Inside a Private HIE: Clinical, Economic and Operational Successes at The Washington Hospital
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The Washington Health Information Network (WHIN) is a private health information exchange (HIE) that connects The Washington Hospital and physician practices affiliated with the Washington Physician Hospital Organization (WPHO). MobileMD is the backbone of WHIN. Denise Abraham, the health information exchange coordinator for The Washington Hospital, and Charles R. Vargo, executive director of the WPHO, work closely to keep this vital piece of caregiver connectivity alive. WHIN is having a positive impact on patient care and clinical practice by increasing physician knowledge and boosting efficiency by allowing physicians, nursing and key clinical staff secure access to key information such as lab and radiology reports and EKGs. The private HIE has united 13 EMRs from different vendors via interfaces to provide one data repository for enterprise access. Learn why they chose a private HIE, how it has evolved from 2006 until now and what advice they offer to other healthcare systems ready to embark on a private HIE project.
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Inside a Private HIE: Clinical, Economic and Operational Successes at The Washington Hospital
- 1. Inside a Private HIE: Clinical, Economic and Operational Successes at The Washington SPONSORED BY: Hospital Presenter Presenter Moderator Denise Abraham Charles Vargo Mary C. Tierney Health Information Exchange Executive Director, Washington Chief Content Officer, Coordinator, The Washington Physician Hospital Organization TriMed Media Group Hospital, Washington, Penn. (WPHO), Washington, Penn. Providence, RI, USA Presented by CMIO
- 2. Washington Hospital Information Network (WHIN) - Private HIE - Joins The Washington Hospital & the Washington Physician Hospital Organization SPONSORED BY:
- 3. The Washington Hospital - Community Teaching Hospital - Washington, Penn. - 274 Beds - 17,000 Annual Admissions - 700,000 Annual Outpatient Visits - 14 Offsite Care Facilities SPONSORED BY:
- 4. Washington Physician Hospital Organization (WPHO) - Established in 1994 - Joint Venture between The Washington Hospital & the Onstaff Physicians - 250 Physicians – Primary Care & Specialists - 90 Practices - 40 Specialties SPONSORED BY:
- 5. Washington Health Information Network (WHIN) - Private Health Information Exchange (HIE) • Data repositories • Bullet point • Physician portal SPONSORED BY:
- 6. Advantages: A Private HIE - Improving Patient Care - Increasing Physician Knowledge & Efficiency - Secure Access to Key Information • Lab • Radiology • EKGs SPONSORED BY:
- 7. WHIN: A Private HIE - Unites 13 EMRs from Different Vendors - 1 Data Repository - 375 Physicians with Enterprise Access - 90% of Practices Participate in Physician Portal SPONSORED BY:
- 8. WHIN: A Private HIE - Why Start a Private HIE? - Evolution 2006 to 2012 - Advice for Health Systems Seeking to Start a Private HIE SPONSORED BY:
- 9. WHIN: The History - 2006 – Started the Project - August 2007 – Launched MobileMD - October 2007 – Went Live - November 2007 – First Pilot Practices SPONSORED BY:
- 10. WPHO: The Challenges - 2005-2006 – Excellent EMR Penetration - 12 Different EMRs - A Need to Interface - Choosing a Vendor • Spent one year vetting solutions • MobileMD emerged as the right choice SPONSORED BY:
- 11. WHIN: The Technology Inside - Data Repository Fed by Hospital IT Systems • Enterprise Access Via Physician Portal • Health Information Exchange Interfaces with Multiple Practices’ EMRs SPONSORED BY:
- 12. WHIN: The Roll Out - Linked in Initial Practices - December 2007 – ADT Registration Feed, Lab, Radiology - April 2008 – Dictated Reports - Added since then: EKGs, Reports & Parameters SPONSORED BY:
- 13. WHIN: Where We Are Today - Interfaces Complete with 9 Physician Practices - Interfaces in Progress with 6 Physician Practices - 7 More Practices Have Requested an Interface - Interfaces to 12 Different EMR Vendors - 50% of Active Medical Staff Now Linked to Private HIE SPONSORED BY:
- 14. WHIN: The Physician Portal - 90% of WPHO Physicians Have Inboxes & Staff Accessing Information - 375 Users SPONSORED BY:
- 15. WHIN: Why A Private Exchange? - EMR Users Needed Interface to Multiple EMRs - Manage Information Differently - Nothing Happening on a State or Local Level - Lack of Control of State or Regional Exchange(s) SPONSORED BY:
- 16. WHIN: The Funding - Hospital: Custodian of Clinical Information Systems • Pays for the Relationship of the Clinical IT systems and Moving Information to the Exchange - Physician Organization: Funds Enterprise Access Applications • Pays for Information Coming Out of the Exchange - Physician Access: Interface Is Supported by Grant Program • Stark Compliant SPONSORED BY:
- 17. WHIN: The Support - Partnership between Hospital and WPHO - Share Responsibility: • IT • Managing Interface Streams • Training • Support & Help Desk - Trust & Cooperation - Communication SPONSORED BY:
- 18. WHIN: Staff Training - Reached Out to Office Contact People - Solicited Users with Computer Acuity SPONSORED BY:
- 19. A Private HIE: The Capabilities Typical User can: - Look Up Patient Results • Lab, Radiology, EKGs, Demographics, Insurance Information - Track Admissions, Number of Admissions, Length of Stay & ER Visits - Optimization of Preoperative Clearance Process SPONSORED BY:
- 20. WHIN: What Enterprise Access Offers - Help with Care Transitions - Hospitalist Notices to PCPs – Real Time - Discharge Instructions and Summaries Sent as Messages to Physician Inbox - Inpatient and Outpatient Test Results SPONSORED BY:
- 21. WHIN: What Enterprise Access Offers - Customizable Interfaces • Inpatient EMR - Portal Offers Total Picture of Patient - Secure Messaging • Hospital Practice • Practice Practice - Robust Local Search Capability • Assists Specialists & Avoids Unnecessary Testing - Defines Roles, Permissions & Privileges SPONSORED BY:
- 22. WHIN: Physician Feedback - Rely on Office Staff to Gather Information Automate the Process - Support Staff – Initial Users - Physician Adoption Has Grown - Physicians Using EMR & WHIN to Reference Data - ‘Finest Thing You Have Ever Done’ SPONSORED BY:
- 23. WHIN: Practice Benefits - Look at Processes & Automate - Turn Off Paper Reports - Eliminate 9,000 Pieces of Paper/Month - Eliminate Staff Time to Sort Mail/Stuff Mailboxes - with Information that Often Gets Lost or Delayed - Increase Efficiency of Information - Drastic Reduction in Medical Records Requests - EKG Image Enterprise Access - No Fax Artifacts; All-the-time Access SPONSORED BY:
- 24. WHIN: Encouraging Physician Adoption - Medical Records a Critical Partner - Target Progressive Physicians & Office Staff - Private HIE Sold Itself by People Becoming Aware & Embracing It - Intuitive to Use • Sort • Search SPONSORED BY:
- 25. WHIN: Enterprise Access Document Tree Includes: - Lab, Radiology, ADT Registration-Patient Demographics, Medical Records, Pathology Reports, Cardiovascular Department-EKGs, Hospital Clinical Documentation, Interface for Discharge Instructions & ER Visit Notifications, Physical and Respiratory Therapy Reports - Eliminates the Need for Non-hospital Employees Using the Hospital EMR SPONSORED BY:
- 26. WHIN: What’s Coming Next Document Tree: - Caregivers Involved in Transition of Care from Inpatient to Outpatient • Skilled Nursing • Home Care - Caregivers Involved SPONSORED BY:
- 27. WHIN: The Challenges - Primary Care Hospital - Primary Care 50% of Physicians Still Admit Patients - Keeping Caregivers Tied to Hospital Community SPONSORED BY:
- 28. Private HIE: High Reliability - Since December 2007: No Unplanned Downtime - Planned Time for Updates: Midnight to 8am • Doesn’t Impinge on Physician Office Requests - Addition of New Clinical System – Full Testing Follows Upgrade - Siemens and MobileMD – Work Closely to Facilitate Interfaces - Work Well with Wide Variety of EMR Vendors SPONSORED BY:
- 29. Private HIE: Challenges - HIPAA - State Laws: Pennsylvania • HIV/Aids • Substance Abuse Information - Careful Routing of Information – with Consent - Identifying Appropriate Providers Practices Owned by Competing Health Systems - Managing Enthusiasm – i.e. Secure Messaging - Work with Regional Exchanges SPONSORED BY:
- 30. Private HIE: Access Key to Building Value - Surgicenter – Preoperative Testing Being Done by Hospital Because of WHIN Access - Lab Use Increasing – Managed Care Organizations Have Access - For-profit Imaging Centers Lack Effective Interface to Physicians = Retained Business - Accountable Care Organization (ACO) – Expect Positive Growth • Integrated Information Platform + Enterprise Access to View Data Over Time • Avoid Duplication of Testing, Other Cost Savings SPONSORED BY:
- 31. Private HIE: The Benefits - Enhance Transitions of Care - Better Communication - Secure Messaging Supports Move Toward ACOs - Supports Meaningful Use Standards – EMRs Must Be Highly Coordinated SPONSORED BY:
- 32. Private HIE: The Benefits - Physicians: High Satisfaction – Easy Access to Information - Information Available to Physician & Staff - Supports Efficient, Effective Care at the Point of Care - Physicians Like that They Have A Choice in EMRs • Preserves Ability to Choose EMR that Works Best for Practice While Having Full Access to Information at The Washington Hospital SPONSORED BY:
- 33. • Homepage: http://www.cmio.net • More Webinars: http://www.cmio.net/events • Topic Areas: http://www.cmio.net/topics • Conference Coverage: http://www.cmio.net/conferences • Magazine • http://www.cmio.net/magazine