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HIE Pilot between Military and Civilian Providers in a SOA FrameworkLessons Learned from a HealthInformation Exchange (HIE) Pilotbetween a Military Treatment Facility andits Purchased Care Network (PCN)Presented By:LTC Nhan Do, MD, MSChief, Business Process Management,Office of the Surgeon General, USAHuy Nguyen, MDCEO, COGON System,July 13, 2010Nhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIED
HIE Pilot between Military and Civilian Providers in a SOA FrameworkAGENDA Current state of health information exchange in the Military Health SystemDescription of Pensacola Health Information Utility Project–––––Technical BackgroundScreen Shot DemoUser Experience and Lessons LearnedTechnical ChallengesBusiness Challenges Life in the Healthcare Cloud SOA What?Nhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 2
HIE Pilot between Military and Civilian Providers in a SOA FrameworkCurrent State of HIE in MHS SystemNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 3
HIE Pilot between Military and Civilian Providers in a SOA FrameworkCurrent system for consult trackingfor military beneficiaries in PensacolaArchiveShare folderAHLTAReferral ManagerFaxTricare Service CenterPrimary CareManagerFaxArchiveMailConsultWeb siteSpecialistPatientSlide prepared by CAPT Robert Hoyt, NOMINhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 4
HIE Pilot between Military and Civilian Providers in a SOA FrameworkChanges after HIUAHLTAReferral ManagerPrimary Care ManagerConsult NotesFaxTricare Service CenterConsult NotesHIEArchiveMailConsult NotesConsultWeb siteSpecialistPatientSlide prepared by CAPT Robert Hoyt, NOMINhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 5
HIE Pilot between Military and Civilian Providers in a SOA FrameworkBHIE/FHIE Architectural ComponentsDoDFHIE/BHIE FrameworkMHS LinkVistAVA Host(Station 200)RDV TAHL7/ADTDoDDoDWebServerWeb ServerWS/XMLCDRWS/XMLCPRSPre/PostCACHE’SHARE DSVA(VA AITC, Austin TX )WS/XMLVAVitriaVitria InterfaceIEEnginePIDS/ CorrelationVA MPI-Correlation of Patient IdentityTMDSBHIE-AHLTAWeb ServerNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.com-Information FTUNCLASSIFIEDSlide 6
HIE Pilot between Military and Civilian Providers in a SOA FrameworkPensacola Health Information UtilityProjectNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 7
HIE Pilot between Military and Civilian Providers in a SOA FrameworkOverview Congressional sponsor is Jeff Miller from Florida (FY07). Cogon and the DoD entered into a Data Use Agreement, November 2008.The Pensacola Health Information Utility (HIU) was deployed in theSpring of 2009, between Sacred Heart (SHH) and Naval HospitalPensacola (NHP).Baptist Health System (BHH) joined the Pensacola HIU May 2010, andboth SHH and BH can view the military health records via a commonsecure portal.Through BHIE, DoD users have access to SSH and BH health data.Pensacola HIU will migrate toward SAS 70 compliant, world-class datahosting center (Terremark) – ‘cloud computing’Nhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 8
HIE Pilot between Military and Civilian Providers in a SOA FrameworkShared Data C32 patient summary specification of CCD Patient demographic and administrative information Diagnoses/problem list Providers Allergies Medications Laboratory results Radiology results Previous procedures Clinical notes such as consult notesNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 9
HIE Pilot between Military and Civilian Providers in a SOA FrameworkVirtual Health Network (VHN) Cogon’s Virtual Health Network employs a service-oriented architecture built upon a Java platform that provides theframework for healthcare data transmission, transformation,and transparency.Technical Guiding Principles:Security, Interoperability, Scalability, ExtensibilityBuilt to support a utility/transaction-based business modelNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 10
HIE Pilot between Military and Civilian Providers in a SOA FrameworkVirtual Health Network ArchitectureNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 11
HIE Pilot between Military and Civilian Providers in a SOA FrameworkHEALTH INFORMATION EXCHANGEStrategic Health Intelligence(Slide - courtesy of Robert Johnson- BH)Baptist AllFacilitiesSacred HeartNavyHospitalVA ClinicHIE (Health Information Exchange )Connection to FloridaRegional HealthInformation NetworkNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comine dbmCoicalgolonChro t ation of tnnPre se trea tm ent ’seitie siltiacaPall Ff ro mUNCLASSIFIEDConnection to NHIN(National HealthInformation Network)Slide 12
HIE Pilot between Military and Civilian Providers in a SOA FrameworkScreen shots of health data fromSHH through BHIE/SHARENhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 13
HIE Pilot between Military and Civilian Providers in a SOA FrameworkLaboratory ResultsNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 14
HIE Pilot between Military and Civilian Providers in a SOA FrameworkDetail View of Lab ResultNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 15
HIE Pilot between Military and Civilian Providers in a SOA FrameworkMedication ProfileNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 16
HIE Pilot between Military and Civilian Providers in a SOA FrameworkDetail Medication ViewNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 17
HIE Pilot between Military and Civilian Providers in a SOA FrameworkClinical DocumentationNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 18
HIE Pilot between Military and Civilian Providers in a SOA FrameworkC32 SummaryNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 19
HIE Pilot between Military and Civilian Providers in a SOA FrameworkCardiac Catheterization ReportNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 20
HIE Pilot between Military and Civilian Providers in a SOA FrameworkCardiac Catheterization ReportNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 21
HIE Pilot between Military and Civilian Providers in a SOA FrameworkScreen shots of health data fromDoD throughMcKesson Physician PortalNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 22
HIE Pilot between Military and Civilian Providers in a SOA FrameworkMcKesson Physician Portal SHHNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 23
HIE Pilot between Military and Civilian Providers in a SOA FrameworkVisit Results from the RequestNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 24
HIE Pilot between Military and Civilian Providers in a SOA FrameworkLab Results from the Request:Nhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 25
HIE Pilot between Military and Civilian Providers in a SOA FrameworkRadiology Results from the RequestNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 26
HIE Pilot between Military and Civilian Providers in a SOA FrameworkPatients in HIU Sacred Heart Hospital currently has 290,000 unique patients in the HIU systemCorrelations with 28,400 patients from the Pensacola NavalHospital.Nhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 27
HIE Pilot between Military and Civilian Providers in a SOA FrameworkLessons Learned Clinical relevance Clinical workflow Data Critical mass Marketing TrainingNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 28
HIE Pilot between Military and Civilian Providers in a SOA FrameworkTechnical Challenges BHIE data integration (not plug and play) Network connectivity and maintenance Two different MHS portal (BHIE SHARE, AHLTA 8viewer) Multiple civilian EHR portal Integration multiple disparate HIS system with multiple standardIntegration of mental health data with multiple rule ofgovernanceNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 8
HIE Pilot between Military and Civilian Providers in a SOA FrameworkLife in the Cloud Cost Efficiency Cost Sharing and Sustainability Standards-Based Commodity Business Model Decreased Capital Requirement – Risk Mitigation Security Recommended on a “Cloud” Level Scalability and Distributive Network Extensibility to technology innovation andcollaborationNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 30
HIE Pilot between Military and Civilian Providers in a SOA FrameworkSOA What?(Meaningful Use)Clinical TransformationPopulation HealthDisease ManagementPatient Centered Medical HomeEnd User ExperienceMobilityVoice TechnologyBusiness Process Management (BPM) in HealthcareCase Study: Tissue Organ DonorReferral ManagementMedication ManagementHospital AdmissionsNhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 31
HIE Pilot between Military and Civilian Providers in a SOA FrameworkQuestions?Nhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.comUNCLASSIFIEDSlide 32
McKesson Physician Portal Slide 22. HIE Pilot between Military and Civilian Providers in a SOA Framework Nhan.Do@us.army.mil/ and Huy.Ngyuen@cogonsystems.com UNCLASSIFIED . Radiology Results from the Request Slide 26. HIE Pilot between Military and Civilian Providers in a SOA Framework
