Plenary Session #1Plenary Session #1

““What Technology is What Technology is currently available to currently available to

support care in the home for support care in the home for older adults?”older adults?”

Medical / Personal RecordsMedical / Personal Records

SPRY NATIONAL CONFERENCESPRY NATIONAL CONFERENCE"Computer-Based Technology "Computer-Based Technology

and Caregiving for Older Adults“and Caregiving for Older Adults“

October 2–3, 2003October 2–3, 2003NIH Campus/Natcher Conference CenterNIH Campus/Natcher Conference Center

Bethesda, MarylandBethesda, Maryland

www.ptsafety.orgwww.ptsafety.org

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OpportunityOpportunityOpportunityOpportunity

…access to a timely, accurate, consolidated patient-centric view of critical clinical information.

Solving one of the major

problems of care coordination…

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ProblemProblemProblemProblem

Every year preventable medical errors cause:

• Death to approximately 100,000 hospitalized Americans (more than breast cancer, traffic accidents and AIDS)

• Injury to one million more hospitalized Americans

• Indirect tax (cost) of $29B to the nation

Healthcare cost escalation is out of control

• 2003 health premiums increased 13%, largest increase in decade

• In 2002, 20% of states' budgets was for Medicaid, creating fiscal crisis in many states

• One in seven Americans are without health insurance

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SolutionSolutionSolutionSolution

Studies have indicated that well over half of all preventable deaths and over $40B in annual cost could be saved if clinicians had current clinical information at the point of care or decision.

Studies have indicated that well over half of all preventable deaths and over $40B in annual cost could be saved if clinicians had current clinical information at the point of care or decision.

National Medical Information Exchange

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Patient Safety Institute IsPatient Safety Institute IsPatient Safety Institute IsPatient Safety Institute Is

• PSI is an industry represented non-profit organization focused on BUILDING a secure, "trusted" national, medical information exchange network.

• PSI provides (with patient permission) real time access to critical patient information at the point of treatment or decision similar to the way VISA® provides real time financial information at the point of service.

• PSI completes missing connectivity, replacing nothing and joining relevant electronic clinical data within and outside the community.

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Requirements for National MedicalRequirements for National MedicalInformation ExchangeInformation ExchangeRequirements for National MedicalRequirements for National MedicalInformation ExchangeInformation Exchange

• "Trusted" cross-industry representative governance

• Non-profit

• Core mission of patient privacy, security and choice

• Open, non-proprietary, scalable infrastructure architecture

• National design while community driven– Connectivity to national data

sources

– Single membership model rather than peer to peer contract model

• Single focus on healthcare network access for all (like VISA® for financial information)

• States

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• The Board of Directors includes nine representatives drawn equally from national leaders in the patient, physician and hospital communities. This composition ensures the safety and security needs of each group are being met as PSI delivers its solution to the marketplace.

– Chair and President: Dr. Jack Lewin, CEO of the California Medical Association

– Vice Chair: Don Black, President of the Child Health Corporation of America

– Secretary/Treasurer: Dr. Jane Delgado, President and CEO of the National Alliance for Hispanic Health

– Twila Brase, RN, PHN, President of Citizens’ Council on Health Care

– Dr. Richard F. Corlin, past President, American Medical Association

– Sister Karin DuFault, Ph.D.,RN, Vice-President, Providence Health System (former Board Chair) and Trustee of Catholic Health Association

– Linda Golodner, President of the National Consumers League

– Dr. William Jessee, President of the Medical Group Management Association

– Dr. Daniel H. Winship, Petersdorf Scholar in Residence, Association of American Medical Colleges (former Vice Chancellor for Health Affairs and CEO, Univ. of  Missouri Health Care)

The Board is advised by Dee Hock, Founder and CEO Emeritus of VISA® in areas of governance and structure.

PSI GovernancePSI GovernancePSI GovernancePSI Governance

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PSI – Technical OverviewPSI – Technical OverviewPSI – Technical OverviewPSI – Technical Overview

PSIHub

PhysicianPatient

CommunityLabs

CommunityPharmacies

Hosp./Clinic B

Hosp./Clinic A

1

1

Physician requests information using a PDA or Browser. The request

is transmitted to the PSI Hub

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2

2

The PSI Hub sends a request/response message

to retrieve the local “Basic Safety Data,” or “BSD”

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3

The PSI Hub gathers and formats the BSD.

The BSD is then transmitted tothe requestor, formatted to

the appropriate device footprint

3

Pharmacist Patient

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(of patient’s choice)

Caregiver

Physicians

Services

Research, Treatment & Clinical Trial

Information

Hosp./ClinicCommunityLabs

CommunityPharmacies

PSI – Patient ConnectivityPSI – Patient ConnectivityPSI – Patient ConnectivityPSI – Patient Connectivity

PSIHub

Physician

Patient

•Review•Append

•Contribute•Communicate

Patient

Pharmacist

Patient

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PSINational

Hub* StateY

Model

StateX

Model

PatientPortals

National PatientVerification

& SupplementalData

InsurersNational Diagnosis

Meds, Immunizations & Enrollment

LabCo’s

NationalLabs

PBMs & Pharmacies

NationalMeds & Allergies

StatePrograms

Immunizations & Other State RegistriesMedicaid, SCHIP

State-Funded Indigent CareHead Start

WICCommunity Health Centers

Workers’ CompensationEMS

Correction FacilitiesFood Stamps

Etc.

Physician DataIntegrators

Physician Portals,

ASPs and large clinics*

State Public Policy& Academic Research* Hospitals

& Other Providers

Basic Safety Data*

IndividualPhysicians

Via State Designee(State Medical Society or

Licensing Board)*

* w/Patient Permission

StateZ

Model

PSI Core withState Specific Functionality

PSI National/State Community ApproachPSI National/State Community ApproachPSI National/State Community ApproachPSI National/State Community Approach

Medicare & Employers

Claims Data & Enrollment

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Additional InformationAdditional InformationAdditional InformationAdditional Information

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Participation must be equitably open to all individuals and organizations that materially affect patient health and safety.

Deliberations must be conducted, and decisions made, by bodies and methods that reasonably represent all such parties, controlled or dominated by none.

Individually identified data must remain the property of that individual and must not be disclosed or disseminated to others without that individual's consent.

All participation shall be voluntary with the right to withdraw.

Any data accessed for the development of improved health or patient safety must be de-identified and remain under the control of PSI.

PSI operation will only be funded by those means which do not compromise the above principles.

PSI will be designed and will function to enable and enhance community-based collaboration for improved health and patient safety.

PSI PrinciplesPSI PrinciplesPSI PrinciplesPSI Principles

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Improve healthcare quality

Reduce medical errors

Lower the cost of health care

Strengthen the privacy and security of patients, physicians, and hospitals

Enhance the patient-physician and hospital-physician-patient relationships

PSI GoalsPSI GoalsPSI GoalsPSI Goals

Thank YouThank You

QUESTIONS?