Health Information Exchange in Post-Acute and Long-Term Care Case Study Findings: Final Report. Notes

09/18/2007

  1. Unaffiliated, for the purposes of this study was defined as not being owned by the hub site.

  2. Affiliated, for the purposes of this study, refers to settings that are owned by the hub site.

  3. In the case of Erickson Retirement Communities, the protocol was turned on its head. That is, because the Erickson campus included a skilled nursing facility and a home health agency, the “referral” sites were places that served the needs of Erickson residents that could not be met on the campus (i.e., acute care and hospice services). Johns Hopkins Home Health also was visited, as they receive a few referrals from Erickson per year, based on the patient’s request.

  4. In general this is not possible today because different sites use different, usually proprietary, lists of drug names.

  5. Although this definition was used for initial screening of candidate sites, the site visits did include a few settings that had some type of relationship with one another. For example, the Visiting Nurse Service, Inc. (VNS) of Central Indiana has gone through a vetting process at some of the local hospitals and after meeting the hospitals’ criteria, have established a “preferred provider status” with these referral sources. So although they are not owned or affiliated in a legal sense, this relationship does directly influence their referral stream. Similarly, at Erickson (Maryland CCRC), St. Agnes Hospital receives close to 100% of acute care referrals, although strictly speaking they are unaffiliated.

  6. Website: https://myhealth.erickson.com.

  7. Website: http://intermountainhealthcare.org/xp/public/documents/institute/faculty_clayton_building_system.pdf.

  8. A remittance advice or “remit” is an electronic notice received by the provider or biller after Medicare has processed a claim and gives an explanation for the payment.

  9. BioCrossroads is an entity that provides money and support to both existing and new life sciences businesses, expanding collaboration and partnerships among Indiana’s life science institutions, expanding science education, and building awareness and marketing Indiana’s life sciences industry. See http://www.biocrossroads.com for more information.

  10. The four consortia are IBM, Accenture, Northrup Grumman, and CSC.

  11. As stated before, in the case of the site visit to Erickson Retirement Communities, the authors asked for referrals to an acute care hospital and any other PAC or LTC settings that may treat the Erickson residents.

  12. See, for example, http://dhfs.wisconsin.gov/forms1/DDES/dde2191.doc.

  13. Website: http://www.health.state.ny.us/nysdoh/hcra/pri.htm.

  14. Website: http://www.cms.hhs.gov/CFCsAndCoPs/.

  15. Website: http://aspe.hhs.gov/daltcp/reports/2007/HIErpt.htm.

  16. Website: http://www.extendedcare.com.

  17. Websites: http://www.jointcommission.org/SentinelEvents/SentinelEventAlert/sea_35.htm; http://www.ihi.org/IHI/Topics/PatientSafety/MedicationSystems/Tools/Medication+Reconciliation+Review.htm.

  18. On November 2, 2005, HL7 announced that in collaboration with ASTM, they are developing an implementation guide to express the CCR data set in an HL7 Version 3 (v3) CDA, r2 document. The CCR is snapshot summary of a medical record that is delivered from setting to setting, and could potentially be displayed in an EHR. This collaborative specification effort is referred to as the CCD. HL7 approved and the HITSP has endorsed the CCD. The CCD will map CCR content into a CDA r2 representation, which will enable the exchange of human-readable (text) and/or coded transfer documents.

  19. Website: http://www.whitehouse.gov/news/releases/2006/08/20060822-2.html.

  20. Website: http://ncvhs.hhs.gov/061128lt.pdf.

  21. As the then Secretary of HHS, Tommy Thompson, often observed, “If Lands End can remember my shirt size, why can’t my doctor’s office remember my phone number and other demographic informatiom?”

  22. Website: http://www.hhs.gov/news/press/2007pres/20070103.html.

  23. Website: http://www.ericksoncommunities.com.

  24. Website: http://www.ericksoncommunities.com/wellness/centricity.asp.

  25. Dan Cobb, CareMEDX Chief Technology Officer, and prominent contributor to professional and standards organizations, accompanied us on relevant portions of the Erickson site visit.

  26. Website: http://www.dbmotion.com/.

  27. Website: http://aspe.hhs.gov/daltcp/reports/2007/HIErpt.htm.

View full report

Preview
Download

"HIEcase.pdf" (pdf, 1.68Mb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"HIEcase-A.pdf" (pdf, 236.81Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"HIEcase-B.pdf" (pdf, 115.31Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"HIEcase-C.pdf" (pdf, 169.18Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"HIEcase-D.pdf" (pdf, 134.56Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®

View full report

Preview
Download

"HIEcase-E.pdf" (pdf, 150.97Kb)

Note: Documents in PDF format require the Adobe Acrobat Reader®. If you experience problems with PDF documents, please download the latest version of the Reader®