Long-Term and Post-Acute Care Providers Engaged in Health Information Exchange: Final Report. Data Sent to HealthInfoNet by Eastern Maine HomeCare

10/29/2013

HIN has a Home Care and Hospice Data View, which presents summary of care document information sent by the EMHC EHR. The summary of care document includes medication and laboratory data from the home care POC.

There are two other HHAs and two SNFs participating on HIN. They have access to HIN data and send ADT alerts and diagnoses for the problem list.

Additional Opportunities for EMHC to Provide Information to HIN

During interviews with HIN, opportunities for submitting other home care information were discussed including submitting the Outcome and Information Assessment Set (OASIS) and minimum data set (MDS) patient assessment summary. Information was provided on Keystone HIE pilot study in Danville, Pennsylvania and references available on the standards and interoperability (S&I) Framework Longitudinal Coordination of Care (LCC) wiki. Tools are available for a HIE organization and LTPAC provider to send the OASIS and MDS in the CMS format, have it transformed into a CCD and sent to HIN. Also discussed was a new opportunity to test the S&I Framework LCC initiative to exchange a home care POC using the HL7 Consolidated CDA standard.

User Access and Security

HIN creates and manages all user accounts for providers/caregivers who have access to the exchange. The exchange maintains five roles for use access that define the scope and nature of an individual user's access to patient identified clinical data. Employers, insurance companies, and the government cannot access patient information at this time.

After a user has been "authorized" by HIN, they are sent a secure login and required to change their password immediately. Passwords must be unique and can only be reset by authorized personnel who can verify the user's identity.13 HIN maintains audit reports to keep track of who views the records in the exchange.

At the time of the site visit, patients did not yet have online access to their health information on HIN. However, they may request a printed or CCD copy of their HIN record through their provider and/or request an audit from HIN on who has accessed their medical information through the exchange.

HIN Support for Care Management

HIN provides EMHS with the technical tools to coordinate care using HIE and secure e-mail messaging.

HIN has a care management portal view which provides pertinent data for the various care managers in the system (such as primary care managers, inpatient care managers, cardiology care managers, mental health care managers, home care nurse managers, and palliative care nurse managers). This portal view reduces the care manager's search time when accessing patient data and allows selected information to be viewed on one screen. Data elements incorporated into this portal view include:

  • Patient demographics;
  • Insurance coverage;
  • Primary care provider information;
  • Allergies;
  • Medications (including prescription);
  • Immunizations;
  • Diagnoses;
  • Encounter/Visit History;
  • Diagnostic and imaging test results; and
  • Vital sign records.

The availability of technical tools to support care management across different types of provider organizations and health systems is instrumental for EMHS to test and deploy new care and payment models in accountable care and medical homes.


13. See http://www.hinfonet.org/about-us/privacy-and-security.

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