1September, 2005 What IHE Delivers

Presenters Ian Stahl, Initiate SystemsPresenters Ian Stahl, Initiate Systems

PATIENT IDENTIFICATION PATIENT IDENTIFICATION CROSS-REFERENCING CROSS-REFERENCING (PIX and PDQ):(PIX and PDQ):

AS THE STRATEGIC FOUNDATION FOR AS THE STRATEGIC FOUNDATION FOR

INTEROPERABILITYINTEROPERABILITY

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Your PresenterYour Presenter

Ian Stahl, Director of Product Management,

Initiate Systems, Inc.• istahl@initiatesystems.com• (512) 634-5183

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The healthcare realityThe healthcare reality

Volume of patient data increasing exponentially

Quality of patient data declining

Fragmented, duplicate and conflicting patient information within and across databases andtouch points

Regulatory and safety issues drivenew requirements

ADTRob Johnson

1000 Main St.

ADTRob Johnson

1000 Main St.

PACSBob Johnson

(555) 123-4567

PACSBob Johnson

(555) 123-4567

LabRobert Johnsonrobj@aol.com

BillingBobby M. Johnsoncredit card# 5555-55-1234

BillingBobby M. Johnsoncredit card# 5555-55-1234

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Critical Data DetailsCritical Data Details

Over 30% of all Master Person Index (MPI)records have an invalid or blank value inname (first/last), date of birth or gender Jumps to over 60% if middle name counted

Over 80% of all confirmed duplicate recordshave a data discrepancy in one or more keypatient identifying fields i.e., Name, date of birth, SSN/SIN or gender

Nearly 40% of all duplicate records havea discrepancy in the first or last name

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Clinics, Labs, Imaging

Hospital1

Hospital1

Hospital2

Hospital2 Hospital

3Hospital

3

Physicians Network

Physicians Network

ClinicalSystemClinicalSystem

Pharmacy&

Pharmacy Benefits Mgmt.

Pharmacy&

Pharmacy Benefits Mgmt.

Hospitals(for Inpatients &

Outpatients)

Hospitals(for Inpatients &

Outpatients)

Labs & ImagingLabs & Imaging

Lab SystemsLab Systems PhysicianPhysician

Public HealthPublic Health

CountyGeneralCounty

General

GeneralGeneral

Real-t

ime

Query

API

Nightly Update

XML

Real-timeQuery

API

Real-timeUpdates

SOAP

SearchFlat File

Real-time

Updates

HL7

NCPDP

Real-timeQuery

IdentityIdentity

IdentityIdentityIdentityIdentity

IdentityIdentity

IdentityIdentity

IdentityIdentity

IdentityIdentity EHR

Interoperability will drive and deliver EHRInteroperability will drive and deliver EHR

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The Basic QuestionsThe Basic Questions

How do I begin to integrate all these solutions? Use and insist on IHE Profiles – Templates for needed Use and insist on IHE Profiles – Templates for needed

interoperability functionsinteroperability functions

What do I use to “glue” these solutions together? HL7 Messages – Healthcare messaging standard HL7 Messages – Healthcare messaging standard

already used already used

What drives access to all the solutions? The patient – Healthcare is about the patient informationThe patient – Healthcare is about the patient information

How do I deliver an EHR? Find the patient – Use IHE Profiles with HL7 Messages Find the patient – Use IHE Profiles with HL7 Messages

to access the patient records and other supporting datato access the patient records and other supporting data

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Patient Identity Drives Interoperability Patient Identity Drives Interoperability

Do we know this patient?

Is this the correct patient?

What information do I have about this patient?

Where did this patient information come from?

What “view” do I have of this patient?

What else do I know about this patient?

The Key to Patient Identity is:The Key to Patient Identity is:

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How Does PIX/PDQ Drive Interoperability How Does PIX/PDQ Drive Interoperability

Do we know this patient? PIX/PDQ Query from client to XRef ManagerPIX/PDQ Query from client to XRef Manager

Is this the correct patient? PIX/PDQ Manager must handle, accurately, the matching and PIX/PDQ Manager must handle, accurately, the matching and

linking with tunable probabilistic algorithmslinking with tunable probabilistic algorithms What information do I have about this patient? PIX/PDQ Manager Response to queryPIX/PDQ Manager Response to query

Where did this patient information come from? Domain based HL7 Messages Identify sourcesDomain based HL7 Messages Identify sources

What “view” do I have of this patient? Security applied at the application, PIX/PDQ Manager , or bothSecurity applied at the application, PIX/PDQ Manager , or both

What else do I know about this patient? Extending the PIX/PDQ Manager and using other IHE profiles Extending the PIX/PDQ Manager and using other IHE profiles

(i.e. XDS)(i.e. XDS)

By answering the questions:By answering the questions:

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Interoperability requires accurate patient matching and linkingInteroperability requires accurate patient matching and linking

P&C policyholder dataP&C policyholder data

Claims and billing dataClaims and billing data

Debbie BeckerNULL5555-55-1234

Local identifierDBECKER1234

Commercial policyholder dataCommercial policyholder data

Debbie Becker9146 E VILLA DEL SOLNETOWN, CA 45885

Local identifierHOSPABC98765

Store #3908, Zip =

Debbie Dozier -Becker9146 E VIA DEL SOLNETOWN, CA 45883

Local identifier12/19/61 – 727

Debbie DozierNEED INFO5555-55-1234

Local identifier12345ABCDE

Web self service dataWeb self service data

Debbie Becker9146 VIA DEL SOL480-473-3486

Local identifierBECKER4804733486

InitiateIdentity Hub™ software

1. Derives & standardizes data for efficiency2. Finds all potential matches3. Use sophisticated probabilistic statistics to

compare many attributes & score records4. Puts results in 3 buckets – link, don’t link,

needs manual review

Trusted systemof record

Trusted systemof record

1: 12/19/61 – 7272: DBECKER12343: 12345ABCDE4: HOSPABC987655: BECKER4807343486

Debbie Becker9146 VIA DEL SOLNETOWN, CA 45883480-473-34865555-55-1234

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Clinics, Labs, Imaging

Hospital1

Hospital1

Hospital2

Hospital2 Hospital

3Hospital

3

Physicians Network

Physicians Network

ClinicalSystemClinicalSystem

Pharmacy&

Pharmacy Benefits Mgmt.

Pharmacy&

Pharmacy Benefits Mgmt.

Hospitals(for Inpatients &

Outpatients)

Hospitals(for Inpatients &

Outpatients)

Labs & ImagingLabs & Imaging

Lab SystemsLab Systems PhysicianPhysician

Public HealthPublic Health

CountyGeneralCounty

General

GeneralGeneral

Real-t

ime

Query

API

Nightly Update

XML

Real-timeQuery

API

Real-timeUpdates

SOAP

SearchFlat File

Real-time

Updates

HL7

NCPDP

Real-timeQuery

IdentityIdentity

IdentityIdentityIdentityIdentity

IdentityIdentity

IdentityIdentity

IdentityIdentity

IdentityIdentity

PIX/PDQ Managers change the healthcare ecosystemPIX/PDQ Managers change the healthcare ecosystem

Trusted systemof record

Trusted systemof record

1: 12/19/61 – 7272: DBECKER12343: 12345ABCDE4: HOSPABC987655: BECKER4807343486

Debbie Becker9146 VIA DEL SOLNETOWN, CA 45883480-473-34865555-55-1234

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Billing

Care delivery Purchasing

Research

Diagnosis Treatment

Scheduling

Communications

The invocation of the necessary

services to provide the most accurate information to the right place at the

right time

Registration

ProcessProcessProcessProcess

Interoperability definedInteroperability defined

PatientPatient PayorPayor ProviderProvider PBMPBM SupplierSupplier PharmacyPharmacy PublicHealthPublicHealth

RadiologyRadiology RHIORHIO

PeoplePeoplePeoplePeople

PhysicianPhysician Etc.Etc.

ERPERP ClinicalClinical RxRx ResourceResource FormularyFormularyFinancialFinancial ResearchResearch

DataDataDIDIPatientPatient 3rd party/

Ref. data3rd party/Ref. data

Etc.Etc.ProviderProvider

Pri

vacy,

Secu

rity

, S

tan

dard

s,

Reg

ula

tory

Com

plian

ce

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Solution

Reference architectureReference architectureLabmgt

EMPIEMPI HISHIS ClinicalClinical FinancialFinancial ProviderProvider 3rd party3rd party

Radiologymgt

Customerportal

Business

Integration

Hosting

Medicalmgt

Medicationmgt

Sticky applications

On rampto RHIO

Business Logic

Infrastructure

Application ServicesApplication Services

Core Business ServicesCore Business Services

Messaging Services and Source AdaptersMessaging Services and Source Adapters

Data ServicesData Services

Identity ServicesIdentity Services

Con

su

lting

Data ServicesData Services

Security ServicesSecurity ServicesInitiate

Sta

nd

ard

s

Service

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How to get startedHow to get started

Start with choosing a solution that supports the IHE PIX/PDQ Manager functionality

Choose vendors who have products that support the PIX/PDQ client to call the IHE PIX/PDQ Manager

Feed the IHE PIX/PDQ Manager patient identifying information

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IHE Web site: www.IHE .netIHE Web site: www.IHE .net

Frequently Asked QuestionsFrequently Asked Questions

Integration Profiles in Technical Frameworks:Integration Profiles in Technical Frameworks: CardiologyCardiology IT InfrastructureIT Infrastructure LaboratoryLaboratory Patient Care CoordinationPatient Care Coordination RadiologyRadiology

Connectathon ResultsConnectathon Results

Vendor Products Integration StatementsVendor Products Integration Statements

Participation in Committees & ConnectathonsParticipation in Committees & Connectathons

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Questions?Questions?

Ian Stahl, Director, Product Management istahl@initiatesystems.com

Bill Klaver, Healthcare Solutions Architect bklaver@initiatesystems.com

www.initiatesystems.com

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