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Marc Overhage, M.D., Ph.D. Associate Professor of Medicine and Investigator

Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coordination and Communication. Marc Overhage, M.D., Ph.D. Associate Professor of Medicine and Investigator Regenstrief Institute for Health Care Indiana University School of Medicine.

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Marc Overhage, M.D., Ph.D. Associate Professor of Medicine and Investigator

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  1. Enhancing Public Health, Health Care System, and Clinician Preparedness: Strategies to Promote Coordination and Communication Marc Overhage, M.D., Ph.D. Associate Professor of Medicine and Investigator Regenstrief Institute for Health Care Indiana University School of Medicine The Indiana Network for Patient CareAn operational community-wide electronic medical record

  2. INPC database organization St. Vincent’s Community Hospitals VA Global Patient Index Global Doctor File Winona Dictionary Clarian Health St. Francis Reportable Conditions Wishard MCHD LabCorp

  3. Minimum data set • Emergency Department visits • Hospital Discharges • Laboratory Results

  4. Expanded data set • Minimum data set plus: • Admission notes/Discharge summaries • Operative Reports • Radiology Reports • Surgical Pathology Reports • Inpatient Medications • Tumor Registry

  5. HL7 HL7 LAN Intranet Electronic reporting flow Reportable Condition Processor Reportable Condition Database Interface Engine Lab System Other Hospital Systems Hospital Fire Wall

  6. Reportable condition processor E-mail Summary Abnormal flag, Organism name in Dwyer II, Value above threshold Realtime Compare to Dwyer I Daily Batch To Public Health Reportable Conditions Databases Inbound HL7 Potentially Reportable Reportable Condition To Infection Control Record Count as denominator Print Reports

  7. Provider to Public Health Communications • Doubled reporting completeness • Reduced reporting time lags • Potential for syndromic surveillance

  8. Clinical Information Standards • Health Level 7 (HL7) • Digital Imaging and Communications in Medicine (DICOM) • Logical Object Identifier and Numerical Code(LONIC)

  9. Public health to provider communication • Screening reminders • Syphillis screening for high-risk patients • Stool cultures for patients with diarrhea during outbreaks • Outbreak alerting

  10. Barriers encountered • Obtaining cooperation • Sustaining focus • Inconsistency of data representation • Modifying workflow

  11. Consent forms in place Private WAN in place to all sites RCT started Global INQ software complete All EDs receiving printed abstract Minimum dataset from everyone 2002 2000 2001 INPC timeline

  12. Creating cooperation • Shared vision • Trust • Neutral party

  13. Security/Confidentiality • Agent of State Department of Health under Memorandum of Understanding (MOU) • Private network (moving to Virtual Private Network) • Encrypted file transfer • Controlled database access • Location linked IP address • User name/password

  14. Support • Funding from Federal agencies • National Library of Medicine • Agency for Healthcare Research and Quality • In-kind support from hospitals

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