The New Statewide Clinical Data Repository€¦ · 18-03-2016 · •Data segmentaon, privacy and...
Transcript of The New Statewide Clinical Data Repository€¦ · 18-03-2016 · •Data segmentaon, privacy and...
WSHIMA 2016 Annual Mee1ng
April 29, 2016 Lynnwood, WA
The New Statewide Clinical Data Repository
Session Objec1ves
• Background–howwearrivedhere• TheWALink4HealthClinicalDataRepository(CDR)• ClinicalinformaDonexchange,thestateHIEandaccessingtheCDR• DatasegmentaDon,privacyandsecurity• ParDcipaDonrequirements• TheRoleoftheHIMProfessional• GeMngstartedwiththeCDR
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The Framework for Strategic Ac1on
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“Wewillhavefailedthoseweserveifwedon’tovercometheinteroperabilitychallengesthatmakeitdifficulttodeliverconnectedandcoordinatedcare.”
Mee1ng Emerging Needs
SponsorClinicalDataRepository
(CDR)Pla5orm
Moreorgsgoingatriskforperformance,needinfo/analy>cstohelpmanagethatrisk
Neworganiza>onalarrangements(ACOs)requirecapabili>esoutsidetradi>onalenterpriseHITresources
Needsincluderepository,analy>cs,repor>ng,individualcareandpopula>onmanagementtools
DataneedsgobeyondcurrentclaimsandADT,includeclinicalsummaries,care
plans,assessments
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The Strategy: Advance Health IT Beyond Organiza1onal EHR’s with a CDR
• TheWALink4HealthiniDaDveispartoftheState’slong-termeffortstoimprovehealthcarequality,beVermanagecostsandimprovehealthoutcomesforallWashingtonians.• HCAisiniDaDngWashingtonLink4Health,amulD-yeariniDaDvetoadvancethestatewideelectronicexchangeofnearrealDme,consolidatedclinicalrecords.
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Staged Implementa1on- Mul1 Year Effort
• IniDalservicespurchased– Clinicalportal– ReporDngportal
• ImplementaDonunderway• IniDallivescommiVed
– AppleHealthEnrolleesassignedtoManagedCare(1.4M)– MorelivesoverDmesuchasPublicEmployees,feeforservice,othersponsors.
• IniDaldatasets– CareSummariesfromProviderEHRsystems– Eligibilitydata– Claims/Encounterdata(6mthinclinicalportal&2yearsinreporDngportal)
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What is the Clinical Data Repository? • AClinicalDataRepositoryorCDRisadatabasedesignedtocollectandindexclinicalcontentforspecificuses.– CreatealongitudinalviewofallcareprovidedonasinglepaDent(paDent-centric,point-of-careaccessforpracDDoners)
– ClinicalPortal– AggregatedatathatcanbeusedinpopulaDonanalyDcs– AggregatedataforperformancereporDngtoprovidersacrossalllivesmanagedbytheprovider
– ReporDngPortal
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Par1cipa1on in Link4Health Helps Meets Stage 2 MU Requirements
• DriveadopDonofclinicaldatasharingviatheStateHIEthroughpurchasingeffortsandMeaningfulUse.• ReducetheneedtobuildexpensivepointtopointinterfaceswithmulDpletradingpartnersoutsideyourorganizaDon.• EnableeligibleprofessionalsandhospitalstomeetMUrequirementsandtapintoremainingincenDves.
Note:HCAisworkingwithCMStoensurecontribuEngdata(CCDA)totheCDRmeetsMUrequirementsforexchangingsummariesofcareacrossvendorplaMorms.
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CDR Features and Benefits
• Leveragesstandardsforsharingclinicalsummaries• SupportsclinicaldataexchangewithorganizaDonswithoutsimilarplaborms• OfferscommonplacetoshareinformaDonforthoseparDcipaDngindifferentarrangements• AggregatesclinicalandadministraDvedataintolongitudinalpaDentrecord• AvailablebeyondMedicaidandPEB
• MayhelpprovidersmeetongoingMeaningfulUseObjecDvesandqualifyforaddiDonalincenDvepayments• ProvidesthecareteamamorecomprehensiveunderstandingofthepaDent’smedicalhistory.• ProvidesmainstreamqualityreporDngcapabiliDes• EnableslargedataextractsforadvancedanalyDcsandpopulaDonhealth
Features Benefits
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CDR Portals
• Clinical:ViewindividualpaDenthealthinformaDonforcaredecisionsandcoordinaDon.– Buildscomprehensivemedicalrecordincludingdiagnoses,meds&allergies.– EnablesdatasharingregardlessoftheEHRvendorsystem.– ProvidesasinglesourcetoviewfullpaDentprofileandmedicalrecord– ResultsinloweradministraDvecostsandimprovedpaDentsafetybyloweringthefrequencymedicaDonerrors
• Repor>ng:Viewaggregatede-idenDfieddataforclinicalqualityreporDngandpopulaDonmanagement.– Receive,parseandsortclinicalandadministraDveinformaDonfromavarietyofsourcesandinvariousformsandformats.
– Usea“digitalenvelope”toinformclinicians,providingreal-DmereporDngonpaDentqualityatthepointofcare.
– Storedisintegrateddatasothatphysicianscanaccessdatatheyneedtodeliverevidenced-basedmedicineandhighqualitycaremanagement.
– Develop,interpretandreportonstandardCMSandstatespecificqualitymeasures.
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High Level Timeline and Gates
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What Does Provider Par1cipa1on Look Like?
• January2016MCOssentHCA’s“ProviderPar>cipa>onLeQer”totheirprovidernetworks:
hVp://www.hca.wa.gov/HealthIT/Documents/Provider%20Requirements%20LeVer%202015%2012%2021.pdf
LeQerContained:
1.IntroducDontotheCDRtotheprovidercommunity2.ListofthethreecriteriadefiningwhoisrequiredatthisEme -ContractwithMCOtocareforAppleHealthenrollees
-Haveanelectronichealthrecord-Havea2014cerEfiedEHR3.ClarificaDonforprovidersthattheyneedtobegingeMngreadysooninpreparaDonfortheFebruaryof2017deadlinetobecontribuDngdata4.Linkto“howtogetstarted”tools
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C-CDA=(ConsolidatedClinicalDocumentArchitecture)–modular
Na>onalstandardforclinicalinfoexchange
Cer>fiedEHRsdesignedtoexportandingestC-CDA
Earlyinthegame–aworkinprogress
C-CDA – Clinical Document Standard
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CDR Business Model
• SponsorpaysforCDRcosts• TradingPartnersmustbecomeHIEParDcipants– Mosthospitals,somepracDcesalreadyparDcipateinHIE
– HIEParDcipantsexecuteacommoncontractualframework
• HIEParDcipantspayasingleannualsubscripDonfee– Coversallservices,notransacDonfees
• HIEParDcipantannualsubscripDonfeesderivedfrommatrixbelow
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AnnualOrganizationRevenue AnnualSubscriptionFee $0–$10Million $600
$10Million–$100Million $6,000
$100Million–$500Million $12,000
$500Million–$1Billion $24,000
$1BillionPlus $48,000
EHR Vendor Role VendorsplayacriDcalroleinsupporDngproviders’abilitytomeetC-CDAdatacontribuDonrequirements
EnsureC-CDAmeetsfileformatconformanceagainstna>onalstandardWorkwithprovidertoclassifydataasN,RorVSet-upconstraintsforC-CDAmessageheaderAllowparameterstobesetbyprovidertotriggerdatasubmissionperSponsorspecifica>ons
AutomateC-CDAdatasubmissionprocesstotheCDR
OneHealthPortEngagedwithEHRVendors
• OHPworkingwithEHRvendorstoaddresstechnicalrequirements• WhatyourEHRvendorhastodotosubmitaC-CDAtoCDRwilldependonwheretheyaretoday• OHPschedulingwebcastsforEHRvendors/technicalITstaffandotherpracDcestaff• CDRTechnicalWebcastsign-uplinkhVps://onehealthport.formstack.com/forms/cdr_technical_webcast_registraDon
• CDRProviderStaffWebcastsign-uplink:hVps://onehealthport.formstack.com/forms/cdr_clinical_webcast_registraDon
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Access Controls and Data Classifica1on
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• AuthenDcateconnecDons
• UseProviderDirectorytoroutemessages
• Facilitateexchangeofstandarddata
• HostAPI/webservices• APIDirectory• StandardsPropagaDon
C-CDAResponsetoAPIQueryfrom/toEHR
HospitalEHRspushC-CDAtoCDRapereachMedicaidencounter.AperacriDcalmassofdataisreached,hospitalscandrawC-CDAfromCDRintotheirEHRthroughtheHIE,orviewCDRthroughsecureportal.
Push
EHRpushesC-CDAtoCDR
ViewonlyuseoftheCDRusingPortal
Accessing the CDR Sponsorbulk
loadsclaimsandeligibilitydata
SponsorandotherauthorizedparDescanaccessreports
and/ordata
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Data contributed to the CDR is classified to provide confiden1ality, data integrity and user
accountability
Data Classifica1on conforms to HL7 na1onal rules.
Organiza1ons contribu1ng data are responsible
for classifying the data prior to submiang to the CDR
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Data Classifica1on • CDRdatasubmissionsmustbeclassified– DataclassificaDonperHL7specificaDons– ClassificaDonprovidesconfidenDality,dataintegrity,anduseraccountability
• OrganizaDonscontribuDngdataareresponsibleforclassifyingthedatapriortosubmiMngtotheCDR
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CDR Access Levels • AccesscontrolisdelegatedtotheproviderenDty• LeveragetheOHPSingleSign-Onservice• Sevenaccessrolesareestablishedforthefirststage• AppropriateaccessguidedbytwokeyquesDons:
– WhatlevelofpersonallyidenDfiableclinicaldatadoesthisuserneed?
– WhatneeddoesthisuserhaveforpopulaDon-levelreports?
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Repor1ng • Reportsbasedonaggregatedclinicalandclaimsdata– Clinicalsummarydatacontributedbyprovidersaperencounter– 2yearsofhistoricalclaimsplusmonthlyupdates
• IndividualProvider,Team/Dept.,OrganizaDonandSponsorviewsofdataavailable• DimensionsreportsmaptotheQualityMeasuresthatSponsorshaveelected:– Financial(e.g.,highcostpaDents,providers,PMPM)– ACOReports– PQRSReports– HEDISStarMeasures– WashingtonStatePerformanceMeasureSet
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Safeguarding Privacy and Confiden1ality
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• HCAiscommiQedtopa>entprivacyandaccuracyofpa>entrecords• CurrentEffortswithinter-agencyprivacyworkgroup:– OpennessandTransparencyprinciples– Datacollec>on,useanddisclosureprinciples
– Safeguardprinciples(administra>ve,technical,physical,etc)
The Role of Health Informa1on Management
• ReinforceinformaDonregardingthepurposeandbenefitsoftheCDR
• CollaboratewithITandclinicalleadershiponreadinessacDviDes(role-basedaccessandbusinessprocessanalysis)
• ProvideanyguidanceneededregardingtheclassificaDonofdatafordataexchange
• ReinforcewhatdataexchangeisallowableunderHIPAA• Contributecomments/feedbacktoSAMSHAregarding42.2CFRproposedrule-making
• ReinforceneedforstafftocompleteCDRtraining
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Geang Started With the CDR
CDRStartPageprovidesallthestepsneededforproviderstoonboard,testandcontributedatafortheWashingtonLink4HealthCDRiniDaDve
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Next Steps/Ques1ons • HCAandOneHealthPortwelcomeopportuni>estoexpandontoday’ssummaryoverview• Generalques>onsaboutCDRpar>cipa>[email protected]
(Put“CDR”inthesubjectline)• ForQues>onsaboutyourMCOcontract:contacttheproviderrepresentaDvefortheMCO• Visitourwebsite:www.HealthIT.wa.gov
– Shortinforma>onalwebinars– FAQandDecisionTreeregardingCDRpar>cipa>on– Otherhelpfulreferencematerials
• Generalques>onsaboutpar>cipa>ngintheHIEorconnec>ngtotheCDR:hVp://www.onehealthport.com/HCA_CDR
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