HealthTech Council Meeting

2. HealthTech Council Meeting October 21, 2012 Jay Moskowitz

3. HSSC Overview: HSSC Stakeholders Spartanburg Regional Healthcare System Greenville Hospital System Clemson University University ofSouth Carolina Palmetto Health Affiliates… MUSC Self Regional Healthcare AnMed Health McLeod Health • http://www.healthsciencessc.org/

4. HSSC’s Updated Mission Statement: Operational Emphasis HSSC MISSION STATEMENT (Adopted February 2, 2012) The mission of the Health Sciences South Carolina is to support our members in improving the health of all South Carolinians by collaborating across the State of South Carolina with the goal of enabling evidence based research. HSSC will achieve this by: • Creating a unique and comprehensive clinical data store which collects data from providers, enhances its usability, and makes it available in an easily accessible form for participants to use for clinical improvement and research purposes; • Developing and deploying information management tools that improve the efficiency and effectiveness of each member institutions research processes, including the ability of researchers across South Carolina to collaborate; • Serving as a convener for the identification, preparation, development and implementation of innovative collaborative research initiatives which have the potential for improving the health of South Carolinians through evidence based biological and clinical research informed by care givers, patients, and providers. Through its role as a collaborative organization, HSSC will engage and encourage its members to create and develop new products, new jobs, and new industries that positively impact economic growth; contain and reduce health care costs; minimize healthcare disparities; improve patient safety and effectiveness; improve access to healthcare services; and improve the patient care experience.

5. HSSC Role HSSC’s role is to support our members and to provide enabling services, assets and tools for translational research initiatives Research Implementation Improvement • Grant opportunity identification • Grant management • Institutional studies- comparative effectiveness • Disease management • Evidence based protocols • Population health management • Metrics tracking & management • Rapid-Learning Health System • Education Member Processes • Multi-institutional grant opportunity identification • Convener • I2b2 pre-study support • Grant preparation • Aggregated, de-identified clinical data • Analytical tools & support • Research process management tools • Comparative de-identified data • Identifiable clinical data (member’s data) • Analytical tools & support HSSC Support

6. CDW Overview Collection Storage Analysis i2b2Cohort Analysis Data Types: Demographics Diagnoses Procedures Medications Labs Data Feed Consolidation& Cleansing RESEARCH Operational Data Store (HTB) HSSC Clinical Data Warehouse (CDW) MPI MUSC CLINICAL GHS Data Marts &Registries SRHS PH

7. HSSC’s Current Research Applications Recruitment Regulatory Research Permissions SCResearch.org eIRB RPMS EMPI and DataWarehouse CDW Data Capture Services and Budget Research Collaboration Hypothesis & cohort analysis SPARC i2b2 Palmetto Profiles

8. Collaboration & Alignment: HSSC Portfolio of Infrastructure Projects 7

9. 8 Collaboration & Alignment: HSSC Portfolio of Infrastructure Projects

10. HSSC CDW Solution Architecture Technology Components Data Transformation Data Store & Management Data Intake Data Delivery CDW/MPI Research i2b2 GHS GHS GHS PH Interface Engine Master Person Index (MPI) Operational Data Store (ODS) Data Trust PH PH Clinical Data Marts/Registries MUSC MUSC MUSC SRHS SRHS SRHS Current data includes: Patient Demographics, Procedures, Diagnosis, Medications and General Labs Data is organized and integrated using standards that enable aggregation and multi-purpose use The data is made available through data marts & applications I2b2 LDS will be the first application but HSSC is ready to begin detailed planning for clinical applications

11. Data Fields Available in the CDW DT-Service-In-Patient DT_SVC_LAB_RESULT DT_SVC_MEDICATION DT_SVC_PROCEDURE DT_SVC_DIAGNOSIS DT_PATIENT_CONSENT DT-Service-Provider

12. CDW Scope: Initial Data Feeds DrivingBiomedicalProjects Multi-site data integration Cohort Analysis Clinical Trial Recruitment n+ Over 90% of research-based queries to an existing clinical database use data elements from sections 1, 2, and 3. 1 3 2 Labs Diagnosis 1 Medications PatientDemographics Procedures Data Types Inclusion Goal/Result 1 2 3 n+ 1 Optimizing healthcare research data warehouse design through past COSTAR query analysis. S. N. Murphy, M. M. Morgan, G. O. Barnett, and H. C. Chueh Proc AMIA Symp. 1999: 892–896

13. CDW Core & Optional Data Services Vision Data Integrated Claims and Clinical Data Services (optional) Care Continuum Data Services (optional) Practice eHR data Care Coordination Registry (Automated) Population Health Unknown ACO Management Medicare/Medicaid Data mart and BI Costs data Duplicate Service Reduction Claims data eRx Reconciliation All Claims Database Exploring Death Data Death Registry eRx Data Clinical Decision Support Diagnostics Standardized Reporting For External Measures Comparative Analytics/ Benchmarking ClinDoc Low Difficulty Results Clinical Data Mart & Business Intelligence Tools Orders Individual Member Clinical Data Marts &/or Registries (optional) Chronic Disease Registries Problems Pilot Diagnoses Meds Research CDW/i2b2 Core CDW Services Enterprise Master Patient Index Labs Live (MUSC) ADT Complexity

14. Core & Optional Services

15. 14 HSSC Information Solutions Approach Today 6 Months 12 - 16 Months Information Architecture Detail Planning Clinical Research Solutions Detail Planning Clinical Solutions (Optional)

16. Methodology: Phase Detail

17. Revised CDW Implementation Timeline Affiliate Hospitals Data Loaded – Q2 2014 New Vendor Contract Hospital 2 Data Loaded Start workgroup HSSCaffiliate Hospitals 2nd HospitalProject Started Hospital 1 Data Loaded End-to-end HL7-i2b2 2012 2014 2013 Hospital 1 Production on New System Start Conv of Hospital 1 to New System CompleteTechnology Audit Hospitals 3 & 4Projects Started Hospitals 3 & 4Projects Data Loaded Data Collaboration Agreement must be signed