CRISP: Maryland’s Health Information Exchange

1. CRISP: Maryland’s Health Information Exchange September 2013

2. What is CRISP? CRISP (Chesapeake Regional Information System for our Patients) is Maryland’s statewide health information exchange (HIE) and Regional Extension Center (REC) • Health Information Exchange, or HIE, allows clinical information to move electronically among disparate health information systems. The goal of HIE is to deliver the right health information to the right place at the right time—providing safer, more timely, efficient, effective, equitable, patient-centered care. • Regional Extension Center (REC) is a program created by the ONC that is funded through the stimulus bill. RECs will offer technical, implementation, and educational assistance to facilitate providers’ adoption and meaningful use of electronic medical records (EMRs).

3. Our Mission Our mission is to advance the health and wellness of Marylanders by deploying health information technology solutions adopted through cooperation and collaboration. 

4. Our Mandate To electronically connect all health care providers in the state of Maryland.

5. Policy Board and Opt Out Policy • CRISP was designated as the state’s HIE by the Maryland Health Care Commission (MHCC) • The MHCC facilitates a consumer oriented Policy Board, which advises the MHCC on setting policies, which are then adopted by the HIE • The MHCC’s Policy Board has determined Maryland will be an opt out state for patient participation

6. Patient Awareness • All participating organizations are required to update their HIPAA Notice of Privacy Practices with a paragraph on their participation with CRISP • All participating organizations are required to make CRISP brochures and opt out forms available at intake areas • Patients are responsible for completing and submitting the opt out form to CRISP.

7. How Can Patients Opt Out? • Call our toll free number [1-877-95-CRISP (27477)] • Mail the completed opt out form • Fax the completed opt out form • Submit the opt out form through our website (www.crisphealth.org)

8. Current Four Areas of Focus • Query Portal Growth • to give providers access to prior hospital and medication records • Direct Secure Messaging • to enable referrals and other care coordination • Encounter Notification System (ENS) • to notify in real time about patient visits to the hospital • Encounter Reporting System (ERS) • to help hospitals understand readmission patterns

9. Query Portal

10. Web Portal Offering for Providers • CRISP offers a free, web-based portal to access data through the HIE • Physicians and support staff can query patients they are treating and view lab, radiology, and transcribed documents in the HIE for that patient • Information obtained through the portal can be printed and incorporated into records • No integration with third party systems has occurred to date, but we are working on this as a priority project

11. Who Can Have Access to the Portal? • Access is for TREATMENT PURPOSES ONLY • Access should be given to those providers and support staff who have access to patient records for treatment purposes both within and outside the facility as a course of their usual workflow • The portal CANNOT be used for payment, operations, reporting, research, or any purposes other than treatment at this time

12. CRISP Query Portal The CRISP Query Portal can make clinical information available at Ambulatory sites • Access must be part of a treatment encounter. • Single sign on integration can be enabled to transparently pass credentials and patient context to CRISP. Types of data available: • Patient Demographics • Lab Results • Radiology Reports • Medication Fill History • Discharge Summaries • History and Physicals • Operative Notes • Consults

13. Requirements for Users • Complete Online User request form: hie.crisphealth.org • Complete CRISP training through weekly online web-ex sessions • Submit a Photo ID • Be verified by the Organization Point of Contact Once ALL above conditions are met, CRISP will email the username and password directly to user

14. Query Portal Login Screen

15. Query Portal Patient Search

16. Query Portal Search Results

17. Query Portal Patient Medical Records

18. Query Portal Lab Report

19. Query Portal Download

20. Encounter Notification System

21. Encounter Notification System • Encounter Notification System (ENS) is a system built by CRISP to notify a participant in real time when one of its patients has an encounter at any hospital in Maryland. • CRISP currently receives notifications in real time for any patient admissions, intra-facility transfers, and discharges in the state of Maryland. • Using ENS, we have the ability to send notifications of these hospital events to participants who wish to track a certain patient population.

22. ENS Trigger Event Selection Trigger Events Frequency In real time Once a day Once a week Once a month • ER admission • Inpatient admission • Intra-hospital transfer • ER discharge • Inpatient discharge • Cancel admission • Cancel transfer • Cancel discharge

23. CRISP Direct Messaging

24. Email Style Notification

25. Spreadsheet Style Notification

26. Encounter Reporting Service

27. CRISP Encounter Reporting System • The Encounter Reporting Service (ERS) is a CRISP-developed solution that relies on the real-time HL7 Admission-Discharge-Transfer (ADT) messages from all hospitals to produce utilization reports • ADT data can be extracted for various time periods and processed through scripting logic to produce consolidated reports showing in-patient admissions, ER visits, or other hospital utilization data across all Maryland hospitals. • Our initial efforts have focused on creating an “inpatient admission/discharge” report that is then used to create sub-reports, such as inter-hospital 30-day readmissions • Reports showing inter-hospital activity have not previously been possible due to the absence of a unique patient identifier across unaffiliated facilities

28. MRN Drilldown Reports • This report enable hospitals to see inbound and outbound readmissions by patient MRN and account number • This report is the basis off which we will build additional detail.

29. Encounter Reporting Service GIS Mapping • Based on the indexed identity information we can produce visualizations of hospital utilization data in near real time. • This capability can enable targeted use of resources / interventions. • Program such as Maryland Health Enterprise Zone initiative could leverage geographic data to better understand localized use of services.

30. ERS Mapping

31. CRISP User Support • We offer a support email info@crisphealth.org and phone line 1-877-952-7477 that is manned during business hours • Any account that has no activity during the last 60 days will be locked, and users must call CRISP directly to unlock account • Any requests for password resets, account unlocks, etc. must come directly from the user and communication of new passwords will only occur via the email we have on file • Or visit CRISP on the web at www.crisphealth.org

32. Questions? CRISP info@crisphealth.org www.crisphealth.org (877) 952-7477