Maximizing Healthcare Integration Efforts for Operational Efficiency

1. Integration OUI 2016

2. Introduction • Director of Operations • Been at OTTR Since 2008 • Managed Integration Team • Manage Support and Upgrade Team

3. Overview • Introduction • Review Existing “Legacy” Interfaces • Capitalize on Existing Interfaces • Decisions From The Past • Review Some Newer Integration Efforts • Review Other Integration Efforts • Questions

4. OTTR Integration Team • Shyla Punteney – Lead Integration Analyst • Don Doumakes – Sr. Developer • Ryan Hill – Sr. Integration Engineer • Santosh Shetty – Integration Engineer

5. Definition • Integration: an act or instance of combining into anintegral whole. • Interface: acommon boundary or interconnection between systems,  equipment, concepts, or human beings.

6. Reasons To Interface • Manual Entry • Errors • Timeliness • FTE’s • Duplicate Entry • Data Aggregation • Process and Efficiency • Drives Workflow • KPI’s • Readmissions • Medicare Cost Report

9. Existing Interfaces • ADT • Automatically updating the patient’s status based on certain registration events. • Automatically updating the patient’s demographics, or filing demographic changes for review and approval in the application. • Providing data for calculating length of stay. • Adding diagnosis to the OTTR problem list. • Adding allergies to the OTTR allergies list. • Adding vital signs taken at point of care as discrete lab data. • Adding care providers, such as consulting and referring physicians from each visit. • Adding insurance to the OTTR financial tables. • Adding next of kin to the OTTR contact list.

10. ADT • Auto Insert Solution • By Department • Internal Referrals • Capture Data on Potential Patients • Longitudinal Patient Care • Multiple MRN’s • Online Referral • Bi-Directional Registration • Start of Referral/Registration Process

11. Existing Interfaces • Lab/Micro/HLA/Blood Bank • Providing the ability to view and trend labs side by side with medications and medication dosage in both discrete value comparison as well as through graphing. • Providing the ability to configure lab rules to flag a particular lab for review. This is in addition to the display of normal reference ranges and abnormal flags. These rules can be set up at the individual lab level to evaluate of a set of labs for a given patient over time to alert increases or decreases outside of an acceptable threshold. • Providing the ability to post results as both discrete and as text. This allows for storage of an HLA report as well as the different components into individual locations

12. Existing Interfaces • Transcription/Radiology/Pathology • The ability to include a PDF, Word Document, or other document format as an attachment to a report. When selected, the attachment will be opened on the user’s workstation. • The ability to include a “link” as an attachment to the report. When selected, the attachment will trigger the action of accessing/opening that document from its source location. • The ability to include the physical location of a document with the intent of accessing that location to retrieve and store the document in the OTTR database. • The ability to use discrete data from a Radiology or Imaging report transaction such as MRN, Accession, Facility to dynamically build a link to the images in the PACS system that are associated to that report. This “link” would also be an attachment to the report that when selected would trigger the action of accessing/opening that image from its source location.

13. Existing Interfaces • Scheduling • Automating the addition important scheduled events occurring in the ambulatory setting to an existing action list for a given patient. • Contributing to workflow by routing required actions to the appropriate personnel. • Allowing for a side-by-side comparison of lab levels and medication dosage, including a graphical display of these values over time. • Providing the ability to update or cancel an appointment/event along with recording the reason, dates, and responsible persons.

14. Existing Interfaces • Medications • Providing the ability to quickly view a patient’s current active medication list • Providing the ability to view the medication history and dosage changes over time. • Provide the ability to be alerted when a patient’s medication has changed or a refill is needed. • Allowing for a side-by-side comparison of lab levels and medication dosage, including a graphical display of these values over time. • Optimizing workflow when a lab comes back and medications need to be addressed. • Using the stored data to generate patient lists and reports.

15. Existing Interfaces • Problem List • Providing the ability to quickly access a patient’s active problem list including diagnosis, date/time, code, and problem status. • Providing the ability to view the complete problem history including end dates and responsible persons associated with sign-off. • Allergies • Provides the ability to quickly access a patient’s active allergies including allergy type, date/time, and code if present. • Imaging Interface (.pdf, url, dropbox) • Provides the ability to quickly access to diagnostic images.

16. Existing Interfaces • Outbound interfaces • Physician Notes sent as an ORU based off of encounter sign-off. • Billing Events sent as a DFT based off of encounter sign-off. • Referral Notes sent as an ORU based off of referral ending. • Lab results sent as an ORU based off of entry of manual labs. • Allergy data sent as an ADT based off of changes to the patient’s allergy list. • Problem data sent as PPR base off of changes to the patient’s problem list.

17. CCD Interfaces • Meds • Allergies • Problems • Immunizations • Vitals

18. eHealth Global • Demographics Management – OTTR to eHealth • Medical Records Management – eHealth to OTTR • The document image is stored as an attachment to a text document in OTTR.

19. Pass Through Patient Context

20. Pass Through Patient Context

21. Misc Items • Filtering Criteria • Need More Than One Identifier • Discourage Using SSN or First Name • “Tiered” Filtering • Email Notifications • Errors • Interface Management • Stem Cell Lab Interfaces

22. Summary • Introduction • Review Existing “Legacy” Interfaces • Review Some Newer Integration Efforts • Review Other Integration Efforts • Questions

23. Questions?

24. Integration OUI 2016