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May-June 2013

Solving EHR interoperability challenges

ICA Logo Mark CMYKKHIN and our technology partner ICA are solving the most pressing of interoperability challenges: integrating data from many disparate EHR systems together.

KHIN and ICA have been very successful in integrating data from multiple EHR systems into a consolidated view for providers. This is due in large part to ICA's experience and expertise in a variety of data transport models. ICA has a long history in integrating data from HL7 data feeds. Many of the Kansas health care organizations sharing data with KHIN use EHR systems that send KHIN data via HL7 feeds. EHR systems currently sending KHIN "live" HL7 production data include Siemons, HMS, SuccessEHS, Meditech and Greenway.

ICA also has expertise in data integration with EHR systems that send data in an XDS format. In this case a CCD or Continuity of Care Document is sent to KHIN which includes the most recent patient information. Many of the Kansas EHR vendors are sending "live" data to KHIN in a CCD format. This includes Allscripts, CPSI, eClinical Works and Meditech (through an Iatrics interface).

KHIN also receives data from EHR systems through an XCA Gateway. This is the transport model that Epic uses. It is also used to share information across health information exchange organizations. KHIN is currently integrating "live" data from two Kansas Epic facilities.

KHIN and ICA are working with other Kansas EHR vendors and are very close to integrating data from Healthland, McKesson Practice Partners and eMDs all using HL7 interfaces. Lastly, KHIN is working with Prognosis to complete an XDS connection.

In all, KHIN has successfully integrated data from 10 different EHR vendors using HL7, XDS and XCA transport methods. We will add four more EHR vendors this summer. For more information regarding EHR vendors and their data integration with KHIN contact Laura McCrary, Ed.D. at lmccrary@khinonline.org.

KHIE responsibilities transfer to KDHE

KHIE Logo with blue backgroundOver the next 30 days Kansas Health Information Exchange (KHIE), the state regulatory organization for health information exchange, will transition its responsibilities to the Kansas Department of Health and Environment (KDHE). The transition from KHIE to KDHE will reduce the costs associated with regulating health information exchange in Kansas. KHIE's last day of business will be June 30, 2013. All assets held by KHIE will be turned over to KDHE.

As KHIE concludes its work, the organization deserves significant recognition for its achievements over the last two years. Under the volunteer leadership of Karen Braman and Joe Davison, MD the KHIE Board developed regulations to govern health information exchange in Kansas, developed a patient consent process, implemented a public awareness campaign and developed a Certificate of Authority process to ensure high standards for organizations doing health information exchange business in Kansas. Along the way KHIE dealt with a multitude of difficult issues and successfully resolved them.

Recognition is also deserved for the KHIE staff including Bill Wallace, Terri Kennedy and Jamie Mullen. All made significant contributions in the development of Kansas health information exchange and the resulting improved care for Kansas patients. Many members of KHIE Board of Directors will continue to serve on an Advisory Board which will provide input to KDHE.

KHIN HealthHOME seeks pilot sites

KHIN-Logo-on-art-backgroundKHIN HealthHOME is the name of KHIN's new personal health record which allows Kansas patients the ability to manage their own health care information. KHIN HealthHOME will be ready to launch in September 2013 and KHIN is looking for several physician practices and hospitals to serve as pilot sites. If you are interested in being a pilot site please contact Michelle McGuire at mmcguire@khinonline.org.

KHIN HealthHOME is certified by the Office of the National Coordinator (ONC) as a patient portal and meets the Stage 2 Patient Engagement Meaningful Use requirements for KHIN members. The following patient engagement MU2 functionality is available:

  1. Secure emailing between providers and patients.
  2. Ability for the provider to send a summary of care document electronically to the patient's account.
  3. Ability for the patient to view, download or transmit the summary of care document.
  4. Patient specific educational information.

KHIN HealthHOME has several advantages for KHIN providers.

First, there is no additional cost. KHIN HealthHOME is part of the KHIN product suite. This can save KHIN members from having to purchase an expensive patient portal from their EHR vendor.
Second, patients have one location for their health information. This is preferable as patients struggle with managing many patient portals and trying to combine the information from each into an understandable format.

Lastly, to meet the Stage 2 MU requirements at least 5 percent of the health care organization's patients must view the portal at least once. Using the KHIN portal allows all health care providers who have contributed information to the portal to count any time the patient views their information, even if they don't specifically look at the information from their facility. For more information on the KHIN HealthHOME contact Michelle McGuire.

ONC pilot: KHIN and MHC

Missouri Health ConnectionThe Kansas Health Information Network (KHIN) and the Missouri Health Connection (MHC) have been chosen by the Office of the National Coordinator (ONC) and the National EHR/HIE Interoperability Workgroup (IWG) to pilot a project together to develop a shared provider directory for Kansas and Missouri health care providers. Currently KHIN and MHC both provide secure email capabilities (DIRECT) for their providers. However, KHIN and MHC maintain separate provider directories. This makes it difficult for a provider in Kansas to find the correct email for a provider in Missouri and vice versa.

The work of the pilot will be to develop the technical process and procedures for KHIN and MHC that will allow health care providers in Kansas and Missouri to find another provider's DIRECT email address when they need to exchange information on patients they share.

Pilot activities will take place during the next six months with a kick off meeting on June 28. Beside the ability to look up providers across the Kansas/Missouri state line it will also result in an undated implementation guide that will be available in 2014 to help other states. For more information regarding the pilot or the DIRECT project please contact Tiffanie Hickman at thickman@khinonline.org.

What a difference a year makes

It is has been almost a year since the Kansas Health Information Network, Inc. (KHIN) received a Temporary Certificate of Authority to do health information exchange business in Kansas. In that short time the health information exchange landscape in Kansas has skyrocketed. In August 2012, Via Christi Health Systems and HCA Wesley became the first Kansas health care organizations to share health data. Just 10 months later, 42 Kansas health care systems are live sharing data including all of the largest health systems in Kansas. Nineteen others are actively testing data and 3200 providers have the ability to exchange secure messages. KHIN members can now access information on almost 900,000 Kansas patients, electronically send immunizations to the state registry, electronically send syndromic surveillance data to the CDC and securely communicate with other health care providers through the DIRECT protocols which comply with all HIPAA regulations. Soon, they will be able to provide a personal health record to all of their patients.

In June 2012 the state regulatory organization, Kansas Health Information Exchange (KHIE) began the process of managing patient consent to participate in health information exchange. Since Kansas is an opt-out state patients are included in the health information exchange unless they take proactive action to contact KHIE and opt themselves out (see related story). Now one year later, after a media campaign and significant press coverage only 320 patients have opted out.

The last year has marked significant progress for KHIN and Kansas in ensuring that critical patient health information is available at the point of care. The large number of hospitals and health care providers participating in KHIN and the low number of patients choosing to opt-out is strong indication of the value that health information exchange brings to Kansas health care.

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