MidSouth eHealth Alliance (Text Version)

Slide Presentation from the AHRQ 2008 Annual Conference

---

On September 8, 2008, Thomas Duarte made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (215 KB).

---

Slide 1

MidSouth eHealth Alliance (MSeHA)

Memphis, TN

Thomas Duarte, Executive Director, MSeHA

Slide 2

MSeHA Background

• 501(c)3 organization serving the Memphis area of ~1.1 million citizens.
• 25% of Shelby County citizens are at or below the poverty line.
• Began as a TN funded planning project in August 2004.
• Awarded an AHRQ Regional Demonstration contract, Sept 2004.
• Received additional funding from the State of Tennessee.

Slide 3

AHRQ Grant

• 5 year grant.
• MSeHA to accomplish in years 1-3:
  • Data sharing.
  • Interoperability.
  • Documentation of lessons learned.
• MSeHA to accomplish in years 4-5:
  • Evaluate the impact on patient treatment and care.

Slide 4

MSeHA Participants

• Board was formed in 2005.
• Baptist Memorial Health Care Corporation (5 facilities including MS).
• Methodist Healthcare including Le Bonheur Children's (7 facilities).
• The Regional Medical Center (The MED).
• St. Francis Hospital (2 facilities).
• St. Jude Children's Research Hospital.
• Christ Community Health Clinics (4 facilities).
• Shelby County/Health Loop Clinics (11 facilities).
• UT Medical Group (400+ clinicians).

Slide 5

Early Planning

• Participants identified data elements and agreed to provide clinical and demographic information from inpatient, outpatient and emergency room (ER) encounters.
• Began in the ER and expanded to include hospitalists and ambulatory sites.
• No minimum data sets.
• Participants encouraged to send what they could.

Slide 6

Why the Emergency Department?

• Access to data.
• Ability to impact patient treatment and care.
• Reduce duplication of tests.
• Potential to show ROI.
• Use data to gain sustainability model.

Slide 7

Data Obtained

• Data feeds include IP, OP, ER and Claims information.
• Data includes:
  • Patient identification and demographics.
  • Lab results.
  • Encounter data.
  • Medication history (claims).
  • Dictated reports:
    • Discharge, imaging, cardio, H&P, Diagnostic codes, etc.
  • Allergies

Slide 8

Data Summary: Since May 2006

• Patient medical record numbers = 1.14 million.
• Patient records with clinical data = 874,000.
• Total records with ICD-9 codes & clinical data = 915,000.
• Number of text reports:
  • Imaging = 2.41 million.
  • H&P = 3.35 million.
  • Discharge Summaries = 87,483.
  • Anatomic Pathology = 314,365.
• Patient encounters/month = 151,910.
• Clinical lab results/month = 2.97 million.

Slide 9

How It Happened

• Participant costs: ~$25-35K/year/site (less for subsequent sites).
• Participant resources:
  • IT staff.
  • Internal QA.
• Commitment to NOT let the MSeHA interfere with participant initiatives.
• CEO commitment and champion for Regional Health Information Organizations (RHIO)/Health Information Exchange (HIE).
• Implementation support (Vanderbilt Center for Better Health):
  • Signing up users.
  • Training/support/site management.
  • Privacy & security.
• Establishment of "Work Groups."

Slide 10

Lessons Learned

• Make the data easily accessible and secure.
• Provide ease of search for patients.

Below text is a screen shot of "Recent Ed Registrations at Methodist University Hospital" showing DOS, MRN number, Lastname, Firstname, MH-Univ., and Other Sites.

Slide 11

Lessons Learned—Usability

• Provided standardized mapping of lab results (Logical Observation Identifier Names and Codes [LOINC]) to aggregate clinical data from multiple participants.
• CMP ( Comprehensive Metabolic Panel) [Graph].

Below the text is a screen shot of sample (CMP) Comprehensive Metabolic Panel test results.

Slide 12

Focus

• Get the participants to the table.
• Begin with a narrow focus.
• Identify data where there is agreement on.
• Focus on policies and procedures for a single use of information:
  • Diagnosis and treatment.
• Create a flexible system that can be used in different workflows.
• Take as much data as you can you may need it later.
• Early wins are possible.
• Site visits for feedback, issue resolution and system usage.

Slide 13

MSeHA Today

• 14 hospital ER's.
• Hospitalists in 3 health systems.
• 4 primary care Safety Net clinics.
• 11 primary care Safety Net/Public Health clinics.

Slide 14

Sustainability

• Obtain funding.
• Identify population segments that will benefit from implementation.
• Demonstrate the benefits.
• Identify the potential customers.
• Benefits to payors, employers:
  • Disease management.
  • Specific populations.
  • Pain management.
  • Workman's comp.

Slide 15

MSeHA Goals & Focus

• Improve outcomes.
• Reduce hospitalizations.
• Eliminate unnecessary diagnostic tests.
• Reduce ER visits.
• Control costs.
• Have greater Primary Care Physician (PCP) involvement.

Slide 16

MSeHA Evaluation Goals

• Improve the quality of care by improving access to data at point of care.
• Demonstrate the impact of the MSeHA in the ED.
• Demonstrate how the MSeHA improves community healthcare delivery.

Slide 17

Stakeholder Drivers

• Incomplete information increases admission rates and length of stay.
• Lack of data impacts ED efficiency and ambulatory care.
• Incomplete data at point of care impacts test ordering.
• Incomplete data at point of care impacts clinical outcomes.

Current as of January 2009

---

Internet Citation:

MidSouth eHealth Alliance. Slide Presentation from the AHRQ 2008 Annual Conference (Text Version). January 2009. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/annualmtg08/090808slides/Duarte.htm

---