ONC & Federal Health Architecture (FHA) within the NHIN and CONNECT area 25 demos

Some of the best demos at HIMSS10 of real world solutions to using health IT to meet the 4 key goals of ARRA      are at the Interoperability Showcase, Hall C, Booth #233

1. Improving Quality, Safety, Efficiency and Reducing Health Disparities
2. Improving Care Coordination
3. Engaging Patients and Families in Their Health Care
4. Improving Population and Public Health
    

Communities CONNECTing to the NHIN

Organizations throughout the country – including federal agencies, states and private sector organizations – are making real progress in achieving nationwide health IT interoperability. The Nationwide Health Information Network (NHIN) is providing the framework for interoperability – including the standards, services and trust fabric – and CONNECT delivers an open source solution for organizations wanting to use the NHIN.

The Federal Health Architecture and the Office of the National Coordinator for Health IT (ONC) are sponsoring a series of demonstrations within the NHIN and CONNECT area in the HIMSS Interoperability Showcase that illustrate progress toward interoperability. 

The 25 demonstrations involving 42 organizations show a broad range of uses for the NHIN, including improving care coordination, streamlining benefits determinations, and advancing public health, among others.
The demonstrations are divided into four categories that align with key health outcome policy priorities:

• Improving Quality, Safety, Efficiency and Reducing Health Disparities
• Improving Care Coordination
• Engaging Patients and Families in Their Health Care
• Improving Population and Public Health

Demonstrations in each of these four areas also include another key priority: Ensuring Adequate Privacy and Security Protections for Personal Health Information. All of the priorities are outlined in more detail in the Interim Final Rule (IFR), an initial set of standards, implementation specifications and certification criteria released by ONC on December 30, 2009, with a request for comments (read the IFR and comment
online at http://healthit.hhs.gov/portal/server.pt?open=512&objID=1153&mode=2).

Engaging Patients and Families in Their Health Care

Promoting health IT interoperability delivers on one of the main priorities outlined in the Interim Final Rule, namely “Engaging Patients and Families in Their Health Care.” This priority is associated with a specific care goal:
• Providing patients and families with timely access to data, knowledge and tools to make informed decisions about their health. Organizations working to deliver information to patients and their families to empower them to be more active in managing their health care.

Protecting Soldiers Using Health Information

Military Health System’s MiCare Portal
The U.S. Army enables soldiers and their families to manage their electronic personal health records worldwide online. This demonstration will highlight the Military Health Systems’ (MHS) MiCare patient portal that allows military beneficiaries to export and share their personal health information online and take best advantage of the expanding ecosystem of PHR applications for personalized patient decision support.

Engaging Patients in Their Care

Spartanburg Regional Healthcare System
Spartanburg Regional Healthcare System will demonstrate a model for providing private-sector physicians access to federal health summary information when caring for military personnel. The demonstration includes the ability for the patient to participate directly in the health information sharing through a connected personal health record.

Enabling PHRs with Wireless Technology

Meridian Health
As a premier provider of hospitals in New Jersey, Meridian Health delivers a broad continuum of care through its five hospitals. This demonstration will highlight how wireless technology such as a remote patient monitoring system can enable personal health records (PHRs) to aid in the care of the more than 250,000 people who visit Meridian Health’s hospitals in Monmouth and Ocean Counties.

Empowering Consumers with Family Health Data

Surgeon General’s “My Family Health Portrait”
This demonstration will showcase how the Surgeon General’s “My Family Health Portrait” Web tool helps consumers easily gather their family health histories, and then assembles this information in a structured format. The solution enables families to work together in gathering histories; helps providers obtain better family history information; provides data in formats that can be saved in interoperable form in EHRs/PHRs; and enables the consumer to obtain automated, personalized health information from Web-based services. The demonstration will use Mayo Clinic Health Manager to showcase interoperability.

Improving Quality, Safety, Efficiency and Reducing Health Disparities

One of the five health outcome policy priorities outlined in the Interim Final Rule is entitled “Improving Quality, Safety, Efficiency and Reducing Health Disparities.” This priority is associated with specific care goals, including: 

• Providing access to comprehensive patient health data for patient’s healthcare team
• Using evidence-based order sets and Computerized Physician Order Entry (CPOE)
• Applying clinical decision support at the point of care
• Generating lists of patients who need care and using them to reach out to patients
• Reporting information for quality improvement and public reporting

The descriptions below provide a brief synopsis of the demonstration scenarios occurring related to this outcome goal within the NHIN/CONNECT area.

Supporting Midwestern Grandparents on Vacation

Redwood MedNet, HealthBridge, Thayer County Health Services
HealthBridge, a large urban HIE in Cincinnati, Thayer County Health Services, a community HIE in southeast Nebraska, and Redwood MedNet, a rural HIE in California, will demonstrate how the CONNECT toolkit enables the use of health data as farming community grandparents from Nebraska travel across the country visiting their urban daughter in Cincinnati and grandsons in California. As they visit the different HIEs, the three HIEs exchange electronic medication and diagnostic health data, thereby improving the quality, safety and efficiency of their care.

Simplifying Medicaid Administration through Collaboration

Community Health Information Collaborative (CHIC), Medicaid Information Technology Architecture (MITA) System, Medicaid Provider Portal
This demonstration of MITA and CONNECT collaboration will illustrate the interaction between Medicaid providers and a states’ MITAbased Medicaid system to support the workflow associated with verifying a member’s eligibility. This demonstration illustrates how NHIN services are applied to existing, industry-standard interfaces and aligned with the Medicaid Information Technology Architecture.

Improving Adverse Event Reporting

Food and Drug Administration, Safety Reporting from EHR, Brigham and Women’s Hospital
In this demonstration, adverse events related to human medical products are captured at the point of care within electronic health record systems and reported to the Food and Drug Administration (FDA) directly via built-in reporting capability in electronic health record systems. This automated adverse event reporting capability has the potential to ease the burden of reporting for healthcare providers and provide timely, high quality information required by the FDA and the biopharmaceutical industry.

Improving Care Coordination

“Improving Care Coordination” is one of the central outcome goals outlined in ONC’s Interim Final Rule. It focuses on promoting information sharing among care providers to aid in improving care for U.S. citizens. This priority is associated with the specific care goal of:

•  Exchanging meaningful clinical information among a professional health care team

The descriptions below provide a brief synopsis of the demonstration scenarios occurring within the NHIN/CONNECT area at HIMSS. These demonstrations illustrate the progress organizations are achieving in sharing health data to support citizen health.

Coordinating Care Across California

East Kern County Integrated Technology Association,  Long Beach Network for Health,  Santa Cruz Health Information Exchange
Care coordination represents one of the most promising ways to increase patient safety, improve outcomes and avoid unnecessary procedures. This demo shows how an emergency department physician can evaluate information from different care episodes in far-flung communities across California while addressing an emergent health situation. HIE enables choice of the proper treatment, avoiding a dangerous invasive test, because a more complete knowledge of the patient was available.

Delivering E-Care and EHR Interoperability

Federal Communications Commission,  University of Virginia
This demonstration will follow a veteran from Charlottesville with high blood pressure who develops signs and symptoms of a stroke while traveling in rural Virginia. The demo outlines his coordinated care experience from the community hospital, to the University of Virginia Hospital and finally to his home.

Enhancing Value in Health Care through Health Information Exchange

Mayo Clinic, HealthPartners, Minnesota HIE
This demonstration will illustrate how health information exchange from HealthPartners to Mayo Clinic through the Minnesota Health Information Exchange using CONNECT can add value by enabling the exchange of continuity of care documents for a patient with a complex medical problem. The information in this demonstration is a prototype, but based upon true-to-life cases.

 A Path to Improved Care: Communities CONNECTing to the NHIN Processing Claims with Authorized Release of Information

Social Security Administration, MedVirginia
The demonstration will show how the Social Security Administration requests information from a medical provider (MedVirginia) based on authorization to release information and receives the information using the NHIN. The information flow is seamless and does not require any human intervention. This exchange of information dramatically reduces the time required for the exchange compared to the traditional paper process.

Releasing Authorized PHR Information Over the NHIN

Social Security Administration, Personal Health RecordThe demonstration will show how the Social Security Administration can potentially interact with a PHR using the same technology that it uses to request and receive information from a provider. The information obtained through this interaction can reduce the stress on the claimants by automatically populating the information into the disability application rather than having them fill the information out manually. The demonstration is a technical proof of concept which tries to identify the policy and technical issues to make this interaction work in a production setting.

Enhancing Tribal Care Coordination

Indian Health Service
This demonstration showcases cross-agency, cross-region and cross-facility health information retrieval from across the IHS enterprise-wide health information exchange utilizing the NHIN. The demo will show a provider retrieving C32 documents by logging on to the Universal Client and navigating through the workflow to search for the patient, obtain patient document links, and finally, retrieve the documents.

Delivering HIE Through Medical Grade Networks

Wels Hospital
The session will illustrate how Wels Hospital is utilizing a standards-based architecture to deliver medical data securely and costeffectively over its network. It will explain how Wels Hospital is addressing its need to exchange data between disparate systems and align with national and European data exchange initiatives. It will also describe how Wels Hospital will participate in the ePSOS project, the European initiative similar to the NHIN.

Enhancing Wounded Warrior Care

Department of Defense, Department of Veterans Affairs, Kaiser Permanente
Using fictional, but true-to-life medical encounters and real-time NHIN information exchanges, this demonstration will illustrate how the data exchange through the NHIN can support continuity of care for the wounded warrior patient population.

Exchanging Medical Records During Disasters

National Disaster Medical System, Department of Health and Human Services
This demonstration will highlight a hurricane scenario in which patients in high risk areas are evacuated to remote locations. This scenario will record the initial patient encounter at the high risk location and illustrate the ability for medical teams to access the patient’s record once relocated to an evacuation site.