Jersey Health Connect HIE Image Enablement: A Strategic & Executional Model Sponsored by DISCLAIMER:...

Jersey Health ConnectHIE Image Enablement: A Strategic & Executional Model

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DISCLAIMER: The views and opinions expressed in this presentation are those of the author and do not necessarily represent official policy or position of HIMSS.

Jersey Health Connect TeamLargest Independent HIE in New Jersey

Lou Hermans

Executive Director

• Coalition lead for NJ HealthNet

• CIO, JFK Health System in Edison, NJ (former)

Jim Cavanagh

EHR Interoperability & Member Connectivity

• Lead Technology Executive responsible for connecting statewide members

• CIO, St. Joseph’s Health System in Paterson, NJ (former)

Jeremy Marut, MBA, CHCIO

Chairman of Imaging Taskforce

• Director of Enterprise Architecture at HackensackUMC

Agenda• About Jersey Health Connect (JHC)

• Imaging Technology Approval Process and Selection

• Workflows and Use Cases

• Project Articulation to Members

• Image-enablement Benefits

• Technical uniqueness and business modeling

• Next steps

Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org

About Jersey Health Connect

• Independent, Non-Profit HIE• Membership includes 32 of the Largest Acute Care Hospitals & Health Systems in NJ

800 Connected Practi ces 1,861 Connected Physic ians 23,185 Pati ent Queries 151,000 Connected Pati ent 4,700,000 Pati ent Records 2,180,000 Results & Messages 142 EMR Endpoint Connecti ons 720 Physic ians connected via EMR

Confidential and proprietary information. For internal use only. | © 2014 Jersey Health Connect | www.jerseyhealthconnect.org5

About Jersey Health Connect

Goals:• Accelerate current HIE activity

• Improve care coordination, access, outcomes and efficiencies through real-time clinical exchange

• Allow members to leverage existing technologies

• Patient-centric approach to encourage active and informed participation

Confidential and proprietary information. | © 2015 Jersey Health Connect | www.jerseyhealthconnect.org

Approval Process and Imaging Technology Selection


Imaging Internal Selection Process

• Rigorous RFP process around imaging selection by individual hospital members

• In all cases – Vital – was selected as the preferred partner

• Technology focus was originally driven by “Internal” applications

• Technology focus shifted to “Referral Community” • Central Image Repository: Too costly • Archive deployment: A different use case• Image access: speed was paramount

• “Streaming” technology replaces tradition store-and-forward

• Importance of access to community data


Approval Process

Imaging Taskforce Committee

The CMIO/Clinical Advisory Committee

Executive Board Committee


Selected Technology Solution

VitreaView® & VioStream™ Leverages existing infrastructure

• Scalable, Virtualized• Ability to stream from federated architecture• No cache required

Multi-browser• IE, Safari®, Firefox®, Chrome™

Multi-platform• Windows®, Mac®, iOS®, Android™

Browser Based • HTML and JavaScript: no

plug-ins/downloads• Single sign-on, role-based access control• Access multiple image archives

simultaneously• Simple URL-based integration EMR, EHR,

PHR and HIE • Email a clinician • Smartphone/table support

*All above trademarks and registered trademarks belong to their respective owners.

* When accessed from a mobile device, VitreaView is intended for information purposes and is not intended for diagnostic use.


Workflows and Use Cases

Primary Scenarios


Server Infrastructure

SERVER-TO-SERVER WORKFLOW, IMAGE ENABLED HEALTH INFORMATION EXCHANGE

Windows, Android, Apple iOS/MacOS, etc.

Physician

PACS Data(DICOM)

HIE Launch

Centralized Data Center(s)

VitreaViewServers

ImageViewing

HSITE As

Proxy Server

DICOM

PACS Data(DICOM)

HSITE C

Proxy Server

DICOM

PACS Data(DICOM)

HSITE D

Proxy Server

DICOM

PACS Data(DICOM)

HSITE B

Proxy Server

DICOM

Study RequestWeb Streaming

Stud

y Re

ques

tW

eb S

tream

ing

PACS Data(DICOM)

HSITE E

Proxy Server

DICOM

Study RequestW

eb Streaming

HIE Platform

Hospital Systems

Hospital Systems

Hospital Systems

Hospital Systems


Use Cases

Access to Universal Viewer via HIE platform

1. Single Study

2. Relevant Studies

3. Encounter Notification


Patient Information Screen & Vitreaview Launch


Project Articulation to Membership


Why “Image Enable”?

University of Michigan Research

• Shows fewer repeat medical images made in ERs of Hospitals taking part in HIE

• Study focused on patients who went to two different ERs in a thirty day period

• Findings showed use of repeat CT scans, chest X-rays & Ultrasound scans lower when patients of both ERs participated in a HIE

• Actual Benefits:• Patients 59% less likely to have a redundant CT, 44% less likely on US, and 67%

less likely on chest X-ray

• Researchers pulled data that showed the following • 20,139 repeat CTs (14.7%)• 13,060 repeat US (21%)• 29,703 repeat chest X-Rays (19.5%)

“Does Health Information Exchange Reduce Redundant Imaging? Evidence From Emergency Departments” - Medical Care, March 2014, Volume 52, Issue 3


Benefits

HIE Benefits

• Reduction of duplicate exams savings

• Increases clinical use of JHC systems

• Aligns with ACO strategy

• Utilization measurement for Population Health Management

$18M annual savings for the uninsured population

EHR Benefits

• Access to local images from multiple archives through the local EMR(s)

• Cross-reference capabilities between studies internal and through HIE (future)

• Reduced costs of specialty viewers

• Meets elective option for MU2 and potentially MU3

Clinical, Financial and Technical Benefits


Membership Articulation

• Business modeling demonstrates member value

• Focus on total healthcare imaging savings across the network


Membership Articulation

• Membership one pager demonstrating image enable value and internal benefits

• Members invited to technical discussions, prior to project implementation

Next Steps

Questions?

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