 |
|
|
design round 4: final reports & closing Tom Lloyd: We had five teams working during this round. Let’s take seven minutes to walk people through your answer and a few minutes for discussion. Team A: Use Case &
Minimum Data Set The things we set out to accomplish were to identify the minimum use case, identify minimum data set and the entries that will participate and contribute to the model. For the minimum use case identified, we tried to check these against the contract as we understood it.
In the end we identified that we needed four different data sources within a RHIO. (refer to table on single panel) The MPI needs to correctly identify the patient and locate the record through the RHIO database. Third, appropriate authentication and access controls from the portal into the RHIO. All functions as “discoverable” services. Basically, what the contract states is that the core functionally with the RHIO has to be exposed to third parties. I would assume this is supposed to be a national proof of concept. We need to have the capability of accessing data through the local portal from the remote RHIO. Next, we set out to identify what we define as the minimum data set. The required data elements from the hospitals are demographic data (ADT and visit history data), from the payors we require diagnosis data, allergies and medication claims data, and immunization data from the payor. Suggested data included the diagnosis data, core lab data, allergies and medication claims, reports including radiology, pathology, and immunization data from the hospitals. We tried to identify the entities within each market that could provide data and got an early nod as to yes, they would be able to provide the data. We did not talk about the users who are receiving this. We did talk about the implication on the outpatient side. Back to number one, so regarding the local data pushed into the RHIO database, is that already existing? That would be translated into the current Oracle database. Our next steps are that we need complete “provider profiles”, regarding data, formats, interfaces, systems, etc. We need data element definitions and to create a set of user defined metrics. We need to look at HL7 capabilities and compliance.
Team B: Technical How/Who’s
Accountable I am going to be talking about expectations. Before we get into expectations, we based this on assumptions. There is going to be a minimum of eight source entities. There will be no “long arm” functionality during this “phase” which is due 9/28.
B.A.A. signed by 4/1/06. De-identified data removed from scope. Web services must provide authentication, patient ID, and location of clinical data. We broke the efforts into three categories: initiation phase, implementation phase, and ongoing phase. In the initiation phase there is a connectivity phase to determine what type you will be using. That will require a network resource for a while. Data transfer is another initiation task and will vary depending on the file format. You can expect to dedicate some type of program resource. The last task is the enterprise view development. We would like to work with a small group of clinicians on the design and to get feedback. In the implementation phase, we will want to validate the data before we go into implementation. Credentialing, assigning users and roles. We assume you will have a site administrator to manage your users. In terms of security, we will need each site to send their role definitions. For training, you will provide a super user who will then run the train the trainer programs. Ongoing, we will generate data quality reports as you send us data, so that everyone’s data gets better. With respect to auditing, we both have responsibilities. Data quality is the patient identification; the system can generate automatic data quality reports. Depending on the method you use to transfer data, you might need a resource or have to manage that capability. Ongoing support calls for the super user to be Level 1 support and LACare would provide Level 2 support. Add a security architect. Credentialing has a different connotation than defining user access. Credentialing refers to whether someone has the credentials to access data. In terms of data transfer, we would like it as often as possible, but we will need to talk about this more later.
Team C: Steering Committee
The other thing we talked about were the two types of documents among the parties. A MOU with the following contents (DHH to draft). The rules of engagement include participating, voting, term, and contributions. The first thing we want to make sure we do is improve the overall project scope and use case. We need to discuss opt out rules and incorporate the privacy regulations. Termination guidelines and credentialing need to be worked through. We also discussed what level of provider gets access to PHI? Please add: MOU would clearly define what the participant entities can expect and what they are expected to contribute. Some of our interim governing principles are that non-participant access to data is not allowed. Transparency will help us get past the trust issue. We will have to share all known information. Publishing participants make governing decisions. Chair selection, we think that DHH should decide who chairs this committee. Decisions should be make by simple majority of quorum, 50%. During the project period, work groups should engage in transition planning as follows: security/privacy/legal, clinical, technology, governance structure, and financial sustainability. At reset, we need to ask the initial question: does the model persist? If yes, we need to address the following issues: governing principles revised, scope of exchange/tech/architecture/use, decide on recommendations from work groups, and regional issues.
Team D: Legislative Post
9/29 Needs
First pass, $1.5 million a year to run this thing. I think we got most
of the variables and issues. This is a first pass at the issues. (Refer
to Technical We low balled the hardware but we think you will add more; the hardware is probably off by half a million. I would say the line items are more valuable than the actual numbers. Again, we tried to take the first pass at the frame work.
Team C (continued): Project Management Plan (Refer to Action Plan)
We have gathering and finalizing the design early. Prior to this line, 9/29 goal, we called this Phase 1 and afterwards Phase 2.
We will need to work on what comes next since we limited our scope for Phase 1. We are going to evaluate Phase 1 and work on future design. Our go live date is 9/29-9/30. Be aware that your deliverable to HHS is due on 9/30. The data draft definition is due in March. I have a question about the sustainability model. We have the cost but what about the return? Are there any thoughts on baseline information? In the tool kit there is an entire set of value propositions but we did not have time to work on that. [click to view larger images of tiles] Discussion How does everyone feel? I think there is a lot of technical work that has to be done. How often is the governance team meeting? Everyday. The team will be kicked off when I get back. I think we are very fortunate in Louisiana to have the alignment of our payors with our providers. Roxane Townsend: I really am overwhelmed by the amount of work that went on here for two days. I think that we have accomplished a ton. I think that everyone realizes at the end of the day that this is not about us, but about making things better. I appreciate the commitment in the room and I can’t thank eHI enough for sponsoring us. To the Vanderbilt group, you are really awesome. To the subject matter experts who came from all across the country, thank you. To the Louisiana folks who are committing their time, thank you. Tom Lloyd: We will send your web journal to you by Monday as you have a lot of work ahead of you.
|
Local
data would be pushed/pointed into a RHIO database. 
Secure FTP method for data transmission. 
Our focus is two-fold. First, short term is the six-month project.
The second fold is the longer term sustainability and what happens beyond
9/30. We need to make sure the Steering Committee has their roles and
responsibilities defined. The Steering Committee will approve the overall
project, make policy decisions, approve recommendations from the work
group, oversee development of the transition plan, develop the sustainability
strategy, and evaluate progress. 
We started with the sustainability/financial model assumptions. We
used the eHI tool kit to help us with the technical operations.
Operations – Annual Costs Hypertile for detail)
We will do some marketing and long term governance structure in the
June time frame. |
Vanderbilt Center for Better Health Copyright © 2005 Vanderbilt University Medical Center |
top of page |