hi3 solutions: accelerating hie standards conformance

Accelerating Adoption of Health Information Exchange Standards

AbdulMalik ShakirPresident and Chief Informatics Scientist

Your Healthcare Standards Conformance Partner

Electronic Health Information

The use of Electronic Health Records and the demand for electronic exchange of health information from one health care professional to another is growing along with national efforts to improve the quality, safety and efficiency of health care delivery.

October 14, 2013Accelerating Adoption of Health Information Exchange Standards2 of 32

National Health Programs

Meaningful use requirements, new payment approaches, and federal financial incentives are all driving the interest and demand for health information exchange.

Similar initiatives are underway in other nations throughout the world.


Healthcare Informatics Standards

Healthcare organizations have

found it advantageous to

collaborate in the pursuit of

solutions to healthcare

information management issues.

Healthcare provider, payer, vendor,

consulting, and regulatory

organizations have formed

industry groups to study

information management issues

and develop standard solutions to

their common problems.


Electronic Health Information Exchange

PharmaciesPhysicians

Testing OrganizationsLab/Images

Hospitals

Payors

Employers

County/CommunityEntities

Patients/ConsumersGovernmentMedicare/Medicaid

Lab results

Patient Data

Orders

ResultsImages

Eligibility

Referral ProcessClaim Status

Claims/Prescriptions

Referral Process

Claim/Status

Health InformationInsurance Updates

Eligibility

Medical Records

Enrollment

Mental Health

Family Planning

Medical Society

Public Health

October 14, 2013Accelerating Adoption of Health Information Exchange Standards

5 of 32

Healthcare Information

System

HL7

HL7

HL7, X12N

HL7, X12N

HL7

HL7

DICOM

IEEE MIB,ASTM

X12N / HL7 (Non-US only)

X12N

NCPDP

Healthcare Data Interchange Standards

October 14, 2013Accelerating Adoption of Health Information Exchange Standards

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Leading U.S. Healthcare Data Interchange SDOs

IEEEInstitute of Electrical and Electronic

Engineers

NCPDPNational Council for Prescription Drug

Programs

X12NInsurance Subcommittee of X12

ASTM

American Society for Testing and Materials

DICOM

Digital Imaging and Communications in Medicine

HL7

Health Level Seven


IEEE

Instrumentation communication standards and generalized information interchange

standards

NCPDP

Standards for communication of prescription, billing, and other pharmacy

material

X12N

Standards for exchange of healthcare insurance and billing information

ASTM

Lab reporting standards and standard guide for content and structure of computer-

based patient records

DICOM

Standards for exchanging digital radiology images

HL7

Inter-application interoperability standards for healthcare

Leading U.S. Healthcare Data Interchange SDOs


HL7 and X12N HL7 and X12N are standards

development organizations accredited by the American National Standards Institute (ANSI).

Each organization adheres to a strict and well-defined set of operating procedures that ensures consensus, openness and balance of interest.

HL7 develops standards that enable disparate healthcare applications to exchange key sets of clinical and administrative data.

X12N develops specification that enable the electronic interchange of healthcare insurance and claims processing data.

HL7Clinical / Administrative

X12NInsurance / Billing


An X12N Data Interchange ScenarioUser InterfaceProgram

ModuleDataset

OutboundTransformation

InboundTransformation

User InterfaceProgramModuleDataset



B to ATransformation

A to BTransformation

Patient Billing Application

System

Claims Processing Application

System

Patient Billing Application

System

Claims ProcessingApplication

System








B to ATransformation

A to BTransformation

Order Entry Application

System

Laboratory Application

System

Order Entry Application

System

Laboratory Application

System

An HL7 Data Interchange Scenario


Reaching the Limits of Application Interfaces

Lab

Order Entry ADT

Pharmacy Radiology

DecisionSupport

ElectronicHealth Record

AdministrativeSystems

?

EnterpriseSystems

?ExternalSystems

?


HIE Standards: Why

• The number of interfaces between N systems is given by the formula (N2-N)/2.

• Linking 2 systems only needs 1 interface, (22 – 2) / 2 = 1;

• Linking 6 systems needs as many as 15 interfaces, (62 – 6) / 2 = 15

• The benefits of using standard increase rapidly with the number of systems involved.



Interfaces Requirements

0

20

40

60

80

100

120

Systems

Inte

rfac

es

W/O HL7 1 3 6 10 15 21 28 36 45 55 66 78 91 105

With HL7 2 3 4 5 6 7 8 9 10 11 12 13 14 15

2 3 4 5 6 7 8 9 10 11 12 13 14 15

HIE Standards: Why

Tolerable Painful Intolerable

Health Information Exchange

Effective, meaningful health information exchange requires that all parties involved in information

exchange adhere to predetermined transaction formats, usage constraints, and encoding rules.


Product Domains

Health Information Standards Compliance

Health Information Integration

Healthcare Quality and Performance Measurement

Service Offerings

Consulting and Contracted Resources

Education and Training

Healthcare Information Integration InfrastructureYour healthcare standards conformance partner


Health Information Standards Compliance

Hi3 Solutions’ STANDARDS CONFORMANCEVALIDATOR™ (SCV) is a comprehensive suite of application services that validates compliance with healthcare information exchange standard specifications and conformance

with related implementation guides and profiles.


STANDARDS CONFORMANCE VALIDATOR

Standard HIE Transaction Specifications

Standard Clinical Terminology Code Systems

Data Item Specific Value Sets

Use Case Driven Specification Profiles

Data Exchange Instance Validation


Short List of HIE Standards

Standards Profiles / Guides

Exchange Structures HL7 v2.x HL7 v3 Messages HL7 v3 CDA Documents ASC X12 v5010

Code Systems SNOMED CT LOINC CPT ICD

HL7 Case Notification Laboratory Reporting Immunization Consolidated CDA

X12 834 Benefit Enrollment 837 Health Care Claim 835 Health Care Claim Payment


Health Information Integration

Hi3 Solutions’ HEALTH INFORMATION INTEGRATOR™ (HII) is a comprehensive suite of application and database services that facilitate the transformation of data structures, translation of clinical terminologies, and

integration of health information.


HEALTH INFORMATION INTEGRATOR

Local structure to standard structure transform

Standard structure to local structure transform

Standard structure to standard structure transform

Coded value to coded value translation

Integrated health information data repository


Healthcare Quality and Performance Measurement

Hi3 Solutions’ HEALTHCARE QUALITY MONITOR™ (HQM) is a comprehensive suite of data warehousing and business intelligence

solutions geared specifically toward monitoring quality and performance in healthcare in accordance with established measurement standards.


HEALTHCARE QUALITY MONITOR

RIM-based Integrated Data Repository

RIM-based Star-Schema Business Intelligence database

Predefine performance measures and metrics

Drill-down and drill-through capabilities

Information publication and data export capabilities

Data visualization and reporting capabilities


Quality and Performance Measures

CMS: Clinical Quality Measures

NCQA: Healthcare Effectiveness Data and Information Set

JCAHO: National Quality Core Measures

CMS: Physician Quality Reporting System

BC/BS: Pay For Performance


Hi3 Solutions Products

STANDARDS CONFORMANCEVALIDATOR™ a comprehensive suite of application services that validates compliance with healthcare information exchange standard specifications and conformance with related implementation guides and profiles.

HEALTH INFORMATION INTEGRATOR™ a comprehensive suite of application and database services that facilitate the transformation of data structures, translation of clinical terminologies, and integration of health information.

HEALTHCARE QUALITY MONITOR™ a comprehensive suite of data warehousing and business intelligence solutions geared specifically toward monitoring quality and performance in healthcare in accordance with established measurement standards.


http://54.200.52.82/

Hi3 Solutions Services

Consulting and Contracted Resources [Hi3 Consulting Group]

Hi3 Solutions’ CONSULTING AND CONTRACTED SERVICES are provided by a diverse set of HITprofessionals with talent and experience in all areas of healthcare informatics, health informationexchange, and health information management in general.

Consulting personnel provide advisory services and expert strategic guidance, while contractedresources provide staffing for projects to augment internal personnel and fulfill gaps in skills or availablebandwidth.

Contracted services are also available to design and develop of custom turnkey solutions to meet clientspecific information management needs.

Education andTraining [Hi3 University]

Hi3 Solutions’ EDUCATION AND TRAINING SERVICES provide the knowledge transfer, skillsdevelopment, and skills certification required to establish an effective HIT workforce.

Education is provided in the form of instructor lead classroom tutorials, custom on-site training andcertification, and online live and pre-recorded webinars.

Hi3 educational offerings include topics in the area of health informatics standards, informationmodeling and vocabulary management, and healthcare information management tools and technologies.


Hi3 University


www.hi3solutions.com


Hi3 Solutions, 3500 W. Olive Ave,

Suite 300, Burbank, CA 91505ww.hi3solutions.com

+1 800 918-6520


hi3 solutions: accelerating hie standards conformance

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