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CommonSpirit Health HIE Overview and Use CasesHealth Current SummitRyan Sommers – Leader, Health Information Exchange and InteroperabilityNovember 13, 20191
Organization Overview February 2019 – merger of Dignity Health and Catholic Health Initiatives wasfinalized to form a single ministry CommonSpirit Health 29 billion system serving 21 states with more than 700 care locations and 142hospitals 150,000 employees 25,000 physicians Largest nonprofit health system by revenue Locations and services will retain the names of the CHI and Dignity Healthfacilities
Organization Alignment"We didn't combine our ministries to get bigger, we came together to provide bettercare for more people. "We created CommonSpirit Health because in order to solvenational health challenges, we need the breadth, scope and resources to make anationwide impact. We believe that no one should ever have to choose betweenbeing healthy and putting food on the table.“- Lloyd Dean, CEO3
HIE / Interoperability ServicesCommunity PortalState/Regional HIEParticipationLongitudinal RecordNational NetworkConnectivityDirect MessagingPrescription DrugMonitoring Program(PDMP)Emergency DepartmentInformation Exchange(EDIE)Patient UnifiedLookup System forEmergencies (PULSE)4
EMR LandscapeAcuteAmbulatory5
HIE / Interoperability Key Stats131.4k40k52kStates Participatingin HIEsHospitalsConnectedNationwideClinics ConnectedNationwideActive HIE Users9M10.8M105k345KPatients withExternal DataCare SummariesQueried / Retrievedper MonthCommunity View /Care EverywhereAccesses perMonthDirect MessagesSent per Month6
Dignity Health – Interoperability Evolution2007 – Dignity Health’s first regional HIE went live in the Sacramento Service Area,Included small results delivery pilot(2 practices, 4 physicians)2011 – Regional HIE deployments live across all of Dignity Healthservice areas2012 – Signed the DURSA and became the 34th Participantof eHealth Exchange2015 – Direct Messaging pilots started2016 – Began establishing eHealth Exchange connections with key community partners2017-2018 – Community View rolled out to Dignity Health clinicians2019- Data Reconciliation, CommonWell/Carequality, Pop Health/Value-based Care opp7
Nationwide Exchange via National Networks8
National Networks OvervieweHealth Exchange – Connected to 22 endpoints (bi-directional)- Began efforts to connect in 2016- Connections are point to point- Connected to other large Health Systems located near Dignity Health facilities- Statewide and Community HIE’s (i.e. Health Current)CommonWell / Carequality – Live on both networks since September 2019- Expands our reach to other health systems and ambulatory practices9
Data Exchange Flow with the CommonWell & CarequalityAuto-enrollmentQuery / ResponseCommonWellFederate queries toCarequalityRecord Locator ServiceZip Code Based HeuristicsCommunity View(Cerner HIE)Include ListCarequality query response to Cerner HIE / Community View10
Health CurrentParticipation11
Health Current Participation Health Current participants since January 2016 Pushing ADT, HL7 v2 , and CCD’s to Health Current HIE Repository St. Joseph’s Hospital and Medical Center St. Joseph’s Hospital and Medical Center - Westgate Chandler Regional Hospital Mercy Gilbert Hospital Arizona and Mesa General Hospitals Dignity Health Medical Group (AZ) Clinics / Urgent Care locations Query-Based Exchange (eHealth Exchange) ED Notifications Population Health Management12
Community View(Cerner HIE)13
Community View / Cerner HIE Overview14
Community View - Overview Community View is a consolidated view of data from the Dignity HealthEnterprise Health Information Exchange repository as well as data from externalorganizations with whom we have established connectivity Community View presents patient data from disparate sources to our cliniciansin a consolidated view and maps patient data to appropriate clinical areas(widgets) Longitudinal view of patient record15
Community View - Cerner mPage16
Community View – External Partners Data loads into the Community View asynchronously from our externallyconnected data partners and maps to the appropriate widgets17
Pre-Fetch and Caching The objective of the pre-fetch service is to proactively query ourconnected data partners for content on a patient in order to improveoverall performance for our clinicians using Community View The content is cached for 21 hours meaning the content retrieved fromour data partners will not change until the cache expires. Pre-fetch is now configured for most encounter types including: Upcoming registration events / patient appointments (next 24 hours) Real-time Encounters: ED Visits, Inpatient, Outpatient, Observation, Home Health,Preadmit18
Emergency DepartmentNotifications19
ED Alert Solution OverviewThe purpose for Health Current ED alerts are to give our ED clinicians theinformation they need to make fully informed decisions so they can provide the bestcare possible for patients who are high utilizers of the ED.When a patient is registered in our ED, the registration message will go to HealthCurrent from our HIE and will return relevant information from other Health Currentparticipants to Community View and the Cerner Millennium Tracking Shell.20
EDIE Alert Thresholds 6 or more Visits in 180 Days (To notify of High ED Utilizers) 3 or more Visits in 30 Days (To Notify of ED Readmits within the last 30 days) 3 or more Facilities in 90 Days (To notify of a traveling patient)21
Technical Data Flow22
Cerner Community View Dedicated ED Information Widget23
Example Notification24
Cerner Millennium Tracking Shell Icon25
Cerner Millennium Notes/Transcription26
Deployment SummaryPhase 1 – ED Alerts to Community View SJHMC Pilot Facility Go Live: September 2019 Remaining hospitals to go-live after pilot is approvedPhase 2 – ED Alerts to Cerner Millennium Tracking Shell All facilities to go-live together Target go-live to be determined27
Population HealthManagement Use Case28
Population Health ManagementHealth Current Data Exchange Process Dignity Health sends an attributed/at-risk member list of our Arizona Care Network toHealth Current monthly Health Current provides all data they have associated with those members The ADTs and Clinical data (CCDA) are then loaded into our Care Coordination tool(Athena) Care Coordinators now have a holistic view for the at-risk members right at their finger tipExample: ACN member visits a non-Dignity Health hospital, Care Coordinators will getalert and be notified of such visit. The information is right there to help with caremanagement activities such as assessment, goal settings, or plans to reduce future EDvisits.29
Health Current Data Flow Process30
Health Current CCDA Data in Athena31
Health Current ADT Data in Athena32
Thank you!Questions?Contact Info:Ryan Sommerse. Ryan.Sommers@DignityHealth.orgp. (602) 502-903933
7 Dignity Health -Interoperability Evolution 2007 -Dignity Health's first regional HIE went live in the Sacramento Service Area, Included small results delivery pilot (2 practices, 4 physicians) 2011 -Regional HIE deployments live across all of Dignity Health service areas 2015 -Direct Messaging pilots started 2012 -Signed the DURSA and became the 34th Participant
