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Health Homes Novel Prototype

Health Homes Novel Prototype. Health Homes are cool solutions for problems that exist today. Patients don’t go to the right doctor What if a care coordinator could guide a patient Care transitions fail 70% of the time when the patient is responsible

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Health Homes Novel Prototype

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  1. Health Homes Novel Prototype

  2. Health Homes are cool solutions for problems that exist today • Patients don’t go to the right doctor • What if a care coordinator could guide a patient • Care transitions fail 70% of the time when the patient is responsible • What if the patient didn’t have to facilitate communication between providers • On average it take 17 years for a best practice to become a common practice

  3. Technology standards and systems enable health homes • Standards Exist • Integration Effort • We are going to show you one simple scenario of how existing systems and standards can be the infrastructure that enable your health home policies

  4. Health HomesA Novel Prototype Person Centered Care Plan Thank You Next Slide

  5. System Stack – Element 1 (eHrs) Providers and EHRs Long-Term Care/ HCBS Developmental Disabilities BH Providers (WITS) FQHCs Hospitals Custom Queries Quality Measures

  6. Standards Stack – Element 1 (eHrs) Providers and EHRs Long-Term Care/ HCBS Developmental Disabilities BH Providers (WITS) FQHCs Hospitals CCD The Continuity of Care Document (CCD) Standardizes Medical Records File Formats So that people have portable medical records

  7. System Stack – Element 2 (HIE) Secure Record Sharing HIE + A DIRECT HIE is: A Directory of Participating Care Provider Addresses (ex doctor@direct.hie.com) Compatible with EHRs, email, and PHRs

  8. Standards Stack – Element 2 (HIE) Secure Record Sharing HIE + CCD An HIE is: A Directory of Participating Care Providers (Internet Address) Secure Transmission of Interoperable Records (Encryption) Assured Record Authenticity (Digital Signing) DIRECT

  9. System Stack – Element 3 (C2S) Secure Record Sharing Consent2Share 42 CFR pt2 HIE + Patient Sharing Preferences enforced at the HIE level so that Providers only share records when the patient allows is

  10. Standards Stack – Element 3 (C2S) Secure Record Sharing Consent2Share 42 CFR pt2 HIE + XACML • So that providers only share records when the patient allows: • Consent2Share uses an eXtensibleAccess Control Markup Language (XACML) standard so that HIEs can determine if the patient has provided permission • Consent2Share DIRECT CCD

  11. System Stack – Element 4 (Pop Health) Transition: txt

  12. Standards Stack – Element 4 (POP Health) Quality Reporting Document ArchitectureQRDA

  13. System Stack – Element 5 (Query Health) Transition: txt

  14. Standards Stack – Element 5 (QUERY Health) Quality Reporting Document ArchitectureQRDA Continuity of Care Document CCD Health Quality Measures Format HQMF

  15. Standards Stack – Element 6 (Health Home) Transition: txt

  16. So that Care Coordinators can…. Transition: txt

  17. Now a Novel Look at a Health Home ProtoType DIRECT CCD XACML Quality Measures Statistics

  18. Referrals Plans of Care Care Coordination Billing Secure Record Sharing Consent2Share 42 CFR pt2 Home Health Functions HIE + Providers and EHRs Long-Term Care/ HCBS Developmental Disabilities BH Providers (WITS) FQHCs Hospitals Custom Queries Quality Measures Query Health popHealth +

  19. Home Health Functionality Referrals Plans of Care Care Coordination Billing XACML DIRECT Consent2Share 42 CFR pt2 + HIE CCD Providers and EHRs Long-Term Care/ HCBS Developmental Disabilities BH Providers (WITS) FQHCs Hospitals Quality Measures Statistics Quality Measures Custom Queries + Query HealthGold popHealth

  20. WITS Providers and EHRs

  21. LTSS Providers and EHRs

  22. DIRECT Health Information Exchange

  23. Consent 2 Share Consent 2 Share

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