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Louisiana Public Health Information Exchange (LaPHIE) A collaborative project of: LSU HCSD DHH –Office of Public Health Louisiana Public Health Institute. Funded in part by HRSA Grant #H97HA08476. Presenters: S usan Bergson – LPHI Jane Herwehe – LSU HCSD Luis Smith – LSU SPH Ml & Telemed.
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Louisiana Public Health Information Exchange(LaPHIE)A collaborative project of:LSU HCSDDHH –Office of Public HealthLouisiana Public Health Institute Funded in part by HRSA Grant #H97HA08476
Presenters:Susan Bergson – LPHIJane Herwehe – LSU HCSD Luis Smith – LSU SPH Ml & Telemed Public Health Information Network (PHIN) Community of Practice March 12, 2009
Background: Summer 2005… LA lead the nation in several of communicable conditions. 1st in syphilis 2nd in Gonorrhea 5th in HIV/AIDS 10th in TB LSU HCSD and OPH sat down to discuss improved methods for leveraging information to be able to better reach and offer intervention for infected individuals with the goal of improving health outcomes and possibly reducing transmission of these communicable diseases.
Project Origin Recognition of the importance for collaboration Organizational support from DHH OPH and LSU HCSD Assistant Secretary of DHH OPH Chief Medical Office LSU HCSD Robert Wood Johnson InformationLinks Grant
Project Status • Established governance • Executed data sharing agreement • Analysis of legislation related to sharing of public health information • Ethics review by national experts in bio medical ethics, public health ethics and AIDS privacy • Consumer research • Evaluation methodology • Messaging system developed and in production
LaPHIE • Secure bidirectional information exchange between LSU HCSD and DHH – OPH • Purpose: to improve timeliness of disease reporting and access to care and treatment for persons with HIV, syphilis and tuberculosis
Project Significance • Improves timeliness of OPH follow up if case report and confirmatory results are delivered in real and near time • Standardizes the content and quality of reported information • Allows for “electronic outreach” for those lost to OPH and the care system • Increases opportunities to intervene with patients earlier in the course of illness which can improve patient outcomes and decrease disease transmission
Potential Impact on HIV Epidemic • As of December 31, 2008, 16,430 persons were living with HIV/AIDS in LA • OPH HIV/AIDS Program estimates that 45% of persons living with HIV in LA are “not in care” • Data analysis demonstrates that nearly 1100 persons that OPH considers not in care for HIV and 1500 persons with untreated syphilis are attending care in HCSD facilities for other medical reasons.
Who will be targeted by LaPHIE? • Only persons that OPH considers “not in care” for the targeted conditions. • Those that have not received test results and are unaware of infection status • Those that may have received results, but OPH has no laboratory or clinical info indicating monitoring or treatment • Exposed infants in need of follow up
How does LaPHIE “work?” • Connects LSU HCSD clinical information systems with OPH surveillance and treatment information systems • Disease reporting from HCSD to OPH can be real and near time • Important OPH messages can be electronically exchanged with health care providers at the point of care • LSU HCSD intervention information can flow back to OPH
Messaging LSU Firewall OPH Firewall ADT Registration ADT PPR PPR / PRR PRR OPH Server Interface Engine CLIQ/EMR
LaPHIE Messaging Design • Created with input from clinicians and public health professionals • EMR-based messaging • Simple, intuitive design that informs users of recommended actions and allows for recording of actions taken
LaPHIE Architecture HL7Interfaces IIS Web Farm Radiology SQL Server Data Repository Labs OPH Disease Alerts Clinician Actions Clinical Reports Clinician Actions CLIQ/EMR GUI Registration
Acknowledgements • OPH HIV, STD and TB programs • OPH nurses • OPH epidemiologists • OPH Disease Intervention Specialists • OPH Medical Directors • DHH Legal Counsel • LPHI • LSU/TU clinicians • UH Infection Control • Delta Region AETC • LSU SPH Medical Informatics & Telemedicine • HCSD CEO, CMO, CIO/CMIO • LIS Core Group • HCSD Programming Support
Thank you for your attentionFor more information, please contact: S. Bergson – sbergson@lphi.orgJ.Herwehe – jherwe@lsuhsc.eduL. Smith – lsmith@lsuhsc.edu