HIE Chronicles Part II: Building a better system
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After overcoming administrative and naturally occurring hurdles, including a record-breaking flood, the Rhode Island Quality Institute (RIQI) began its journey last summer to install currentcare, a new statewide health information exchange (HIE), to assist the quality of care among the Rhode Island patient population.
As part of the initiative, RIQI purchased InterSystems’ HealthShare platform to serve as the foundation of the statewide HIE. Purchasing a new system was beneficial because the product had an array of functionality that the previous system did not, including integration with Surescripts for medication history, said Laura Adams, CEO and president of RIQI.
currentcare performs on the InterSystems HealthShare platform, including its Caché database management system and middleware Ensemble component, according to Gary Christensen, CIO and chief operating officer at RIQI. “There’s also a web-based presentation layer that runs in real time, so if a clinician queries a patient, the presentation layer will locate the patient’s record amassed through the data-sharing process, and present that information through the viewer,” said Christensen.
Coupled with the InterSystems platform is a QuadraMed statistical matching engine. “Because there’s no universal patient identifier, we have to do matching based on data coming into the system,” including names, addresses, phone numbers and other bits of information, he said.
The matching engine looks for statistical matches for patients in the data. Matches are analyzed in real time for probability that the patient with a clinician is the same patient in the currentcare database. “Additionally, the system fine-tunes itself as it learns from the data over time to get better at matching as data gets more populated,” said Christensen.
The final moving part of currentcare is a compendium management system from Apelon, which maps the data formats from data-sharing partners to the industry-standard formats stored in currentcare. Data sharers may or may not use pure industry standards when storing clinical data, Christensen said. currentcare translates the incoming medical data inside the system.
“The mapping package allows us to keep an industry standard compendium mapped to the data-sharing compendium, which we will have to manage over time as organizations change formats within their systems,” he said.
RIQI has built a robust framework to handle a flood of a different kind—a data deluge. RIQI is gearing up for a March rollout of currentcare. At go-live, RIQI will begin to collect and input data into the system from consented patients. Once activated, the HIE will begin collecting lab results and medication history.