Marilee Benson, Vice President of Sales -...

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What’s all the smiling about?

Marilee Benson, Vice President of Sales


Making a difference in people’s lives:

Greater Cincinnati Beacon Collaboration

Mirth HIE functionality:

Automated ED/IP alerting

Results:

Alerted Medical homes call ED’s - Reducing “time between pediatric asthma related admissions” by more than 100 days for children on Medicaid.



GNOHIE


Automated ED/IP alerting

Results:

Alerted Nurse-Care Managers calling medical home patients before they are even discharged from the hospital to coordinate post discharge follow-up care (and reduce admissions).




End to end message integration

(The Invisible HIE)

Results:

Supporting an optimized workflow means that Clinicians receive the right information at the right time for the best possible patient care and drives adoption.


Notable HIE Customers

HealthBridge (Greater Cinn. Beacon) 4M members, 25 hospitals, 5,500 providers

Colorado Beacon Community 1M members, CDR/EMPI, Legacy System Augmentation

Crescent City Beacon Community ToC, ED/IP, CDR, EMPI, Direct, Chronic Disease/Care Management

San Diego Beacon Community VLER, CDR, Direct

Inland Northwest Beacon Community VLER, CDR

Southern Piedmont Beacon Community CDR, EMPI, Data Integration

Southeast MN Beacon Community

Regional, Federated HIE Infrastructure

Lone Star Circle of Care 25 clinics, ACO

Redwood MedNet Rural HIE

Mayo Clinic Cross Enterprise HIE, 7.8M members


Mirthies

• Local • State • Federal • Foreign

• Hospitals • Clinics • Labs • Radiology • Universities

• HIEs • Beacon

Communities • ACOs • VANs

• HIT Vendors • Service Providers • Integrators • Consultants


Mirth Corporation Software

Development Healthcare

Focus Mirth

Products Headquartered in Irvine, CA

• Global leader in commercial and open source software for Health IT

• Revolutionizing how organizations adapt to evolving HIT requirements and push towards digital, interconnected ecosystem

• Family of Mirth products connect seamlessly and naturally within the HIT ecosystem

• Solution to satisfy demands from private and public HIEs and the emergence of ACOs

1993 1999 2006

19 Years 13 Years 6 Years

Professional Services

Hosting

Support

Appliances

Training

Licenses


What do Mirthies want? A private, profitable company with accessible decision makers

An open SOA technology that supports extensibility, flexibility and nimbleness

To be empowered

Access to a highly experienced, skilled and knowledgeable technical team

Affordable HIE components that scale and integrate well


Mirth Products Mirth Connect Healthcare Data Integration Engine – Open source and commercial licenses

Mirth Results Clinical Data Repository and HIE Portal

Mirth Match EMPI and RLS

Mirth Mail Direct Project Messaging & Provider Directory

Mirth Analytics Healthcare Business Intelligence, Reporting and Analytics

Mirth Care Chronic Disease Management and Care Coordination

Mirth SignOn Single Sign-on Solution

Mirth Appliance Ready-to-Run, Secure, Optimized Server Platform for Mirth Applications

Mirth Appliance

Mirth Care

Direct Messaging

Mirth Match

Mirth Mail

Mirth Connect

NwHIN Exchange

Clinical Data &

Systems

Mirth Results

Mirth Analytics

Mirth SignOn

Provider Directory


Mirth Connect Overview • Healthcare integration engine and administration tool

– Cross-platform. Any operating system that can run Java

– Feature comparable to top proprietary systems (tens of thousands of users worldwide)

– Released in 2006 – newest version coming soon!

• v3.0 Beta 1st Quarter 2013

• Easy to Use and Powerful

– Graphical administration tools

– Simple channel-based interface


Mirth Connect Overview • Flexible

– Multiple routes, filters, and transformations

– Extensible via Java and JavaScript

– Plug-in architecture

• Cost Effective

– Open source license option

– No “per interface or user” fees

– No “additional instance” fees when running Mirth Connect on appliances

– Commercial support, training, and consulting services


Mirth Connect Premier healthcare data integration engine. Quickly and easily transport healthcare information between data sources and destinations.

Supported Messages Types: • HL7 (v2 & v3) • XML • DICOM • NCPDP • X12/EDI • Delimited Text

Included Connectors: • MLLP • TCP • HTTP • FTP/SFTP • File System • Web Services • JMS • Database • Email • PDF/RTF • JavaScript • NwHIN Connectors • Channel Report Tool


Mirth Results is a Clinical Data Repository and Provider Portal that supports healthcare clinical data aggregation and data exchange for HIEs, hospitals, and other clinical settings.

Focuses on efficiently building comprehensive longitudinal patient record from many various data sources.

Also emphasizes capabilities for data standardization and normalization.

Mirth Appliance

Mirth Care

Direct Messaging

Mirth Match

Mirth Mail

Mirth Connect

NwHIN Exchange

Mirth Analytics

Mirth Results


Standards-Based Leverages Mirth Connect integration engine, Mirth Match (EMPI) and Mirth Mail Supports consumption of HL7 v2.x, HL7V3, NCPDP and DICOM messages to populate clinical repository. Consumes CCD, C32, C37, C48 messages which adhere to the general CDA and HL7 v3 standards Provides flexible and practical integration with popular EMR, EHR, LIS, PACS and other HIS data sources. Supports IHE standards for XCPD, XCA and XDS.b document submission and retrieval.


Integrates with EMPI Integration with Mirth Match EMPI.

Master Data Management Tool

• Master Patient Index

• Master Provider Index

• Master Facility Index

• Record Locator Service

Provides support for patient longitudinal record, record locater service (RLS), duplicate & overlay detection and notification patterns to source systems.

Mirth Appliance

Mirth Care

Direct Messaging

Mirth Mail

Mirth Connect

NwHIN Exchange

Mirth Analytics

Mirth Results

Mirth Match


Longitudinal Health Record As clinical data is received from multiple sources it is integrated with an existing community patient record, which allows for a full longitudinal view of the patients clinical data over time.

Multi-tenant: Supports storing clinical data for multiple segregated communities with one application instance.


Enhanced Results display The Patient Summary page has been enhanced such that detailed information about an item on the page can now be viewed without leaving the page.

This allows the provider to view all information for the patient without having to move from page to page.


Confidentiality Mirth Results supports confidentiality at a data element level via our use of clinical concepts.

Data can be marked either (R)estrictive or (V)ery restrictive.


Confidentiality

To view restricted or very restricted data, you use the Unlock Sensitive Data option which results in an audit of the request.


Consent Management Results has a very robust Consent Management system that allows you to specify consent at a Site, Source, and Provider level. For each of these, a patient can decide to Opt-In, Opt-Out, or allow “Break the Glass”. Opt-in means that his data is always visible, Opt-Out means that his data is never visible, “Break the Glass” means that by default, his data is not visible, but a Provider can use the “Break the Glass” feature of Mirth Results to see the patient’s data.

Default Consent can also be set at both a Site and Source level. For example, if you set a Source with default value of “Opt-In”, all patient data from that Source will be visible unless the patient has explicitly set it to Opt-Out or “Break the Glass”. This is contrast to a Source with a default value of “Opt-Out”. In this case data from that Source would never be visible unless the patient has explicitly set his consent to Opt-In or Break the Glass.

Consent can be set by a user of Mirth Results and it can also be set via HL7 message.


Patient Population Powerful community patient search.

Build patient groups or cohorts on filter criteria.

Direct export or import patients from flat files or XML or web-services

Search the the CDR or using the integrated MPI.


Lab Results Automatically highlights out-of-range result values.

Deliver results to ordering providers.

Supports searching for clinical data on a multitude of dimensions, including but not limited to: report dates, critical values, providers, labs, demographics, order and result codes.

Display lab results on screen, print or Fax as PDF.


eHealth Exchange NwHIN CONNECT

Supports Patient Discovery, Document Query, Document Retrieve and so-called Document Push (XDR) natively via direct integration with OSS CONNECT eHealth Exchange platform. (formerly NwHIN)


Providers Complete interface for managing and grouping providers.

Track provider aliases from multiple data sources.

Associate providers with patients and assign rights to authorized user accounts.

HPD and HPD+ support


Export Data Automatically generate PDF documents from stored data for archival.

Easily import/export patient and provider data.

Utilize Mirth Connect, Web Services or Agents to transmit data to other systems.


Secure Messaging Forward individual documents via fax, Direct (Mirth Mail) or secure internal messaging to other users.

Route incoming data to downstream consumers using Clinical Message Delivery rules.


Code Mapping Codes data to terminology standards for reporting.

Import standard or custom code sets for mapping incoming data.

Concept Mapper tool allows you to to map local codes (for example, lab codes) to standard code sets.

Provided code sets include: ICD-9, NDC, HL7, and LOINC.

Other code sets can be added once licensing requirements are met.


Administration Use the web-based administration user interface to create users and manage user roles.

Setup Providers, Provider Groupings and ad-hoc Subject Groupings.

Manage system settings and application plugins.

Setup scheduled jobs and monitor job queues.


Audited Role-Based Access Access to clinical data is secured through a role-based access system that can be configured by several dimensions (such as provider or lab).

Viewing of clinical data either through the user interface or API are audited and include the requesting user, the time, and the request type.

Supports LDAP and Mirth Sign-On as authentication back end.


CDAPI

“reaction is hives”

<entryRelationship typeCode="MFST” inversionInd="true”> <observation classCode="OBS” moodCode="EVN”> <templateId root="2.16.840.1.113883.10.20.1.54"/> <code code="ASSERTION” codeSystem="2.16.840.1.113883.5.4"/> <statusCode code="completed"/> <value xsi:type="CD" code="247472004” codeSystem="2.16.840.1.113883.6.96” displayName="Hives"/> </observation> </entryRelationship>

Java Library for CDA document creation and consumption.

Fully integrated with Mirth Results.

Document templates included: • C32 • C37 • C62 • SSA compliant C32

Convert to and from the Mirth Clinical Data Model.

Highly simplified document creation.


Mirth Agents Parse incoming messages and place the associated subject into a subject group.

Use to configure alerts, build reports, and trigger workflow.

Uses cases include care coordination and chronic disease management, as well as supporting public health reporting. For example:

• ED alerting for Primary Care physicians

• Inpatient discharge alerting for physician(s)

• Encounter alerting for specified patient cohorts (diabetic patient)

• Public Health Reporting

Clinical Data Model

•Monitor data flowing through Mirth Results

Is Interesting?

•Set criteria to trigger the Agent Process

Process •Perform

action and collect Agent Payload

Approve Group

Membership

•Associate Patient with Subject Group

Subject Group

Member

•Stores the Agent Payload for the Patient


WEBMAIL CLIENT

REGISTRATION

ADMIN UI

PROVIDER DIRECTORY


Web Registration System


Webmail Client


MIRTH MAIL v1.3.6 PRODUCT FEATURES

Feature Standard Implementation

Custom Implementation

Notes

Compatible w/ Direct Specification X Mirth Mail is compatible with ONC’s Direct Reference Specification.

Hosted in Mirth’s Data Center X We can host your HISP on a VM hosted in our SAS 70 data center.

Hosted in Your Data Center X Mirth Mail can be delivered on a VM and hosted in any VMware-

compliant infrastructure.

Webmail Email Client X A robust webmail client is included for providers, organizations and

delegates to use to send Direct-compliant messages.

Provider & Org Directory White Pages X A web-facing provider and organization directory that can be public or

private to display information for provider and org discovery.

Admin Interface X Web-based Admin tool to handle all the operations of your HISP

Registration X A generic web-based registration allows new HISP members to join.

Federated Queries X X Query other HISPs to do Provider & Org discovery, done via a DSML

service based on the IHE HPD specification.

Notifications X Send a notification email to your standard non-Direct email address

that you have a new message at your HISP.

Reports X Mirth has built over a dozen standard reports to run within the Admin

UI.

Multi-Domain Aliasing X Orgs can have their own domain name, an alias of their HISP account.

Account Creation via Importing X A built-in CSV importer tool to auto-create accounts.

Certificate Self Installation X Upload and install certificates yourself from the Admin Interface.

Delegation X Allow another user to be a Delegate which grants access to that

Delegate to read/respond on behalf of the Delegator.

End User Account & Profile Management X End users may update their profile data, change their passwords, or

recover lost account IDs or passwords.

Single Sign-On Between Mirth Mail

Components X Users can go between the Webmail client and the White Pages

seamlessly without having to log-in more than once.


Healthcare Provider Directory (HPD) / White Pages


Trust Establishment & Trust Anchors • Trust is secured at the HISP level

between organizations

• All members within the same HISP may message each other. If TAs have been installed, all entities in one HISP may message all entities at the other HISP, and vice versa.

• Providers may only message others outside their HISP if both HISPs have exchanged Trust Anchors (certificates)

• Trust Anchor CA Certs (x.509) only works in a one-to-one HISP relationship environment. (In cryptography, X.509 is an ITU-T standard for a public key infrastructure (PKI) and Privilege Management Infrastructure (PMI). [Wikipedia]


Deployment Options Mirth Results can be deployed using one of three convenient deployment options:

1. Mirth Physical Appliances in your data center;

2. Mirth Virtual Appliances running on a VMware or Xen-based virtual infrastructure in your data center or using a third-party hosting provider;

3. Turn-key Mirth Hosted Appliance service managed by the expert engineers on Mirth’s Operations Team.

Select the standard approach that best fits your needs, or talk to Mirth about your unique requirements.


Mirth Appliance Ready-to-run server platform for deploying Mirth applications. Applications are pre-installed and pre-integrated, ready to configure. Built by Mirth for optimum security and performance.

Easy setup and management through a browser-based control panel.

Simplified upgrades with built-in software update service.

Improved data connection uptime with Mirth Connect fail-over clustering service.

Enhanced hands-on support with Mirth SupportNet service.

Available as physical hardware appliances or as virtual appliances running on customer-provided Vmware or Xen virtual server infrastructure.


Two independent data sets yielded convergent results, showing that adoption of EHRs by family physicians has doubled since 2005, exceeds other office-based physicians as a group, and is likely to surpass 80% by 2013.

MU2 emphasis on Health Information Exchange & Standards HIE to HIE HISP to HISP

Financial Incentives rewarding “sharing” • Readmission

penalties • Pay for

Performance • ACO’s

Is Health Data Exchange at a tipping point?

Right data for the right patient at the

right time


What could possibly go wrong?

Security & Privacy

Consent

Highly Sensitive Data

Constantly changing standards

HIE Sustainability

Changing healthcare policies

EMR Vendor Consolidation

Data Quality


What’s all the smiling about?

Q & A

Marilee Benson, Vice President of Sales

[email protected]

Marilee Benson, Vice President of Sales -...

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