Get Connected. Be Interoperable. Start now.

Transcription

1 Connectivity Get Connected. Be Interoperable. Start now Know enough to be dangerous: interoperability 101 Speak the language: ask the right interoperability questions What s a CCD? Show and tell Back to basics: why use an HIE? Open the door to success with the right patient portal Connecting the dots

2 Welcome! It all starts with connectivity. For a healthcare organization like yours in today s environment, it s vital. It s non-negotiable. It s the only way you can ensure the health of your patients, while safeguarding the health of your business. How do you get connected? You need a powerful, integrated, interoperable EHR to start. However, few EHRs are even integrated, let alone interoperable. And, lack of interoperability is a real obstacle to improving patient care. Where does your organization stand on this key issue? Do you use an integrated EHR? What about a Health Information Exchange (HIE) or Patient Portal? Every day, our team of connectivity experts strategizes with clients on their connectivity and interoperability challenges and goals. Our implementation team and Engagement Managers solve those challenges and get our clients up and running. Like a jolt of caffeine, getting connected really invigorates a healthcare organization and like water, it is the essential lifeblood of your business. I truly love working with our clients to get them better connected and seeing the value that it brings to their organization and their patients. In this ebook, we ll talk about what basics you need to know about interoperability to be dangerous. We ll help you ask potential vendors the right interoperability-related questions. We ll explain crucial industry terms related to connectivity and interoperability. Finally, we ll go back to basics and explain why you can benefit from an HIE and how your organization can increase its odds of success with a patient portal. Happy reading! Bob Barker Vice President, Connectivity Solutions NextGen Healthcare

3 CHAPTER Know enough to be dangerous: interoperability

4 You don t know what you don t know That applies twofold when you re talking about interoperability. Many prospective technology users feel unsure about interoperability standards. To get a baseline on your level of expertise, here are some key questions to ask yourself: Do you know the various interoperability methods available today? Do you understand the technology used to create interoperability? Do you understand the type of data being included, the frequency of transmission, and your data sharing consent policy? Do you know what a CCD looks like? Do you understand CCD configuration options? Do you know the difference between a CCD and a CCDA? (And if you don t know what a CCD is, see Chapter 3.) If you re not sure how to respond to these questions, or your answers don t give you confidence, ask your current or prospective vendor to explain interoperability standards to you.

5 Also, tap into the resources below to learn more: NEWS Healthcare IT News: General healthcare IT news source NHINWatch: News /guide to the Nationwide Health Information Network INDUSTRY ORGANIZATIONS HealtheWay: Non-profit public/private partnership supporting the ehealth Exchange (formerly NHIN) EHRA: HIMSS Electronic Health Record Association which helps shape public policy, regulations, and vendor engagement IMPORTANT GOVERNMENT SITES ONC-Interoperability: The HealthIT.gov website provides policy researchers and implementers a wealth of tools and programs to help spur interoperability development CHPL: The Certified Health IT Product List of certified EHRs Federal Advisory Committees: Governing body of Health IT Standards, Clinical Quality, Implementation, and other committees charged with developing standards and making recommendations to help improve interoperability This ONC site is for interoperability initiatives. Many of these go into Meaningful Use requirements. INFLUENTIAL BLOGS Gartner s Wes Rishel: Writes about Interoperability and HIT standards for Gartner Research Geekdoctor: Life as a Healthcare CIO. John Halamka, MD. Vice chair of Health IT Standards Committee, former CIO at Harvard Medical School, current CIO at Beth Israel Deaconess. HealthITBuzz: ONC s blog covering the government s efforts to improve the national drive towards healthcare IT Healthcare IT Guy: writes about general IT issues and experiences in healthcare

6 CHAPTER Speak the language: ask the right interoperability questions. It can sometimes feel like no two organizations speak the same interoperability language. Education and understanding about interoperability standards are often up for interpretation. It s common for diverse organizations to interpret data requirements differently, and to prioritize one type of data exchange over another. 2

7 Does your vendor play nice? From an interoperability standpoint, how can you be sure that a healthcare information technology provider delivers solutions that play nice with others? How can you tell if a vendor will really be able to help you meet your interoperability goals? Ask about MU. You can look at certifications, but these have become almost costof-entry type deliverables. Every vendor worth your time should have them. Ask potential vendors if they can help you meet Meaningful Use (MU) Stage 1 and 2 requirements. Interoperability testing and validation are part of these standards. Be sure to confirm each vendor s listing on the Certified Health IT Product List (CHPL) to view certification details: Demand success statistics. Most importantly, any trusted vendor will have a large number of successful implementations. Think hundreds or thousands of proven, strong connections and success stories. You should ask for the number of live interfaces and the number of systems with which your potential vendor connects. Again, the numbers should be impressive. Ask the RIGHT questions first. User experience trumps all. Most importantly, ask current users of the technology about their experience and, if possible, observe their use of any prospective systems first-hand. You want to be part of a winners club of happy connectivity technology users!

8 No industry visibility? No thank you. In addition, any vendor worth your time and resources will have a strong presence and high visibility at healthcare industry events that test and prove interoperability skills. For example: Workgroups: These groups include members of the healthcare information technology community and its stakeholders, such as ONC, Medicare, or large hospital groups. These entities get together in workgroups to solve a particular interoperability challenge. For example, NextGen Healthcare representatives have a long history of leading or contributing to EHRA, Standards & Interoperability, and ONC workgroups. Your potential vendor should be very active in these types of workgroups and its leaders should be chairing committees for them. Why? Because standards are developed in these workgroups, and having a seat at the table is important for vendors. Ask your potential vendors for their workgroup-related involvement and achievements. Pilot Projects: Active involvement in industry workgroups invariably leads to pilot projects at the cutting edge of interoperability technology and workflows. Within the last 12 months, NextGen Healthcare participated in nearly a dozen successful pilot programs including the Beacon Community EMR Vendor Affinity Group, ONC s Prescription Drug Monitoring Program, the MedAllies Direct Pilot, and the Clinical Decision Support Consortium. Connect-a-thons: Whether your potential vendor participates in connect-a-thons is very telling. During these events, vendors test exchanges of nearly every clinical document type through a variety of workflows, including HIE (Health Information Exchange), EHR, and cross-community exchanges. At the end of the event, vendors publish a conformance statement, which lists the types of standards against which each company s technology is certified. Ask your vendor what it has tested in the context of these events and ask to see its outcomes.

9 What s a CCD? Show and tell. CHAPTER A continuity of care document (CCD) can be a thing of mystery. Many healthcare professionals may not really understand what it is, what it looks like, or what it can do. But CCDs are critical to your organization s connectivity, interoperability, and HIE participation and success. CCD generation is required to meet one component of Meaningful Use. We ll also explain the importance of the consolidated clinical document architecture (CCDA) along with the various methods to transport these clinical documents. 3

10 What is a CCD? A CCD is an electronic document standard for sharing patient summary information. These summaries include the most commonly needed pertinent information about a patient s health status, demographics, insurance and healthcare provider information, medications, allergies, and recent medical procedures. What does a CCD do? A CCD is a type of CDA (Clinical Document Architecture). A CDA is the architecture that helps identify the content/ document types that are being exchanged. A CDA s primary purpose is for exchange, specifically exchanging patient content from one care setting to another. It s not intended to be a complete medical history for a patient. Instead, its purpose is to include only the information that s critical to continue care. Also, one of the most important characteristics of a CCD is that it must be human-readable, using any standard Web browser so any patient or clinician can open a CCD and view patient health data. CCD See expanded view of a CCD below.

11 Expanded view of a CCD A CCD includes the following content: Patient Information Intended Recipients Reason for Referral Payers Problems Family History Social History Allergies, Adverse Reactions, Alerts Medications Immunizations Results Vital Signs Procedures Encounters Advance Directives

12 What is a CCDA? The consolidated clinical document architecture (CCDA) is an updated standard format for clinical data. This is the most recent, robust release of a clinical document structure, with substantial coding behind it, that is now required for MU2. Within a CCDA, each data element visible to the user has a rich, uniquely identifiable coding system that helps recipients parse the data and analyze its contents. Additionally, CCDAs have document templates that support a variety of uses, such as Clinical Summary, History and Physical, Consult Note, and Discharge Summary. What does a CCDA do? The richer data requirements of the CCDA support expanded data sharing abilities. CCDAs can be used to provide patient summaries, facilitate transitions of care, and to populate external systems with patient data. Additionally, since the CCDA supports a variety of narrative text entries, we expect CCDAs to be valuable in the support of natural language processing tools. In addition to the original clinical content included in a CCD, a CCDA also includes: Cognitive status Functional status Reason for referral Referring or transitioning provider s name Vital signs height, weight, blood pressure, BMI Care plan field(s), including goals and instructions Procedures Care team member(s)

13 1 2 Must-know list: Key connectivity options You ve got choices when it comes to connectivity. Here are some of the most talked about options: Direct via HISP What is Direct? The Direct Protocol specifics a simple, secure, scalable, standards-based way for participants to send encrypted health information such as a CCD or CCDA directly to known recipients over the Internet. What is a HISP? Direct interfaces can require a Health Information Service Provider (HISP), which is an entity that is responsible for delivering health information messages between senders and receivers over the Internet. What does it all mean? Essentially, the HISP provides the secure transport of the Direct Message content. Direct via HISP is the method of transport for meeting the interoperability requirement in MU2 (Core Objective #15). XDS.b to third party system XDS.b is an IHE, industry standard to provide, register, and retrieve documents from a third party system, such as an HIE. 3 4 An HIE provides a data repository so other people in the community can connect and share documents. The difference between XDS.b and Direct? Unlike XDS.b, Direct messages via HISPs do not get stored in a centralized repository. The message is transient and it is only shared between the sender and recipient. HIEs store a copy of each document submitted to its repository and provides users the ability to query and retrieve clinical data. HealtheWay: This non-profit, public-private partnership supports the ehealth Exchange and is an ONC-approved method for supporting the transport of CCDAs as required by MU Core Measure # 15 Clinical Summaries. (Formerly the Nationwide Health Information Network Exchange). Its mission is to enable the safe, secure, nationwide exchange of health information. CommonWell Health Alliance: This is a vendor- driven effort designed to be an independent non-profit trade association supporting interoperability. CommonWell promotes and certifies a national infrastructure with common standards and policies, allowing built-in EHR data access.

14 Back to basics: why use an HIE? CHAPTER 4

15 Interoperability and coordination are key. True clinical integration of patient care around PCMH and collaborative care ACO models requires healthcare technology interoperability with other organizations. PCMHs need to provide coordinated, proactive care throughout their patients lifetime this isn t possible without a health information exchange (HIE). What s more, ACOs manage risk by managing patient populations. You can better accomplish this with shared data via an HIE. Enable care collaboration, care quality, and patient safety. To connect disparate technology systems and reap the associated benefits of controlled data flow, decreased costs, and reduced errors, you need a powerful and proven HIE. Care collaboration via HIE makes all patient encounter data available in the patient record, helping to improve care quality and safety. Plus, data-driven patient population management decisions enabled by your HIE help to create your desired operational, clinical, and financial outcomes. Make an intelligent business investment. To support the wide variety of business relationships that exist between and among healthcare providers, while focusing on the common goals of improved patient care, effective use of HIE technology is a necessary business tool, and a wise investment. Whatever vendor you choose, ensure your success by leaning on HIE experts who can help you: Map out your short- and long-term HIE strategy Form a viable entity to support your evolving goals Build your scalable technology road map Intelligently leverage your existing technology infrastructure Build and deploy a clinical model/gain physician acceptance

16 Achieving interoperability through HIE technology is crucial for several reasons By effectively sharing information with other healthcare providers, you can improve care quality, coordination, and safety The data aggregated by an HIE is critical to managing the health of your entire patient population HIE technology can improve patient and community relations, while enhancing referral management The HIE can enable more efficient electronic prescribing and pay-for-performance measurement/reporting

17 CHAPTER Open the door to success with the right patient portal. 5

18 If you haven t already taken the plunge with a patient portal, your patients will be asking about it; and you ve probably been considering it. It s called a portal for a reason. Think of your patient portal as the virtual front door to your practice, or as the single online point of entry to your enterprise, whether patient or provider. It s important that your front door is easy to use and clearly indicates where your patients need to go. Pick a smart portal. The right portal will allow your patients to interact seamlessly with your practice, will automate communications to ensure they go to the proper provider or administrator, and will never leave your patients feeling like they must look elsewhere for comprehensive, collaborative care. In other words, your portal has to be smart enough to handle medical, financial, and scheduling tasks automatically. When that happens, patient satisfaction will increase and your patients affinity to your practice will strengthen.

19 To improve care and collaboration within your organization, a Patient Portal is crucial. Why? Keep healthcare providers more involved and connected to patients, and vice versa Help improve disease management and ensure patients are up to date with treatments Enable easy scheduling of maintenance visits by running quick reports by disease state Become a hassle-free practice. Being part of an ACO helps you become a hassle-free practice. The right portal can help you achieve that goal. How? Tightly integrate into your workflow and your EHR and Practice Management solution Quickly and easily enable prescription renewals and facilitate online payments Streamline documentation, such as questionnaires, surveys, and other online forms Simplify and accelerate administrative tasks such as patient intake, calls, s, scheduling, sharing labs, and more Strengthen your bottom line. Also important, a proven patient portal can help improve your bottom line: Reduce expenses via electronic forms and by eliminating snail mail Enable productivity improvements that save time and money Lower the cost of healthcare through better coordination and improved outcomes To achieve your MU Stage 2 and 3 goals, and hit your PCMH or ACO objectives, a patient portal is not only essential, but required! The right portal will deliver the communication capabilities needed to reach these goals and give patients a more active role in their own care and involvement in how their data is managed, all while enhancing your productivity. Not every patient portal will integrate into your EHR. If it won t, you ll need a third-party interface. That s a big consideration as you evaluate the right portal for your organization.

20 CHAPTER Connecting the dots. 6

21 No matter where you are on your connectivity journey, we hope you found this ebook interesting, educational, and helpful. Do you now know enough about connectivity, interoperability, and the capabilities of an HIE to be dangerous? Do you have a better sense of what questions to ask potential vendors? Do you know how an HIE and Patient Portal can help your organization succeed? If you still have questions, we have answers. Don t hesitate to reach out to our experts. We re happy to consult with you, help you solve your connectivity challenges, or just give you some peace of mind by sharing the many success stories from our 30,000 HIE provider-users. It all starts with connectivity. Get connected. Be interoperable. Start now!

22 NextGen Healthcare Information Systems, LLC, a wholly owned subsidiary of Quality Systems, Inc., provides integrated clinical, financial and connectivity solutions for ambulatory, inpatient, and dental provider organizations. For more information, please visit nextgen.com and qsii.com. Copyright 2013 NextGen Healthcare Information Systems, LLC. All rights reserved. NextGen is a registered trademark of QSI Management, LLC, an affiliate of NextGen Healthcare Information Systems, LLC. All other names and marks are the property of their respective owners. Patent pending. EDU18-7/13