hie in ems california emergency advisory committee meeting · 7/7/2016 · hie in ems advisory...
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HIE IN EMS ADVISORY
COMMITTEE MEETING
California Emergency Medical Services Authority
GoToWebinar: Attendee Participation
• All participant lines are muted
• Note: Today’s presentation is being recorded and will be provided within 48 hours.
GoToWebinar: Questions
• Send questions using the chat feature during the presentation
• Send questions to the
organizer, California EMSA
GoToWebinar: Hand Raising
• There will also be a Q&A session at the end of the webinar.
• Please raise your hand to be unmuted for verbal questions.
* This webinar is being recorded.
PETER KARRAS
Office of the National Coordinator for Health IT
LESLIE WITTEN-RODD
California Emergency Medical Services Authority
© 2016 California Association of Health Information Exchanges Licensed under a Creative Commons Attribution Share-Alike 3.0 License
SME Report EMSA Statewide HIE in EMS Advisory Committee
Robert M. Cothren, PhD Executive Director 26 July 2016
Agenda – Timeline for upcoming PULSE activities – Items being discussed
– Workflow for PULSE – Sustainability for PULSE
26 July 2016 EMSA Statewide HIE in EMS Advisory Committee 8
26 July 2016 EMSA Statewide HIE in EMS Advisory Committee 9
Develop Directory Services
Develop PULSE Message Broker, Portal Add Adapters, DS
Procure PULSE Operator
Inte
grat
e w
ith C
TEN
Integrate DHV
UAT
Provision Data
Center
Operate PULSE
Select HIOs
Maintain PULSE
Readiness Review – 4/26
Final Report
PULSE Drill – 5/1-12 Contingency Drill – 5/15-26 Today
Transition to Operator
Integrate DHV
Test Connectivity
Create Drill Materials
UAT
Apr May Jun Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug
Procurement
PULSE Workflow – Continue meetings with PULSE Workgroup – Have a working version of the storyboard – Have discussed issues concerning PULSE participation
and authorization – Next steps
– PULSE Portal mock-ups – Details of transactions between systems
26 July 2016 EMSA Statewide HIE in EMS Advisory Committee 10
PULSE Sustainability – How is PULSE exercised?
– Are there regular drills? – How is connectivity to HIOs verified?
– Should PULSE be used outside of disaster response? – What are the use cases? – Who pays for the service?
26 July 2016 EMSA Statewide HIE in EMS Advisory Committee 11
Other discussion?
26 July 2016 EMSA Statewide HIE in EMS Advisory Committee 12
Contact Information Robert M. Cothren, PhD Executive Director California Association of Health Information Exchanges
p 925-934-2280 e robert.cothren@ca-hie.org w http://www.ca-hie.org
26 July 2016 EMSA Statewide HIE in EMS Advisory Committee 13
+EMS Grant San Diego Health Connect
Mark Branning Program Manager
July 26, 2016
Business Case/Goals
• “…integrate pre-hospital care documentation seamlessly into the contemporary health information exchange (HIE) environment.”
• “…create an asynchronous bi-directional connection…” – ePCR (ambulance EMR) – HIE – Hospital EMR
• Improve decision making – At the scene – Transport/Hospital Prep
PRIMER – SDHC (SAN DIEGO HEALTH CONNECT)
San Diego Health Connect Status
• 3.5 million patients properly identified
• 2.1 million patients to share information
• 21 of 23 hospitals participating
• Over 7.5 million transactions per month
Virtual Record
EMS Grant Deliverables = SAFR
• SEARCH – HIE for patient information • ALERT – hospital re patient’s status • FILE – patient care report into hospital EMR • RECONCILE – outcome and billing
– from hospital to ePCR – quality analysis and system improvement
SEARCH
EMS Hub
30 more
Kaiser
Sharp
Scripps
UCSD
• Problems • Allergies • Meds
HIE
PatientMatch
ALERT
EMS Hub
30 more
Kaiser
Sharp
Scripps
UCSD
• Narrative+++ from Paramedic
HIE
FILE
EMS Hub
30 more
Kaiser
Sharp
Scripps
UCSD
Complete Record • Narrative • Vitals • More
HIE
RECONCILE
EMS Hub
30 more
Kaiser
Sharp
Scripps
UCSD
HIE
Ambulance/Agency • Billing • eOutcomes for quality analysis
Partners Overview: 1 hosp, 1 ePCR, 1 Agency; 3 Counties
County
ePCR HIE Hosp Ambu-lance
LEMSA Agency Pop ED Expert-ise
San Diego
WATER SDHC UCSD AMR County City SD ~1.4 High
Orange Image-Trend
OCPRHIO
UCI CARE (NA) Newport Fire
~0.1
Imperial Traumasoft
SDHC El Centro
Scha-effer
County County ~0.2
Deliverables Timeline
Attestation Complete Milestones
San Diego County
Search 03/31/17
Alert 04/14/17
File 05/18/17
Reconcile 06/05/17
Orange County
Search 04/28/17
Alert 05/15/17
File 06/17/17
Reconcile 07/05/17
Imperial County
Search 04/28/17
Alert 05/15/17
File 06/17/17
Reconcile 07/05/17
Final Reports 8/30/2017
Barriers and Risks
• Traumasoft 3.4 compliance • Orange County changes to workflow • Timeline compressed • NEMSIS 3.4 reporting Jan 1
Standards
• NEMSIS 3.4 • HL7/CCD(A) • Web services • HIE query technology – currently operational
Questions
EMS Hub - Architecture
30
Mission
To connect healthcare stakeholders to
deliver quality, comprehensive information for better care
Narrative from Paramedic - example
San Diego Health Connect Status
• 3.5 million patients properly identified • 2.1 million patients to share information • 21 of 23 hospitals participating • 15 of 17 FQHCs participating • Over 9.5 million transactions per month • 2015 = 3% of influenza cases reported electronically
– 2016 = 53% of influenza cases reported electronically
PULSE Development Update HIE in EMS Advisory Committee Meeting
July 26, 2016
PULSE Background
PULSE History • 2013: CalEMSA holds its first HIE in EMS Summit
• April 2014: ONC Engages Ai to evaluate use of HIE infrastructure for
disaster preparedness and response; HIE Services in Support of Disaster Preparedness and Emergency Medical Response report published
• March 2015: HHS Ideas Lab funds use case and technical architecture development of PULSE; detailed Patient Unified Lookup System for Emergencies report published
• July 2015: ONC grants EMSA a grant to advance HIE statewide during a disaster and regionally in daily EMS
• January 2016: EMSA releases PULSE Development RFO
• March 2016: EMSA awards Ai the PULSE Development contract
• July 2016: PULSE Contract Amendment signed
Ai Project Team Scott Afzal
Ai Executive Sponsor/HIE SME
Genevieve Morris Health Information
Policy SME
Chris Cimaszewski Lead, Software &
Technology
Andrew Larned Solutions
Architect/Sr. Software Engineer
Katy Ekey Software Engineer
Brian Lindsey Software Engineer
Ashiwini More QA/Test Engineer
Jeremy Wong Project Manager
Deliverables and Project Scope Review
Project Scope Overview 1. PULSE Web Portal
a. DHV integration for user authentication b. Patient query portal capability for providers c. Robust audit logs
2. PULSE Message Broker
a. Federate and aggregate requests/responses b. Interface between Web Portal and message adapter service c. Leverage CTEN Directory Services and Connection Management Services*
3. eHealthExchange Message Adapter Service
a. Allow patient and document queries to be routed to participating organizations in the eHealthExchange standard
b. Organizations' responses, including document transfer, can be conducted using the eHealthExchange standard
4. eHealthExchange Query Service a. Allow patient and document queries to be made directly from EHRs and
HIOs using the eHealthExchange standard *CTEN Directory Services, including Connection Management Services, is out-of-scope and will be developed by CAHIE
Architecture Diagram
Component Model
Key Project Deliverables Ai Development 2016 • April: Project Kickoff
• May: Requirements and Solution
Approach Document
• August: HIO Working Group Meeting, Development complete
• October: EMSA Technical Documentation signoff, End-to-end Integration and User Acceptance Testing complete
• November: Transition to Operations
2017 • February: Transition to System
Maintenance
HIO Integration 2016 • August: HIO Working Group
Meeting • December: HIO onboarding
begins 2017 • February: HIO UAT begins
• February: System
Maintenance Phase begins
• April: HIO PULSE Drill
Key Dependencies • CTEN Directory Services
• This must be developed before PULSE can be operationalized
• DHV SSO • The DHV vendor must be able to pass SAML assertions
• HIO Contracting and Onboarding
• HIO onboarding must be completed prior to the PULSE Drill
• HIO Guidance • The PULSE Workgroup must give clear and timely guidance to
inform PULSE development (e.g., on standards)
PULSE Development Update
Development Update • The following components are in the process of being built
and tested: • PULSE Message Broker Service (85%) • PULSE Web Portal Build (55%) • Audit Management Service (80%) • eHealthExchange Message Adapter Service (10%) • eHealthExchange Query Service (10%)
• As part of the Web Portal, Ai is developing an ACF
Selection feature, which requires users to select a location • This will allow users to leverage the PULSE cache
• Ai will demo the Web Portal to the PULSE Workgroup in
August
Integration Update DHV
• DHV will access an API to determine when PULSE is active
• DHV will authenticate users via SAML
CTEN Directory Services • PULSE will access connection information for HIOs,
which will be maintained by CTEN HIOs
• RFP for participation upcoming • HIO integration scheduled to begin in December
Questions for Discussion
Questions for Discussion • Which HIOs are expected to participate?
• How readily can these HIOs connect to PULSE using eHealthExchange standards?
• Who will use the eHealthExchange Query
Service?
• Is ONC comfortable with the future scalability of PULSE?
• How do you envision PULSE functionality being integrated with day-to-day EMS operations?
Questions?
RYAN STANFIELD California Emergency Medical Services Authority
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