Information exchange: Know your use cases
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It didn’t get there by delivering one type of data one way, said David Dissinger, manager of integrated services at HealthBridge, at an April 25 National eHealth Collaborative webinar titled “One Size Does Not Fit All: Exploring Various Forms of Exchange.” The webinar also featured Cris Ross, executive vice president and general manager of clinical interoperability at Surescripts; and Jon Zimmerman of Availity.
HealthBridge implemented two major health IT systems, according to Dissinger. The organization has an Axolotl HIE backbone, which does most of the provider routing and allows providers to log into a web view and enter their patient information. The second system is the Mirth Mux platform, which includes an interface engine, clinical data repository and enterprise master patient index (EMPI), all based on a relational database, he said.
Currently, HealthBridge provides EHR feeds to 29 vendors and 60-plus EHR versions, and counting. “We’re working with those vendors at the national level to understand how to get the practices up to newer versions,” said Dissinger.
“The Mirth connect interface engine allows us to have that one-size-does-not-fit-all mentality … we can interface with anybody. Anything you need, we will be able to handle,” he said.
New integration and interoperability ventures will likely put that to the test. On tap are state connectivity efforts in Kentucky, Ohio and Indiana; transitions in care (hospital to home or another facility, etc.); and continuity of care initiatives including:
- EHR to EHR (PCP to specialist, for example)
- EHR to HIE (clinical data repository)
- EHR to registry
HealthBridge is also working on a state-level immunization registry and HIE-to-HIE connections, he said.
To accommodate two Beacon Grant demonstration projects, HealthBridge is working on health IT and exchange enhancements, said Dissinger. "We have an RFP up for a new EMPI and we're going to be building a data warehouse repository to help our business intelligence department start an ACO-type organization," he added.
“Through the Connect project, we had care providers from hospitals to providers to some of the nursing home health agencies sending us data, and we were able to create a C-84 document and send it to the ONC. Out of the Connect services, we utilized Connect’s document submission feature,” he said.
“Our Direct project is under development right now, [however,] we see a lot of use cases for this project. A lot will come with state connectivity to Kentucky, Ohio and Indiana." Direct will help with use cases such as transitions of care and continuity of care, said Dissinger, who has been involved with the NwHIN Connect testing and specification workgroups for the past three years.