Challenges and Benefits of Implementing Electronic Messaging in Newborn Screening Laboratories

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Angela Hutchinson
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1 Challenges and Benefits of Implementing Electronic Messaging in Newborn Screening Laboratories Ashleigh Ragsdale, MPH QA & Development Supervisor Newborn Screening Program

$Getting Started MSH ^~\& Neometrics.WA.Prod^2.16.840.1.113883.3.237.4.9^ISO WADOHPHL^50$

2 Getting Started MSH ^~\& Neometrics.WA.Prod^ ^ISO WADOHPHL^50D ^CLIA WASHINGTON STATE HOSPITAL^H0999^L ORU^R01^ORU_R P HIE PID ^^^WASHINGTON HIT STATE HOSPITAL &H0999&L^MR BART SIMPSON M ^White^HL70005 U^Unknown^HL70189 N 0 HL Bidirectional Messaging NK1 1 SIMPSON^MARGE MTH^Mother^HL70063 ORC RE ^WASHINGTON STATE HOSPITAL^H0999^L ^WADOHPHL^50D ^CLIA Meaningful Use WASHINGTON STATE HOSPITAL ^^^^^WADOHPHL&50D &CLIA^PI^^^H SPRINGFIELD DR ^^SPRINGFIELD^WA^98902 ^^^^^206^ OBR ^WASHINGTON STATE HOSPITAL^H0999^L ^WADOHPHL^50D ^CLIA ^Newborn screening panel American Health Information Integration Community Engine (AHIC)^LN F OBR ^WASHINGTON STATE HOSPITAL ^H0999^L ^WADOHPHL^50D ^CLIA ^Newborn Screening Report summary panel^ln F Middleware OBX 1 CE ^Reason for lab test in Dried blood spot^ln LA ^Initial EHR screen^ln F OBX 2 CE ^Sample SNOMED-CT quality of Dried blood spot^ln LA ^Acceptable^LN N F LIMS OBX 3 CE ^Newborn screening report - overall interpretation^ln LA ^All screening is in range for the conditions tested^ln N F OBX 4 CE ^Newborn conditions with positive markers [Identifier] in Dried blood LOINC spot^ln LA137-2^None^LN N F Hierarchic Designator OBX 5 CE ^Newborn conditions with equivocal markers [Identifier] in Dried blood spot^ln LA137-2^None^LN N F System Architecture Interoperabilty EMR Validation Implementation Guide

3 Challenge: Assemble the Team LIMS Vendor Business Analyst HL7 Expert Informatics Leadership Network Architect NBS SME

4 Challenge: Adapting the Implementation Guide

5 Challenge: Adapting the Implementation Guide Use the IG to mimic paper results & orders Review current forms and reports One standard message? LIMS Changes Middleware? LOINC Mapping Create a program specific Implementation Guide

6 Challenge: Changing Laboratory Workflows Current Work Flow Identify areas of change New workflow Will responsibilities shift? How will we review results? What do we do if the data doesn t match? Staff buy-in What happens when we make a correction? Will specimens be accessioned differently?

7 Example: Result Reporting Workflow Testing Mail LIMS Receive specimens Review Release Print Abnormals reviewed by Follow-up Data Entry

9 Challenge: The Data Exchange Pathway

10 Example: Direct Data Exchange LIMS

11 What is an HIE? Pass through Facilitator Hub Data warehouse

12 Example: Statewide HIE LIMS

13 Example: Integration Engine LIMS

14 What is an Integration Engine? Automate Message workflow Pathway between LIMS and HIE Translate Messages Filter Messages Transform Messages

15 Example: Integration Engine NBS Lab LIMS Notifiable Conditions Cancer Registry Vaccinations

16 Challenge: Resource Intensive

17 Challenge: Resource Intensive Estimating Costs Development Implementation Onboarding Maintenance Agency Resources already in place Plan for the long-term Potential for cost savings? Creative Funding Meaningful Use Grants CMS

18 Additional Challenges The Unknown

19 Benefits EMR Reduce Transcription LIMS Reduce Data Entry Build Relationships Improved TAT Improved Accuracy Expedited Access Saving Babies Reduce Carbon Footprint

20 HIT Community HIT List Serve HIT Workgroup Building Blocks NBS Health IT Guide and Toolkit

21 Thank You!! Washington State Newborn Screening Ashleigh Ragsdale, MPH QA & Development Supervisor (206)

GLOBAL HEALTH INFORMATICS STANDARDS FOR NATIONAL HEALTH INFORMATION

GLOBAL HEALTH INFORMATICS STANDARDS FOR NATIONAL HEALTH INFORMATION Vikas Dwivedi (vikas_dwivedi@jsi.com) Boonchai Kijsanayotin (kijs0001@gmail.com) Derek Kunaka (derek_kunaka@za.jsi.com) What is Interoperability?