New Mexico Immunization Information System

Interoperability ProjectDecember 05, 2012

Closeout PhasePresenters: Kevin Bersell, Rand Tilton, & Terry Reusser

Project Background Enhancement to the New Mexico Statewide

Immunization Information System (NMSIIS) Allow Provider Electronic Health Records (EHR)

systems to electronically submit immunization data to NMSIIS

Reduce keying errors for manually entering immunizations and reduce time for reporting immunizations

Funded by CDC Grant Immunizations Improve Health Outcomes

Improve data quality, quantity and timeliness Decrease the number of children that receive too

many or too few immunizations

Certification History Project Initiation and Planning, August 24,

2011, $262,500 Project Implementation , October 26, 2011,

$795,300 Total amount $1,057,800

Project Highlights Project Phase Certification Request: Closeout Project Start Date: January 2011 Project End Date: December 2012 Total project value: $1,057,800 Total expended to date: $773,264

Planning Phase Activities Vendor contract negotiated IV&V contract negotiated Continue proof of concept by testing HL7

messages and interfaces Detailed Schedule, Budget and Communication

Plans completed Resources identified and committed

Implementation Phase Activities

Interface with 6 pilot sites Upgrade NMSIIS to HL7 2.5.1 and then build a web

services framework for fully automated Bidirectional data exchange with the 6 pilot sites

Execute IV&V Contract Execute NMSIIS vendor contract amendment Execute Contract with Lovelace Clinical

Foundation Document testing procedures leading up to future

data exchange efforts with the ~1,100 immunization providers across the state

Close Out Phase Activities Develop transition document defining the roles

and process for project transition to operations.

Establish document library to archive all project documents.

Develop Application Support Plan No additional funding approval requested.

Project Achievements Business Objectives

Goal: 40% of all immunization administered statewide will be captured by the registry via Health Level 7 (HL7) interfacesOutcome: Project resulted in 11% of all immunizations electronically entered into NMSIIS. Project was not successful in recruiting all the high volume providers it had anticipated. In addition the volume of immunizations has increased by 50% since the beginning of project.

Goal: Increase revenue recovery by enhancing tracking of immunization across the state.

Outcome: Infrastructure is in place to capture and report insurance information

Project Achievements Goal: Reduce errors by reducing manual and

redundant data entry, and improve efficiency by automating immunization data entry and retrieval, with real time bidirectional interfaces between immunization provider EHR systems and the NMSIIS system.Outcome: Accomplished. Six providers were able to eliminate manual data entry and to efficiently submit data electronically.

Goal: Help immunization providers meet meaningful useOutcome: Accomplished. Gave providers ability to attest to Immunization Registry use. Provided resources to enhance NMHIT.org for MU and IIS use.

Project Achievements Goal: Overall, improve health outcomes by

increasing immunization rates and reduce over immunizingOutcome: Accomplished. Data Exchange information is a critical component of an overall increase in immunization reporting and improved immunization rates.

Project Achievements Technical Objectives

Goal: The NMSIIS interoperability project will interface with immunization providers to attain a one directional feed of doses administered into the NMSIIS registryOutcome: Accomplished. 6 providers are submitting data via one-way interface.

Goal: By 2012 send bidirectional message, so immunization providers can view, from within their EHR system, the immunization history of a client prior to administering additional immunizations. Outcome: Proof of concept completed. Awaiting provider to use in production.

Project Achievements Goal: Reduce errors by reducing manual and

redundant data entry, and improve efficiency by automating immunization data entry and retrievalOutcome: Accomplished. Six providers were able to end manual and redundant data entry, and improve efficiency.

Goal: Drive compliance to the Health Information Technology for Economic and Clinical Health (HITECH) Act by helping immunization providers satisfy meaningful use criteria.Outcome: Accomplished. Gave providers ability to attest to Immunization Registry use. Provided resources to enhance NMHIT.org for MU and IIS use.

Lessons Learned Working in a consortium with other States has

benefits and drawbacks Benefits: leveraging other state’s experience,

reduced cost Drawbacks: dependent on other state’s schedules,

vendor desire to move on to next state. It’s hard to predict EHR vendor abilities

without objective measures Manage Supplier quality control of

specifications, timeline, and overextension with other customer commitments.

Lessons Learned Executive management support and resource

allocation, excellent working relationship with Operations and ITSD staffs.

Value of being open to alternative solutions Rhapsody solution reduced API costs with increased

flexibility

Questions?

Appendix

EHR-IIS FOA Performance Measurement Milestone Checklist

Milestone 1: Establish grant staffing and contracts needed for the grant. Completed

Milestone 2: Datamart in NMSIIS is operational Completed Milestone 3: Data Quality issues with NMSIIS are addressed Completed Milestone 3a: Complete demographics for all providers in state Completed Milestone 4: NMSIIS HL7 Interface is operational and receiving test data accurately

Completed

Milestone 5: Establish working relationship with participating providers Completed Milestone 6: Conduct pre-implementation survey with participating providers

Completed

Milestone 7: Each participating provider’s EHR system has ability to meet national standards for HIT interoperability.

Completed

Milestone 8: Establish baseline measures for all participating providers Completed

Milestone 9: Build an interface between NMSIIS and the NMHIC HIE network and demonstrate routing and population of information into NMSIIS through the HIE network.

Completed

Milestone 10: Build a direct interface between NMSIIS and a select IHS clinic.

Milestone 11: Build or enhance interfaces to Presbyterian Healthcare Services and demonstrate the ability to transfer immunization records to NMSIIS through the HIE.

In Progress

Milestone 12: Build or enhance interfaces to and Taos Clinic for Children & Youth and demonstrate the ability to transfer immunization records to NMSIIS through either direct interface or via the HIE.

Completed

EHR-IIS FOA Performance Measurement Milestone Checklist

Milestone 13: Build or enhance NMHIC interfaces to After Hours Pediatrics and demonstrate the ability to transfer immunization records to NMSIIS through either direct interface or via the HIE.

Completed

Milestone 14: Build or enhance interfaces to BCA Pediatrics and demonstrate the ability to transfer immunization records to NMSIIS through either direct interface or via the HIE.

Completed

Milestone 15: Build or enhance interfaces to New Mexico IHS facilities and demonstrate the ability to transfer immunization records to NMSIIS through either direct interface or via the HIE.

Milestone 16: Build or enhance NMHIC interfaces to ABQ Health Partners and demonstrate the ability to transfer immunization records to NMSIIS through either direct interface or via the HIE.

Completed

Milestone 17: Build or enhance interfaces to all New Mexico DOH clinics and demonstrate the ability to transfer immunization records to NMSIIS through either direct interface or via the HIE.

Completed

Milestone 18: Implementation of NMSIIS HL7 2.5.1 interface – for INBOUND data

Completed

Milestone 19: Implementation of NMSIIS HL7 2.5.1 interface – for OUTBOUND data

Completed

Milestone 20: Implement bi-directional data exchange from NMSIIS back to providers

Milestone 21: Finalize sustainability Plan Completed Milestone 22: Performance measure reporting Milestone 23: Post-implementation provider survey