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eVital Records Initiative

eVital Records Initiative. What we learned and w hat comes next. Today’s objectives. Healthcare & informatics key terms Project description Our findings Next steps. Collaboration. Centers for Disease Control & Prevention (CDC) National Association for Public Health & Information Systems

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eVital Records Initiative

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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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