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What interRAI Interoperability Means for Continuity of Care

Wed, June 8, 2016

Dr. John Hirdes, interRAI Canada

Adam Prybyl, VP, Momentum Healthware Inc.

Finnie Flores, Program Lead, CIHI

Lynn McNeely, Special Projects Lead, CIHI

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• Describe the relationship among CIHI, interRAI and Momentum

• Explore the value of interRAI interoperability

• Share New Zealand’s experience

• Discuss CIHI’s role

• Discuss opportunities, enablers and challenges in the Canadian environment

Objectives

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  CIHI – creates and maintains Canadian standards

Collaborators

  interRAI – developer of interRAI suite of assessment standards

  Momentum - implements health standards with software solutions

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A face to interoperability – my brother, Glen

  RAI-Mental Health: completed on 3 separate hospital admissions

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  What does interRAI interoperability mean?

  Dr. John Hirdes, interRAI Canada

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  What does interRAI interoperability look like – New Zealand’s story

  Adam Prybyl, VP, Momentum Healthware Inc.

Interoperability - The New Zealand Experience • Country Information

• Population: 4.677m1

• Population 65 Years and Over: 686,4001

• District Health Boards: 20

• Aged Residential Care Facilities: 700+

• Needs identified • Cross sector Comprehensive Clinical Assessment

• National assessment system for simplicity

• Make “clinically rich data, (that also happens to be standardized, evidence based and comprehensive), available to clinical staff at the time they need it in their local clinical system in a way that is least disruptive to their workflow”2

1 Statistics New Zealand (March 2016). Retrieved from http://www.stats.govt.nz/browse_for_stats/snapshots-of-nz/top-statistics.aspx 2Downes, New Zealand National interRAI Software Service Manager

Interoperability - The New Zealand Experience • Solutions

• Adoption of the interRAI® integrated suite of assessments and implementation of the Momentum Convergence Platform’s Assessment Management System+

• 2007 - Pilot of RAI-HC 2.0 and RAI-MDS 2.0

• 2011 – Determined to move forward country wide with interRAI® integrated suite instruments

• 2012 – Began full implementation

• interRAI® Contact Assessment (CA) and Emergency Department (ED) Screeners

• interRAI® Home Care (HC) assessment

• interRAI® Community Health Assessment (CHA)

• interRAI® Long Term Care Facility (LTCF) assessment

• interRAI® Palliative Care (PC) – Pilot

1 A.Downes, New Zealand National interRAI Software Service Manager

Interoperability - The New Zealand Experience • Solutions cont’d

• 2014 - New Zealand MoH implementation of the HL7-CDA standard for interRAI® developed – Approved by NZ Standards body (HISO), endorsed by interRAI®, and supported with set of LOINC codes1

No jurisdictional specific extensions were employed to this international standard with focus on interRAI data.

http://healthitboard.health.govt.nz/our-programmes/common-clinical-information/comprehensive-clinical-assessment-aged-care-interrai

• 2014 - Momentum development of two interoperability web-services per the HISO 10047 HL7-CDA standard for interRAI®

• PDF reports for interRAI® assessments, care plans, and other miscellaneous reports

• HL7-CDA for interRAI® assessment data

1 A.Downes, New Zealand National interRAI Software Service Manager

Interoperability - The New Zealand Experience • Advantages and Benefits of HL7-CDA

• Tech is simple • HL7-CDA is a international standard and allows for structured data to be made available easily. XML based thus very friendly

for web-services.

• interRAI® assessment data is structured and standardized (iCODES)

• The development of interoperability web-services based on the HL7-CDA standard in order to provide or request assessment data was EASY

• Provides the flexibility to produce reports, display data, and even complete analysis of interRAI® data within the providers system!

• Most important! Work with your providers and users – Educate on interRAI® methodology. Find out what data they need to see and how/where they want to see it in their system?

1 A.Downes, New Zealand National interRAI Software Service Manager

Interoperability - The New Zealand Experience

• Current Status1 • 500+ entities use/access interRAI® data

• 5,000+ clinical staff accessing interRAI® data; 1,000+ of which are trained and certified assessors

• 9,000 interRAI® assessments per month (Community, acute, residential care sectors)

• 384,000 assessment to date

• 15% of 65+ age group assessed annually

• 1,000 interoperability web-service calls made per month

• Performance tests making calls FROM New Zealand TO Winnipeg – 200 calls per minute – 4 sec average response

1 A.Downes, New Zealand National interRAI Software Service Manager

Interoperability - The New Zealand Experience

A.Downes, New Zealand National interRAI Software Service Manager

Momentum Healthware • Canadian company established in 1995

• Global Headquarters is in Winnipeg, Manitoba, Canada

• ALL software development is done in Canada.

• Remote offices/employees: Alberta, Ontario, Quebec, Oregon and Tennessee

• 50+ Employees (concentration of nurses, technical and business professionals)

• 100% focused on the continuum of continuing care

• Home and Community Care

• Long Term Residential Care

• Mental Health

• Public Health

• Long partnership history with both CIHI and interRAI®

Momentum Healthware

• International leader in enterprise solutions for continuing care

Global deployments in:

• Canada

• New Zealand

• United States

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  What is CIHI’s role?

  Finnie Flores, Program Lead, CIHI

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Focus of Initiatives

• Raise awareness

• Understand capacity

• Build capacity

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interRAI Interoperability Initiatives • Raise awareness

‒ Pre-Conference workshop in World interRAI Conference

‒ eHealth Conference Panel

• Understand capacity

‒ Scan of existing Canadian and interRAI implementations

‒ Vendor survey of HL7 capabilities

• Build capacity

‒ interRAI Implementation Toolkit

‒ interRAI implementation support

‒ Demonstration projects

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A quick survey

• Go to: https://kahoot.it

• Enter PIN #:

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  What are some of the enablers and challenges in sharing information from one care setting to another?

Let’s Discuss

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  Next Steps

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@cihi_icis

fflores@cihi.ca & lmcneely@cihi.ca