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Inter-institutional Data Sharing, Standards and Legal

Inter-institutional Data Sharing, Standards and Legal. Colorado Health Information Exchange . Arthur Davidson, MD, MSPH Agency for Healthcare Research and Quality, Washington, DC June 9, 2005.

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Inter-institutional Data Sharing, Standards and Legal

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  1. Inter-institutional Data Sharing, Standards and Legal Colorado Health Information Exchange Arthur Davidson, MD, MSPH Agency for Healthcare Research and Quality, Washington, DC June 9, 2005 Funded in part through a contract with Agency for Health Care Research and Quality (AHRQ), and the Foundation for eHealth Initiative (FeHI) and their cooperative agreement with HRSA, Office for the Advancement for Telehealth (OAT).  The contents of this presentation are solely the responsibility of the author and do not necessarily represent the official view of AHRQ, HRSA/OAT or FeHI.

  2. Colorado Health Information Exchange 2 Complementary Initiatives Goal: Create a local health information infrastructure for clinicians to access patient information across individual health care institutions Build upon what exists • Denver Health (DH) • 150,000 residents (25% of population) • Kaiser Permanente of Colorado (KPC) • 3rd largest CO HMO (350,000 members) • The Children’s Hospital (TCH) • Largest pediatric specialty care provider • University of Colorado Hospital (UCH) • Largest Metro area teaching hospital

  3. COHIE to CORHIO COHIE Learning Laboratory PROJECT (10/2004) • Working groups: • Technical • Clinical • Evaluation • Legal • Organizational Steering Committee Community Advisory Council Colorado Regional Health Information Organization A sharing, self-sustaining non-profit structure that: VISION (10/2009) Promotes legal agreements for participation and access Maintains a robust technical environment Defines clinical value through policy and procedures Manages the budget and sustainable business model Supports national standards and public health interfaces

  4. COHIE: 2005 plan

  5. Internet RHIO: 2005 vision Organizing / Convening Entity Financing Entity Organizational / Governance Layer Participating Entity Operating Entity Operational / Project Sub-committee Operational / Project Sub-committee Inter- Enterprise Utility Services Record Locator (MPI) Customer / User Portal Privacy / Security Authorization Hosted Routing Services Message Standards Validation Message or Other Storage Call Center Network Transport Leased Private Network Inter- Enterprise Business Services Message Translation Message Handling Standard Software Applications / Services / Tools Process- / Data Content-Specific Applications Adapter Adapter Adapter Adapter Hospital Information System Physician OfficePractice Management System Payer Claims System Public Health / Disease Surveillance System Internal OperationsLayer Adapter Adapter Adapter Adapter Electronic Medical Record (EMR) System Lab,/ Diagnostic Imaging / Ancillary System Pharmacy / PBM System Adapter Adapter Adapter

  6. The “Primary” Scenario • Clarifies the scope (common understanding) • Provides a structure to focus meetings and discussion • Creates a mechanism for logging issues and decisions

  7. COHIE Working Groups Iterative reviews COMPONENTS Legal Clinical Technical Research/Evaluation

  8. Timeline – October 2005 • MPI prototype, record locater service (RLS) • Data sharing agreement: based on IN • avoids multiple BAA • no research references • Incidental disclosures: CFH Policy Group • Design modification: ? near 100% match for disclosure (high threshold to start), role-based threshold (ED vs. referral MD), challenge to business case • Minimum certainty before RLS returns demographic information to the requester • Minimum number of required demographic fields supplied by the requester before the RLS returns demographic information.

  9. Timeline – October 2006 • Proxy servers with standardized data • Laboratory (LOINC, SNOMED encoded) • ICD-9 billing diagnoses • HL7 messaging • V2.x for MPI queries to/from institutional MPI • V3.0 for clinical data • Future: (after 10/06) • Arden syntax/GLIF for guideline implementation on aggregated data

  10. CORHIO Process • Colorado Health Institute (neutral convener) • Legal support • Explore/define relationship COHIE ⇔ CORHIO • Working Group • Business plan • Articles of incorporation (501c3) • Defining the board • Education/public relations • Community Advisory Council (greater than 40 members, most HIT projects going on in Colorado

  11. CORHIO Candidate Partners

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