hxrefactored 2015: charles boicey "interoperability exercise, triple store & onc...
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INTEROPERABILITY EXERCISE, TRIPLE STORE & ONC INTEROPERABILITY ROAD MAPCharles Boicey, MS, RN-BC, CPHIMS
Enterprise Analytics Architect
Stony Brook Medicine
Stony Brook University
Interoperability Exercise
DSRIP• 8 billion dollar grant (Medicaid waiver) from CMS to NY State• 25% reduction over five years in avoidable hospitalizations
and ER visits in the Medicaid and uninsured population• Collaborative effort to implement innovative projects
focused on• System transformation• Clinical improvement• Population health improvement
Uninsured + Medicaid Members
Medicaid Members Data from DSRIP 2012; Uninsured data from ACS 2012 5 Year Estimate
n = 387,290
Geographic Concentrations in Western, Central and Eastern Suffolk
5 YEAR GOALS• Create integrated Suffolk County care delivery system for 387K lives anchored by safety net providers
• Engage partners across the care delivery spectrum to create a countywide network of care
• After five years, transition this network to an ACO which will contract with insurance providers on an at risk basis
Suffolk PPS Organizational Structurefor exchange of clinical data and alerts for patient visits through e-HNLI
Stony Brook Medicine
Suffolk PPS HIE(SB Clinical
Network IPA, LLC)
Health Systems
Hospitals
Community Health
Centers
Behavioral Healthcare Providers
Skilled Nursing Facilities CHHA’s/
LTHHC
Physician Groups
Health Homes
Community-Based
AgenciesPharmacies
Those not part of the Stony Brook Medicine Network
Other Healthcare Providers
Develop-mental Disability Providers
Suffolk county RHIO
(e-HNLI)
Jim Murry, Charles Boicey
Suffolk Care Colaborative IT ArchitectureSuffolk County Providers
Suffolk county PPS Master Patient Index (MPI)Suffolk county PPS Health Information Exchange (HIE)
E-HNLI RHIO (HIE)
Suffolk County PPS Patient Portal
Stony Brook Medicine
Suffolk County Big Data Platform
Suffolk County PPS Population Management Tools
EMRs or clinical Information SystemEMRs or clinical Information System
eForms Patient Wellness
Alerts Mobile Monitoring Patient Education Clinical Records
Collaboration
Registries Care Plans Workflow Med Adherence Mobility
Predictive Analytics Event Engine Structured Data Financial Data Legacy Data
Machine Learning NLP Unstructured Data Wearables Data Social Data
Anomaly Detection Rules Device Data HL7/CCD Open Data
Clin
ical
Dat
a fo
r Pati
ent C
are
RHIO
Interface Engine
Hl7, CCD, CCDA, FHIR, XML, JSON
PayorsPopulation ManagementPlatform
DSRIPProvider SystemsN>200
Consent Query
SBMHIE
SBMEMRs
nonSBMEMRs
Clinical Claims
Clinical
Claims
Clinical
Clinical
Clinical
View
Clinical
View
Semantic Web – RDF Triple Store
First a Couple of DefinitionsSemantic: Study of Meaning
Semantic Information System for Healthcare: Is a semantic web system based on healthcare ontology
Ontology: common vocabulary, common understanding
Why RDF Triples?• Semantic Interoperability
• Sending data that can be understood by sender and receiver
• Benefits of Healthcare Information Technology Depend on Interoperability
• Interoperability Difficulties Between Systems
Shortliffe, Cimino, 2006
Resource Description Framework
Ogbuji, 2013
DiseaseshasSymptom
isSymptomof
ClassClass
Ogbuji, 2013
ONC Interoperability Roadmap• Public Comment Period Ends
• April 3, 2015 @ 1700 EDT• http://www.healthit.gov/policy-researchers-implementers/
interoperability
• Publications• Connecting Health and Care for the Nation: A Ten Year Vision to
Achieve an Interoperable Health IT Infrastructure (13 pages)• Connecting Health and Care for the Nation: A Shared Nationwide
Interoperability Road Map Draft Version 1.0 (166 pages)
Interoperability DefinedThe Office of the National Coordinator for Health IT is responsible for advancing connectivity and interoperability of health information technology (health IT). ONC follows the IEEE definition of interoperability as the ability of systems to exchange and use electronic health information from other systems without special effort on the part of the user.
Learning Health System
10 Year Plan Guiding Principals• Build Upon Existing Infrastructure• One Size Does Not Fit All• Empower Individuals• Leverage the Market• Simplify• Maintain Modularity• Consider Current Market and Support Multiple Layers of
Advancement• Focus on Value• Protect Privacy and Security
Use Cases Over 10 Years
3 Years
Primary Care Providers exchange patient information with specialist during the referral process
6 Years 10 Years
Individuals manage information from their own electronic devices and share that information seamlessly across multiple electronic platforms as appropriate (health care providers, social service providers, consumer-facing apps and tools, etc).
Primary care providers and authorized researchers are able to understand how well controlled diabetic patient population’s glucose levels (i.e., A1C values) are and how often those patients have been hospitalized based on standardized information from multiple sources.
Building Blocks1. Core Technical Standards and Functions
2. Certification to Support Adoption and Optimization of Health IT Products and Services
3. Privacy and Security Protections for Health Information
4. Supportive Business, Clinical, Cultural and Regulatory Environment
5. Rules of Engagement and Governance of Health Information Exchange
Interoperability Training Courses• Transitions of Care• Lab Exchange• Patient Engagement• Public Health Measures
http://www.healthit.gov/providers-professionals/interoperability-training-courses
Life is short,Build Stuffthat MattersSiqi Chen, CEO of HereLabs
