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eVital Records Initiative: Lessons Learned and Future Steps

Explore the eVital Records Initiative from September 2012 to April 2014, understanding the project's objectives, findings, and collaboration with healthcare entities. Discover the journey from assessment to the proposed solution using a form manager for data exchange. Learn about interoperability needs, testing proof of concept, and facing challenges like non-discrete data. Delve into the future vision and recommendations for aligning policies and seeking support for further development.

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eVital Records Initiative: Lessons Learned and Future Steps

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  1. eVital Records Initiative What we learned and what comes next

  2. Today’s objectives • Healthcare & informatics key terms • Project description • Our findings • Next steps

  3. Collaboration • Centers for Disease Control & Prevention (CDC) • National Association for Public Health & Information Systems • MDH – Office of Vital Records • MDH – Office of Health Information Technology • MN.IT – MN office of Information Technology • Allina Health • Essentia Health • Unity Hospital September, 2012 – April, 2014

  4. eVital Records hypothesis Electronically exchange data from the EHR to MR&C This interoperability would: • Be more efficient • Improve accuracy of data • Be more secure • Reduce filing delays

  5. First step: Assessment What is the current state of birth registration? • Follow process at one hospital • Document each step Special thanks to Unity Hospital

  6. Current hospital birth registration process

  7. Initial assessment: current status • Inefficient process • Manual data entry/transcription • Multiple data sources • State unable to assess data quality/validity • Exposure to extra patient health information

  8. Informatics learning • Healthcare Informatics = using technology to improve patient health • Interface = a link/where things connect or intersect • Interoperability = useful interaction or movement

  9. How? When? Who? The eVital Records Project considered • EHR is compiled throughout the patient stay • When should the data move? • How to make the data useful? • What data should transfer?

  10. Our solution: form manager • Utilize a form manager to package information • Birth registrar will review & forward • Filled form sends data to birth record

  11. Informatics learning 3 Needs for interoperability: • Standards • Data must exist before it can move • Ability to send / Ability to accept data

  12. Multiple systems Multiple stand-alone systems • Viewed through “portals” • Data transcription • Scanning as images

  13. Next Step: Test & Demonstrate Proof of Concept demonstrated to several audiences •  30% data mapped • Form Manager received & sent • Vital record populated

  14. Positive Feedback Great idea! Innovative! Extend to other things Send everything this way Think about bi-directionality How soon can we implement?

  15. More informatics learning • Meaningful Use = an incentive program for electronic health record implementation • Payments & fines • Rolled out in stages • HL7 = Standards • Methods • Data sets • Language

  16. New problem: non-discrete data • EHR created for clinician ease of use • Narratives • “Smart phrases”

  17. What about demographic data? Some things are not in EHR: • Mother’s education, place of birth, race • Father’s information • Child’s name What or who is data source?

  18. Unanswered questions • What about updates to EHR? • Corrections • Lab values, etc. • What about bi-directional exchange? • Name changes • Who owns the data? • Right to share it • Right to correct it

  19. Competing Resources: • Facilities must comply with MU • Facilities also converting other systems • ICD 9 becomes ICD 10 • Innovation takes $$ and time • MDH has resource conflicts, too

  20. Will it happen? Absolutely OUR VISION: • Mother’s worksheet becomes a tablet or kiosk • Birth registrar counsels parents re: registration • Birth registrar reviews computer form • Birth registrar combines demographic record with medical record and submits birth record Birth registrar becomes a specialized duty

  21. Now is not the time eVital records is still (slightly) ahead of its time • Other priorities at facilities • Other priorities at MDH • Lack of federal standards / mandates / funds • EHR data availability

  22. Our recommendations • Align policies • Seek support from ONC • Continue expanding & testing • Develop informatics-savvy • Vital records offices • Stakeholders

  23. What does this mean to you? • Short term: continue the great work • Long term: • Improved prenatal clinic to hospital communication • Increased structured data in EHR • Technology advances for parents’ reporting of demographic data • Specialized birth registrars

  24. In summary The eVital Records project is complete • Tested electronic exchange of data from EHR to MR&C • Documented current process • Proposed future process • Noted potential barriers

  25. Thank you! eVital Records Initiative

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