit community operated HIE to service a local area or region. 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 20 Health Exchange2 Importance •Enhanced care to the patients •Quick access to information at the right time •Efficient •Improvements in healthcare quality 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 21 Health Exchange This Photo by Unknown Author is licensed under CC BY-SA 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 22 Health Updates Interoperability also posing big challenges in the UK • A new report from KLAS shows NHS data sharing to be cumbersome and disruptive to clinical workflows in England. • “[About] 26% have no means to receive electronic patient data”4 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 23 Health Updates CORHIO goes live with new tool to improve care documentation, efficiency • The Colorado HIE with a network of 74 hospitals will use the technology to help manage data into comprehensive continuity of care documents.5 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 24 Health Updates Nonprofit and HIE work together to tackle advance care planning • “Making Choices Michigan offers free advance directive services that Great Lakes Health Connect enables clinicians to access, and Community Manager Carol Robinson said doing so helps the organizations pursue the Triple Aim.” 6 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 25 Health Updates Nonprofit and HIE work together to tackle advance care planning • “Making Choices Michigan offers free advance directive services that Great Lakes Health Connect enables clinicians to access, and Community Manager Carol Robinson said doing so helps the organizations pursue the Triple Aim.” 6 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 26 References 1. What is Interoperability? (2017, October 13). Retrieved from https://www.himss.org/library/interoperability-standards/what-isinteroperability 2. FAQ: Health Information Exchange (HIE). (2017, July 5). Retrieved from https://www.himss.org/library/health-informationexchange/FAQ 3. FAQ: Health Information Exchange (HIE). (2017, July 5). Retrieved from https://www.himss.org/library/health-informationexchange/FAQ 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 27 References 1. What is Interoperability? (2017, October 13). Retrieved from https://www.himss.org/library/interoperability-standards/what-isinteroperability 2. FAQ: Health Information Exchange (HIE). (2017, July 5). Retrieved from https://www.himss.org/library/health-informationexchange/FAQ 3. FAQ: Health Information Exchange (HIE). (2017, July 5). Retrieved from https://www.himss.org/library/health-informationexchange/FAQ 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 28 References 7. PMC, E. (n.d.). Health information exchange among US hospitals. Abstract – Europe PMC. Retrieved from https://europepmc.org/abstract/med/22084896 10/31/2018 (c) 2018 BL Boyer, Harrisburg University 29
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