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HIT Policy Committee Information Exchange Workgroup Provider Directory Task Force Jonah Frohlich, Manatt Health Solutions, Co-Chair Walter Suarez, Kaiser Permanente, Co-Chair January 18, 2011

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ILDP Use Cases 1. Clinic to Clinic Exchange – Push Scenario

ILDP Use Cases 2. Clinic to Clinic Exchange – Pull Scenario

ILDP Use Cases 3. Hospital to Clinic Exchange – Push Scenario

ILDP Uses Cases 4. Clinical Lab to Clinic Exchange – Push Scenario

Other Possible Use Cases and Value of ILPDs ,[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object],[object Object]

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Key Functional Capabilities of ILPDs ,[object Object],[object Object],[object Object],[object Object],[object Object]

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In this slide deck, I present two recently approved FHIR implementation guides: vital records death reporting (VRDR) and chronic disease bi-directional electronic referrals (BSeR). The objective of this presentation is to share insights regarding the processing steps required to go from concept to design, from design to published standard, and published standard into implementation. The VRDR and BSeR FHIR Implementation Guide STUs are used to illustrate and facilitate these learning objectives.

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As the healthcare industry moves closer to full scale implementation of health information exchanges and integrated delivery networks, the call for data integrity and interoperability standards has grown increasingly louder to help ensure that data quality isn’t compromised so physicians and patients can have complete confidence in the information reflected by their electronic health records. We interviewed John Donnelly, President of IntePro Solutions in Colonia NJ and an expert in healthcare technology standards, interoperability and innovation about data integrity and data standardization protocols in the context of the shift to electronic medical records and the subsequent data sharing across health information exchanges.

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This is the first installment of the hitchhiker's guide to Health Level Seven. When complete this presentation will provide a concise overview of the history, operational framework, and standards of Health Level Seven (HL7). It is intended to be a guide to those seeking to engage in the HL7 standards development effort or to be consumers of HL7 products and services. The presentation is being written and posted in five iterations. This particular installment introduces HL7 the organization and HL7 the portfolio of health informatics standard.

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Due to diversity, heterogeneity and complexity of the existing healthcare structure, providing suitable healthcare services is a complicated process. This work describes the conceptual design of an e-healthcare system, which implements integration strategies and suitable technologies that will handle the interoperability problem among its essential components. The proposed solution combines intelligent agent technology and case based reasoning for highly distributed applications in healthcare environment. Intelligent agents play a critical role in providing correct information for diagnostic, treatment, etc. They work on behalf of human agents taking care of routine tasks, thus increasing speed and reliability of the information exchanges. CBR is used to generate advices to a certain e-healthcare problems by analyzing solutions given to previously solved problems and to build intelligent systems for disease diagnostics and prognosis. Preliminary experimental simulation based on Agent Development Framework (JADE) demonstrated the feasibility of this model.

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On top of simple needs for doctors to be connected and be able to efficiently exchange information, there is a lot of external factors driving standardization of information exchange from market to various government initiatives and as the industry moves toward a population health model, there is more need for wider applicability of standards. This Slide share covers an introduction to CDA and establishes the importance of clinical documentation for claims and prior authorization attachments

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Chapter 1 The Transforming World of Health Information Management The Case for an Enterprise Solution The St. Rita’s Case Who appointed the EIM team? CIO Joan Morton Why was EIM the team appointed? Sort out the root causes of data integrity issues at St. Rita’s Determine the feasibility of developing an enterprise division to assure data integrity The St. Rita’s Case The initial members of the EIM team Denise – HIM professional Bob – Business analyst Linda – Decision support analyst Val – Project manager Shirlee – Clinical analyst Monte – Systems analyst The St. Rita’s Case The EIM team’s charge Study St. Rita’s data problems Recommend new ideas and improvements Assess feasibility of an EIM division Develop an action plan to implement improvements Enterprise Information Management Enterprise information management (EIM) A set of functions used by organization to plan, organize, and coordinate people, processes, technology, and content for managing information as a corporate asset that ensures data quality, safety, and ease of use. Data Governance Data governance (DG) A specific EIM function that supports coordination among all other EIM functions by establishing data standards, policies, procedures, and accountabilities that span the entire organization. Definition of health information Definition of Health Information Definition dependent upon the context Information about health science and health-related issues published by an authoritative source For example, journals, magazines, web sources Secondary patient-related data For example, aggregated data in registries Primary patient-related data For example, specific patient data used for healthcare delivery Electronic Health Records: Differing Definitions EMR – Electronic medical record Electronic record Health-related information about an individual Is created, gathered, managed, and consulted by authorized clinicians and staff within one healthcare organization National Alliance for Health Information Technology Electronic Health Records: Differing Definitions EHR – Electronic health record Electronic record Health-related information about an individual Conforms to nationally recognized interoperability standards Is created, gathered, managed, and consulted by authorized clinicians and staff across more than one healthcare organization National Alliance for Health Information Technology Electronic Health Records: Differing Definitions PHR – Personal health record Electronic record Health-related information about an individual Conforms to nationally recognized interoperability standards Is drawn from multiple sources Managed, shared, and controlled by the individual National Alliance for Health Information Technology Complexity of data flow and retrieval Clinic Appointment and Visit Example Healthcare Data Flow Across Users Healthcare Information Exchanges (HIEs) Federal-state collaboration Enable and expand secure electronic movement and use of ...

Chapter 1The Transforming World of Health Information Manageme

EstelaJeffery653

While the Health Insurance Portability and Accountability Act (HIPAA) is best known for its multitude of requirements that govern the way health care providers can use, disclose, and safeguard protected health information (PHI), its reach goes far beyond that to health plans and business associates that only handle PHI on a limited basis. HIPAA implementation in these environments creates unique challenges—for example, which provisions actually need to be addressed—but with 2016 marking an all-time high for HIPAA enforcement cases, it may be more important now than ever to address HIPAA compliance.

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Chapter 6: Health Information Exchange Robert Hoyt MD William Hersh MD After viewing the presentation, viewers should be able to: Identify the need for and benefits of health information exchange (HIE) and interoperability List healthcare data that should be shared Enumerate HIE challenges and barriers Describe several organizations known as Health Information Organizations (HIOs) Summarize the newest HIE models Learning Objectives Health Information Exchange (HIE) is the “electronic movement of health-related information among organizations according to nationally recognized standards” Health Information Organization (HIO) is “an organization that oversees and governs the exchange of health-related information among organizations according to nationally recognized standards” Important Definitions Regional Health Information Organization (RHIO) is “a health information organization that brings together health care stakeholders within a defined geographic area and governs health information exchange among them for the purpose of improving health and care in that community.” Interoperability is defined as “the ability of two or more systems or components to exchange information and to use the information that has been exchanged”. This implies that the data is computable and that standards exist that permit interoperability Important Definitions Foundational: refers to the technology or platform used to exchange information Syntactic: means messages have a structure and syntax that is understandable. Uses XML and HL7 standards Semantic: terminology and coding must be the same for the sending and receiving organizations Interoperability Levels Exchange (sharing) of health information is vital for healthcare reform at the local, state and national level The next two slides will demonstrate the types of healthcare data that should be shared If electronic health records don’t share data, then we have moved from paper siloes of information to electronic siloes; not the goal of anyone HIE is part of the Meaningful Use program, discussed in the module on electronic health records Introduction Clinical results: Lab, pathology, medication , allergies, immunizations and microbiology data Images: Actual images and radiology reports Documents: Office notes, discharge notes and emergency room notes Clinical summaries: Continuity of Care Documents (CCDs); XML-based documents that standardize and summarize care Financial information: Claims data and eligibility checks Medication data: Electronic prescriptions, formulary status, and prescription history Healthcare Data Potentially Shared Performance data: Quality measures like blood pressure or diabetes control, cholesterol levels, etc. Case management: Management of the underserved and emergency room utilization Public health data: Infectious diseases outbreak data, immunization records Referral management: Management of re.

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PSYC 3500 Strategies for Enhancing Learning and Memory Self-Evaluation Template Name: Date: *Level choices: Non-Performance, Basic, Proficient, and Distinguished (please refer to the Scoring Guide for descriptions of each level) Criteria Level Comments Describe techniques for enhancing learning and memory using relevant theories. Define a population of interest and learning and memory issues related to that population. Describe strategies for enhancing learning and memory for the selected population. Apply course readings, including peer-reviewed resources, to presentation. Conduct a self-evaluation of this assignment using the scoring guide and identifying the proficiency level for each criterion. Apply critical thinking and communication skills concerning learning and memory in a manner that is scholarly, professional, and respectful. Apply current edition of APA style, including in-text citations and full references for sources. International Journal of Telerehabilitation • telerehab.pitt.edu International Journal of Telerehabilitation • Vol. 9, No. 2 Fall 2017 • (10.5195/ijt.2017.6231) A SYSTEMATIC REVIEW OF RESEARCH STUDIES EXAMINING TELEHEALTH PRIVACY AND SECURITY PRACTICES USED BY HEALTHCARE PROVIDERS VALERIE J. M. WATZLAF, PHD, MPH, RHIA, FAHIMA, LEMING ZHOU, PHD, DSC, DILHARI R. DEALMEIDA, PHD, RHIA, LINDA M. HARTMAN, MLS, AHIP DEPARTMENT OF HEALTH INFORMATION MANAGEMENT, SCHOOL OF HEALTH AND REHABILITATION SCIENCES, UNIVERSITY OF PITTSBURGH, PITTSBURGH, PA, USA ABSTRACT The objective of this systematic review was to systematically review papers in the United States that examine current practices in privacy and security when telehealth technologies are used by healthcare providers. A literature search was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P). PubMed, CINAHL and INSPEC from 2003 – 2016 were searched and returned 25,404 papers (after duplications were removed). Inclusion and exclusion criteria were strictly followed to examine title, abstract, and full text for 21 published papers which reported on privacy and security practices used by healthcare providers using telehealth. Data on confidentiality, integrity, privacy, informed consent, access control, availability, retention, encryption, and authentication were all searched and retrieved from the papers examined. Papers were selected by two independent reviewers, first per inclusion/exclusion criteria and, where there was disagreement, a third reviewer was consulted. The percentage of agreement and Cohen’s kappa was 99.04% and 0.7331 respectively. The papers reviewed ranged from 2004 to 2016 and included several types of telehealth specialties. Sixty-seven percent were policy type studies, and 14 percent were survey/interview studies. There were no randomized controlled trials. Based upon the results, we conclude that it is necessary to have more s ...

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The proposed Trusted Exchange Framework supports ONC’s goals of achieving nationwide interoperability: Patient Access - Patients must be able to access their health information electronically without any special effort; Population-level Data Exchange - Providers and payer organizations accountable for managing benefits can receive population level health information allowing them to analyze population health trends, outcomes, and costs; identify at-risk populations; and track progress on quality improvement initiatives; and Open and Accessible APIs – The health information technology (health IT) community should have open and accessible application programming interfaces (APIs) to encourage entrepreneurial, user-focused innovation to make health information more accessible and to improve electronic health record (EHR) usability.

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Increasingly, consumers are taking a more active role in managing and generating their own health data. For example, consumers are researching their health conditions and diagnosing themselves online. Consumers are also uploading their information into personal health records and apps that allow them to manage and analyze their data, and utilizing connected health and fitness devices that regularly collect information about them and transmit this information to other entities. The movement of health data outside the traditional medical provider context has many potential benefits; however, it also raises potential privacy concerns. The seminar will address questions such as: What types of websites, products, and services are consumers using to generate and control their health data, and how are consumers using them? Who are the companies behind these websites, products, and services, what are their business models, and what does the current marketplace look like? How can consumers benefit from these companies’ websites, products, and services? What actions are these companies taking to protect consumers’ privacy and security? What do consumers expect from these companies regarding privacy and security protections? Do consumers differentiate between these companies and those that offer traditional medical products and services that are covered by HIPAA? What restrictions, if any, do advertising networks and others impose on tracking of health data?

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On February 19, 2014, the Federal Trade Commission staff hosted a seminar on Mobile Device Tracking. The speakers discussed how retailers and other businesses have been tracking consumers’ movements throughout and around retail stores and other attractions using technologies that identify signals emitted by their mobile devices. While the technologies differ, many work by identifying and collecting the MAC address – which is unique to a particular device – broadcast when a mobile device searches for Wi-Fi networks. Companies can use these technologies to reveal information about consumers including the path taken throughout a location, length of time in one location, whether a visitor is new or returning, and the frequency of visits to a location. According to media reports, major retailers in the United States are using or have tested the technology in their stores in order to gain insights into the behavior of their customers. In most cases, this tracking is invisible to consumers and occurs with no consumer interaction. As a result, the use of these technologies raises a number of potential privacy concerns and questions.

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