Interlinked Registries

1. Interlinked Registries A proposed project leading to a balloted IHE profile for Interlinked Registries (ILR) based on the HL7/OMG Human Services Directory (HSD) specification

2. Project overview A new IHE profile for Interlinked Registries (ILR) will be developed, balloted and tested The co-sponsors of the work item are HI-PPP (PEPFAR) and Canada Health Infoway The work item will be generally based on the HL7/OMG Human Services Directory (HSD) specification Both co-sponsors plan to support project teams at the 2014 Connectathon to demonstrate interoperability with each other and with other participants

3. Overview of this Presentation • Who needs this profile? • Developed country user stories • Developing country user story • Who is supporting this work? • Canada Health Infoway • Health Informatics Public-Private Partnership (HI-PPP, funded by PEPFAR) • What “underpins” the work item? • HL7/OMG HSD service functional model • Infoway “Interdependent Registries” discussion paper • What is the Plan?

4. User Story 1 David Lambert sees his family physician, Dr. Black, regarding a recent knee injury. Dr. Black diagnoses the problem as a torn ACL and decides to refer David to an orthopedic surgeon. Dr. Black uses his EMR to search for orthopedic surgeons; a list is returned sorted by available consult timeslot (soonest to latest) and by location (closest to farthest). After discussing the options with David, Dr. Black chooses Dr. Bone from the list and a “pending referral” is automatically created. David returns home. Later that day, Dr. Bone’s office reviews the pending referral and accepts it. A “scheduled referral” message is communicated to Dr. Black and to David.

6. User Story 2 Alicia is a female veteran in Baltimore who has returned from her 2nd tour in Afghanistan; she is being discharged from active service into civilian life Alicia’s medical records and care continuity is transferred from DoD to VHA VHA wishes to establish primary care for Alicia at a VA Care Center supporting the VA’s female veteran primary care model The VHA care coordinator queries for VA facilities in the Baltimore area which have embraced the model and refers Alicia to a female primary care physician, Dr. Veteran, at the “model” facility closest to where Alicia lives

8. User Story 3 Mosa is a young pregnant woman; she is being seen by a community health worker, Grace, who is conducting Mosa’s 2nd antenatal care (ANC) visit. Grace records ANC observations using SMS on her mobile phone. Mosa’s blood pressure reading is high; she should be referred to see a clinician. The cloud-based mHealth application queries an interlinked registries service to determine the closest facility (geo-coded Facility Registry) offering maternal care services (Resource Registry) within a specific timeframe (Provider Registry / Facility Registry calendar). An SMS reply from the mHealth service indicates to Grace that maternal clinics operate on Tuesdays and Thursdays at the health facility closest to Mosa’s village. Grace prepares a referral note for Mosa. Mosa is automatically added to the patient queue for the next maternal clinic at the facility.

10. Who is supporting this work? • Canada Health Infoway • SMEs • Standards Collaborative • Jurisdictional partners • IHE Canada • HI-PPP funded by PEPFAR • Regenstrief Institute • InSTEDD • Mohawk College • DHIS Project – University of Olso • Jembi (South African NGO) • Columbia University – Earth Institute • Rwanda Ministry of Health – RHEA Project

11. What “underpins” the work item? • HL7/OMG Health Services Directory (HSD) Functional Specification • Detailed use cases and service functional spec • Data dictionary • Infoway Interdependent Registries Discussion Paper • Addresses challenges faced by jurisdictional implementations • Cornerstone of next iteration of Canada’s EHRS blueprint

12. What are the strategic implications? • Aligned with IHE strategy… • Provider & Patient ID • Workflow Enablers • Aligned with IHE’s international evolution • “IHE Africa” • Specification of IHE in national norms & standards

13. Standards • HL7/OMG HSD service functional model • Location Registry • Provider Registry • Organization Registry • Resource Registry • Provider | Organization • Provider | Location • Organization | Location • Resource | Location • Provider calendar • Resource calendar • Organization calendar • HPD profile • HL7 v2/v3 messaging; SOAP; BPEL; hData; json; REST

14. What is the Plan? • Facility Registries Extension & Development project (FRED) • PEPFAR funded; Rwanda and Tanzania are current “customers” • Team is in place and work is underway • Evolve scope to include support for referral workflows • Align FRED work with Infoway’s e-Health Blueprint • Embrace standards • Leverage IHE profiles; IHE community • Develop work product as IHE Profile • Demo at Connectathon 2014

15. Other stuff…

16. Architecture Example 1 (RHEA) Interlinked Registries HPD Organization Registry Resource Registry Referrals Queue management Resource planning Existing IHE Profiles POS Systems New IHE “Interlinked Registries” Profile

17. Architecture Example 2 Client Registry Interlinked Registries HPD Organization Registry Provider Registry Resource Registry Facility Registry Referrals Queue management Resource planning POS Systems Existing IHE Profiles New IHE “Interlinked Registries” Profile

18. Calendar