Brian E. Dixon, MPA, PhD CandidateHealth IT Project ManagerRegenstrief Institute, Inc.

Bi-Directional CommunicationEnhancing Situational Awareness in Public Health and Clinical Practice

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TUESDAY, 12:30 – 12:50PM

Bi-directional Communication

PurposeDemonstrate how health information exchange (HIE) can facilitate efficient and effective dissemination of information to clinicians that keeps them informed of public health threats in their communities

Situational Awareness• Recognition of an Emergent Threat• Raise Awareness of Threat• Action in Response to Threat

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Health Information Exchange

NHIN-EnabledHealth Information

ExchangeOutpatient RXs

Physician Offices

Ambulatory Centers

Local Public HealthDepartments

State Public HealthAgencies

Imaging Centers

Hospitals

Laboratories

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Health Information Exchanges (HIEs)

HIEs provide common infrastructure to connect medical providers and public health organizations

• Minimizes duplicative technical connections as well as healthcare services

Common infrastructure can be reused over time for new services and applications:

• Maximizes initial investments

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The Indiana Network for Patient Care (INPC)

• 15 year old HIE operated by the Regenstrief Institute– Partner with the Indiana Health Information Exchange

• Facilitates data exchange between– 35+ Hospitals– Independent and Reference Laboratories– Public Health Departments (State and local)– 100+ clinics and imaging facilities

• Indianapolis metropolitan area, Lafayette, and Evansville

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DOCS4DOCS® (D4D)

» Delivers laboratory and other clinical messages from one organization to the patient’s responsible provider (PCP)• Managed by the Indiana Health Information Exchange

» Delivered in three formats• Fax• Electronic inbox (Web-based application)• Integration with the Electronic Health Record (EHR) system

» 6 million messages each month to 13,000+ physicians

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Results Delivery – An Illustration

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DOCS4DOCS

DOCS4DOCS

Expanding D4D to Support Public Health

» D4D delivers ISDH laboratory reports to providers throughout the state

» Marion County Health Department (MCHD) partnered with Regenstrief and IHIE to notify physicians of important, emergent situations involving public health threats• Salmonella exposure at local restaurant

» System went live in May 2009• Utilized several times for H1N1 updates

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DOCS4DOCS

Process Diagram

Hospitals, IDNs

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Health Information Exchange

IN

Physician Practice

Generate H1N1 Alert

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Bi-directional Communication Methods

• Clinical messaging is a “push” technology

– Message authored by Public Health entity

– Message integrated into clinical workflow using established systems and processes for communication

• Other methods to support bi-directional communication

– Decision Support (Infobutton) – Query public health knowledgebase for alerts relevant to a given patient’s demographics (e.g., age, home address, chief complaint)

– Case Reporting – Pre-populate notifiable condition reports with HIE data to increase rate of “spontaneous” reporting

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DOCS4DOCS

Reporting Form

Thank You

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The participation of any company or organization in the NHIN and CONNECT area within the HIMSS Interoperability

showcase does not represent an endorsement by the Office of the National Coordinator for Health Information

Technology, the Federal Health Architecture or the Department of Health and Human Services.