Topic

Level

Presenter(s):Ken Banks – Database Manager --Peninsula Community Health Services

Making the Most of Mirth Connect

300

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PCHS – A little history of our practice

Peninsula Community Health Services

• Founded in 1989, Peninsula Community Health Services (PCHS) is the only Federally-Qualified Health Center (FQHC) with comprehensive healthcare services on the Kitsap Peninsula, of Washington State.

• We provide medical, dental, behavioral health, pharmacy, and health education/promotion activities for all stages of life and ensure accessible, affordable, compassionate, quality health care services for all people in our communities.

Peninsula Community Health Services

• PCHS currently operates four medical clinics and two dental clinics, serving over 30,000 patients annually

• We also are developing greater partnerships with other practices in our area including Kitsap Mental Health Services, with which we share patients.

• PCHS began using NextGen in 2005 as part of the PTSO of Washington

• In 2007 PCHS began hosting their own copy of NextGen.• In 2014 PCHS entered in a partnership with NextGen and Dell

hosting to host the hardware for PCHS.

PCHS – Our Interoperability History

Initially in 2007 we began with the NextGen Rosetta Interface

Export Lab Orders and Import Lab ResultsExport Immunizations to the State Immunization Registry

In 2010 we replaced the Rosetta Interface for Immunizations with Mirth Connect

In 2014 we began the planning for the HIE interfaces using Mirth Connect

PCHS – How we use Mirth• Export Immunizations (HL7 2.5 files) to the Washington State

Immunization Registry• Export CCD documents to a private hospital network HIE to

coordinate information between hospital and primary care providers

• Import HL7 clinical documents from the private HIE of hospital visits by PCHS patients

• Export CCD documents to the Washington State HIE (OneHealthPort) that will be passed to our Health Partner –Kitsap Mental Health

• Import CCD documents from Kitsap Mental Health via the Washington State HIE

The Future – two way interoperability• PCHS was recently awarded an ONC interoperability

grant that will use Mirth Connect as one of the key components.

• Consent2Share – An open source consent management and patient portal that will be shared by both PCHS and our behavioral health partner, KMH.

• PCHS will publish documents to Consent2Share using Mirth Connect

• Consent2Share will publish KMH documents to NextGen using Mirth Connect

Mirth – The Decision Making Process

Advantages

• Flexibility – New Interfaces can be developed in a matter of weeks with no additional costs

• Low Cost – As open source, Mirth can be implemented at a very low cost compared with other technologies

• Control – Mirth allows us to determine the content that is exported and imported according to PCHS policies

• Adaptable – As standards change and improve interfaces can be changed to adhere to those newer standards

More Advantages

• Customizations -- Can work with our template customizations• Ease of Use – HL7 files can be built with little or no

programming experience• Support – Support for Mirth can be purchased on a flexible

basis.• Transport – Physical files can be created for transport or Mirth

can be configured to send directly using the MLLP protocol• Modular – interfaces can be built in a series of steps that can

be dropped in one interface and added to another.

Other Considerations

• SQL Experience – to take full advantage of the power of Mirth requires someone with an in-depth knowledge of the NextGen database.

• Programming Experience – For CCD documents, Mirth requires some knowledge of Java Script programming.

• To offset this there are two programming libraries that are available to aid in the development of these documents.

• Documentation – in depth documentation is only available at certain support levels.

Mirth – Terminology

Terminology

• Channels – this represents each unique interface and is the equivalent of an agent in Rosetta

• Transformers – this is what does the work of taking the information that is stored in one format and transforms it into another format. This allows two way interoperability with NextGen as the source or destination

• Message Template – This is the message format that Mirth will use as a template for the input or as a template for the output.

More Terminology – Parts of a channel

• Summary -- outlines the basic information that applies to the whole channel with the data types and the storage settings being the most important

• Source Transformation – this does the work of transforming the input into the formatted output

• Destination Transformation – This can also do the work of transforming the input into the formatted output

• Destination – Where the output is going – this can be to another destination or the final destination

Mirth – Seeing it in practice

Current PCHS Channels

Monitoring Channel Status

Mirth provides details on every processed message

One Example – Hospital HIE Bi-directional Interface

• Used to export the Patient population to the hospital• The import of the hospital visit data into a Nextgen

document• The Document goes to the Provider PAQ for sign off• Provider Test Action opens following the sign off of the

document

One Export ChannelNotice how the channel can be modular:

One Export ChannelA Transformation does the work – we used java script

One Export ChannelThe final destination is sent directly via MLLP over a secure VPN tunnel

Imported Clinical Document

How the imported CCD or HL7 document looks to clinicians

Demonstration

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Any Questions?