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This is a presentation I delivered at AIIM 2010 in Philadelphia. It presents a holistic look at the make up of a patient record and the challenges in moving to a digital environment.
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Can it rally happen?
Presented by:
Bob Larrivee
AIIM Director/Industry Advisor
Digital Patient Records:
January 12, 2009President Obama announces digital health
records for all within 5 yearsAugust 19, 2009
HHS announces “Information Breach” regulations36+ Breaches listed by HHS as of 03/2010
Affecting 500+ individuals
The Mandate
Many in the Electronic Health Records (EHR) spaceOver 70 vendors listed in a single siteIncludes:
GE HealthcareAdvanced Data SystemsCerner CorporationMcKesson
Source: http://www.ehr-software.net/comparison.htm
The Players
MedicalHistory and demographicsMedications, immunizations and allergiesLab results and radiological images
InsuranceCoverage and claims
FinancialBilling Information
Patient RequestsLiving Will
What is a Patient Record?
Nirvana
Acceptance of electronic informationHealthcare
PhysiciansHospitalsLabs
InsuranceClaimsBillings
PharmaceuticalPrescriptions
Global Adoption
Reality
Multi-faceted EnvironmentHealthcareInsurancePharmaceuticalLegal
Process IssueHand-offsOn-ramps and off-ramps
Healthcare - Extended
StandardizationFunctionality – ensuring that the systems can
support the activities and perform the functions for which they are intended
Security – ensuring that systems can protect and maintain the confidentiality of data entrusted to them
Interoperability – ensuring systems implement the recognized standards and can exchange information and work with other systems.
The Challenge
Dynamic integration of content
10
From this
To this
Hand-offsShould be cleanWell definedAutomated
On-Ramps and Off-RampsInformation and Records
Entering a processHandled in the processExiting a process
Note: The end of one process begins the next
Process
ISO 18308Requirements for an Electronic Health
Record Reference ArchitectureElectronic Health Records(EHR)- HL7
EHR – S Functional Model (HER-S FM)EHR – Interoperability Model (EHR/IM)Personal Health Record Systems Functional
Model (PHR-S FM)Digital Imaging and Communications in
Medicine (DICOM)More….
Existing Work and Standards
Office of the National Coordinator for Health Information Technology and the Centers for Medicare & Medicaid Services Defined “meaningful use” of EHR Solutions
Improving quality, safety, efficiency, care coordination, population and public health;
Reducing health disparities;Engaging patients and their families; and,Ensuring adequate privacy and security protections for
personal health information
Certification Commission for Health Information Technology Updated Certification Programs
Progress
The issue is largeExtends beyond healthcare aloneStandards need to be adopted and adhered toProcess within and beyond an organization
must be designed and documented
Looking Ahead
A Lesson from ECM
ECM can be the umbrellaLeverage Content
Management Interoperability Services (CMIS) StandardA common web services
interface to support uniform access across different content repositories
Leverage ERM StandardsLeverage BPM Best
Practices
We are getting there but there is a lot of work aheadStandards need to be set and adopted
EHR should be part of your ECM EnvironmentIncluded as a content/records source
Strong and seamless processes are keyIdentify the on and off ramps of patient records
Digital Patient records can and is becoming a realityLook at it holistically
My Opinion
Bob Larrivee – Director and Industry Advisor – AIIM
Email – [email protected] - @BobLarriveeVisit:
AIIM.ORGInformationZen.orgAIIM Knowledge CenterAIIMCommunities.org
Thank you
