The Washington Health Information Network (WHIN) is a private health information exchange (HIE) that connects The Washington Hospital and physician practices affiliated with the Washington Physician Hospital Organization (WPHO). MobileMD is the backbone of WHIN. Denise Abraham, the health information exchange coordinator for The Washington Hospital, and Charles R. Vargo, executive director of the WPHO, work closely to keep this vital piece of caregiver connectivity alive. WHIN is having a positive impact on patient care and clinical practice by increasing physician knowledge and boosting efficiency by allowing physicians, nursing and key clinical staff secure access to key information such as lab and radiology reports and EKGs. The private HIE has united 13 EMRs from different vendors via interfaces to provide one data repository for enterprise access. Learn why they chose a private HIE, how it has evolved from 2006 until now and what advice they offer to other healthcare systems ready to embark on a private HIE project.
Inside a Private HIE: Clinical, Economic and Operational Successes at The Washington Hospital
1. Inside a Private HIE:
Clinical, Economic and Operational
Successes at The Washington SPONSORED BY:
Hospital
Presenter Presenter Moderator
Denise Abraham Charles Vargo Mary C. Tierney
Health Information Exchange Executive Director, Washington Chief Content Officer,
Coordinator, The Washington Physician Hospital Organization TriMed Media Group
Hospital, Washington, Penn. (WPHO), Washington, Penn. Providence, RI, USA
Presented by CMIO
3. The Washington Hospital
- Community Teaching Hospital
- Washington, Penn.
- 274 Beds
- 17,000 Annual Admissions
- 700,000 Annual Outpatient Visits
- 14 Offsite Care Facilities
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4. Washington Physician
Hospital Organization
(WPHO)
- Established in 1994
- Joint Venture between The Washington Hospital & the
Onstaff Physicians
- 250 Physicians – Primary Care & Specialists
- 90 Practices
- 40 Specialties
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6. Advantages: A Private HIE
- Improving Patient Care
- Increasing Physician Knowledge & Efficiency
- Secure Access to Key Information
• Lab
• Radiology
• EKGs
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7. WHIN: A Private HIE
- Unites 13 EMRs from Different Vendors
- 1 Data Repository
- 375 Physicians with Enterprise Access
- 90% of Practices Participate in Physician Portal
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8. WHIN: A Private HIE
- Why Start a Private HIE?
- Evolution 2006 to 2012
- Advice for Health Systems Seeking to Start a
Private HIE
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9. WHIN: The History
- 2006 – Started the Project
- August 2007 – Launched MobileMD
- October 2007 – Went Live
- November 2007 – First Pilot Practices
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10. WPHO: The Challenges
- 2005-2006 – Excellent EMR Penetration
- 12 Different EMRs
- A Need to Interface
- Choosing a Vendor
• Spent one year vetting solutions
• MobileMD emerged as the right choice
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11. WHIN: The Technology
Inside
- Data Repository Fed by Hospital IT Systems
• Enterprise Access Via Physician Portal
• Health Information Exchange Interfaces with
Multiple Practices’ EMRs
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12. WHIN: The Roll Out
- Linked in Initial Practices
- December 2007 – ADT Registration
Feed, Lab, Radiology
- April 2008 – Dictated Reports
- Added since then: EKGs, Reports & Parameters
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13. WHIN: Where We Are
Today
- Interfaces Complete with 9 Physician Practices
- Interfaces in Progress with 6 Physician Practices
- 7 More Practices Have Requested an Interface
- Interfaces to 12 Different EMR Vendors
- 50% of Active Medical Staff Now Linked to
Private HIE
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14. WHIN: The Physician Portal
- 90% of WPHO Physicians Have Inboxes & Staff
Accessing Information
- 375 Users
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15. WHIN: Why A Private
Exchange?
- EMR Users Needed Interface to Multiple EMRs
- Manage Information Differently
- Nothing Happening on a State or Local Level
- Lack of Control of State or Regional Exchange(s)
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16. WHIN: The Funding
- Hospital: Custodian of Clinical Information Systems
• Pays for the Relationship of the Clinical IT systems and
Moving Information to the Exchange
- Physician Organization: Funds Enterprise Access
Applications
• Pays for Information Coming Out of the Exchange
- Physician Access: Interface Is Supported by Grant
Program
• Stark Compliant
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17. WHIN: The Support
- Partnership between Hospital and WPHO
- Share Responsibility:
• IT
• Managing Interface Streams
• Training
• Support & Help Desk
- Trust & Cooperation
- Communication
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18. WHIN: Staff Training
- Reached Out to Office Contact People
- Solicited Users with Computer Acuity
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19. A Private HIE: The Capabilities
Typical User can:
- Look Up Patient Results
• Lab, Radiology, EKGs, Demographics, Insurance Information
- Track Admissions, Number of Admissions, Length
of Stay & ER Visits
- Optimization of Preoperative Clearance Process
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20. WHIN: What Enterprise
Access Offers
- Help with Care Transitions
- Hospitalist Notices to PCPs – Real Time
- Discharge Instructions and Summaries Sent as
Messages to Physician Inbox
- Inpatient and Outpatient Test Results
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21. WHIN: What Enterprise
Access Offers
- Customizable Interfaces
• Inpatient EMR
- Portal Offers Total Picture of Patient
- Secure Messaging
• Hospital Practice
• Practice Practice
- Robust Local Search Capability
• Assists Specialists & Avoids Unnecessary Testing
- Defines Roles, Permissions & Privileges
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22. WHIN: Physician Feedback
- Rely on Office Staff to Gather Information
Automate the Process
- Support Staff – Initial Users
- Physician Adoption Has Grown
- Physicians Using EMR & WHIN to Reference
Data
- ‘Finest Thing You Have Ever Done’
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23. WHIN: Practice Benefits
- Look at Processes & Automate
- Turn Off Paper Reports
- Eliminate 9,000 Pieces of Paper/Month
- Eliminate Staff Time to Sort Mail/Stuff Mailboxes - with
Information that Often Gets Lost or Delayed
- Increase Efficiency of Information
- Drastic Reduction in Medical Records Requests
- EKG Image Enterprise Access
- No Fax Artifacts; All-the-time Access
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24. WHIN: Encouraging
Physician Adoption
- Medical Records a Critical Partner
- Target Progressive Physicians & Office Staff
- Private HIE Sold Itself by People Becoming
Aware & Embracing It
- Intuitive to Use
• Sort
• Search
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25. WHIN: Enterprise Access
Document Tree Includes:
- Lab, Radiology, ADT Registration-Patient
Demographics, Medical Records, Pathology
Reports, Cardiovascular Department-EKGs,
Hospital Clinical Documentation, Interface for
Discharge Instructions & ER Visit Notifications,
Physical and Respiratory Therapy Reports
- Eliminates the Need for Non-hospital Employees
Using the Hospital EMR
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26. WHIN: What’s Coming Next
Document Tree:
- Caregivers Involved in Transition of Care from
Inpatient to Outpatient
• Skilled Nursing
• Home Care
- Caregivers Involved
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27. WHIN: The Challenges
- Primary Care Hospital
- Primary Care 50% of Physicians Still Admit
Patients
- Keeping Caregivers Tied to Hospital Community
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28. Private HIE: High Reliability
- Since December 2007: No Unplanned Downtime
- Planned Time for Updates: Midnight to 8am
• Doesn’t Impinge on Physician Office Requests
- Addition of New Clinical System – Full Testing
Follows Upgrade
- Siemens and MobileMD – Work Closely to
Facilitate Interfaces
- Work Well with Wide Variety of EMR Vendors
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29. Private HIE: Challenges
- HIPAA
- State Laws: Pennsylvania
• HIV/Aids
• Substance Abuse Information
- Careful Routing of Information – with Consent
- Identifying Appropriate Providers Practices
Owned by Competing Health Systems
- Managing Enthusiasm – i.e. Secure Messaging
- Work with Regional Exchanges
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30. Private HIE: Access Key to
Building Value
- Surgicenter – Preoperative Testing Being Done
by Hospital Because of WHIN Access
- Lab Use Increasing – Managed Care Organizations Have
Access
- For-profit Imaging Centers Lack Effective Interface to
Physicians = Retained Business
- Accountable Care Organization (ACO) – Expect Positive
Growth
• Integrated Information Platform + Enterprise Access to View Data
Over Time
• Avoid Duplication of Testing, Other Cost Savings
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31. Private HIE: The Benefits
- Enhance Transitions of Care
- Better Communication
- Secure Messaging Supports Move Toward ACOs
- Supports Meaningful Use Standards – EMRs
Must Be Highly Coordinated
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32. Private HIE: The Benefits
- Physicians: High Satisfaction – Easy Access to
Information
- Information Available to Physician & Staff
- Supports Efficient, Effective Care at the Point of
Care
- Physicians Like that They Have A Choice in
EMRs
• Preserves Ability to Choose EMR that Works Best for Practice While Having
Full Access to Information at The Washington Hospital
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