American Immunization Registry Association 2004 Annual Meeting

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American Immunization Registry Association 2004
Annual Meeting
From Registries to RHIOs(Regional Health
Information Organizations)
Amy Zimmerman, MPH Rhode Island Department of
Health
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Overview

• Health Care Landscape of RI
• Development of Rhode Island Quality Institute
  (RIQI) - and RHII
• Collaboration of Registry with RIQI
• RIs HIT State Demonstration Project
• What registries have to offer to RIHOs
• What RIHOs have to offer Registries

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Health Care Landscape in RI

• 3 major health insurers
• 2 major hospital systems
• 7 independent hospitals
• 3 very large group practices
• 1 Quality Improvement Organization (QIO)
• 2 State agencies (Health, Human Services)
• 1 University with a medical school public
  health program

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• Development of Rhode Island Quality Institute
  (RIQI)

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The RI Quality Institute

• A collaboration among hospitals, health care
  providers, insurers, business, academe and
  government for the purpose of improving health
  care quality, safety and efficiency
  in Rhode Island.

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The Rhode Island Quality Institute Mission
Statement

• The Quality Institute will promote coordination
  and collaborative relationships, increase value
  to purchasers and improve the overall quality and
  safety of health care in Rhode Island.

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RIQI Guiding Principles

• Collaborationfirst and foremost
• Real improvement is required
• Win-win for all participants
• Focus on system improvements that none of
  individual entities can achieve alone
• Senior Leader participation

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Board of DirectorsOfficers

• Chairman Lifespan Corporation, George
  Vecchione
• Vice Chairs HEALTH, Patricia Nolan, MD,
  Care New England, John
  Hynes, Esq.
• Blue Cross/Blue Shield of RI, James
  Purcell
• President RI Quality Institute Laura
  Adams,

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Board of Directors cont.

• Brown Medical School Richard Besdine, MD
• Rhode Island Medical Society Yul Ejnes, MD
• United Health Care Stephen Farrell
• Chair, Long-Term Care Council Lt. Governor
  Charles Fogarty
• Rhode Island Quality Partners David Gifford,
  MD
• Department of Human Services Jane Hayward
• Central RI Chamber of Commerce Jeff Johnson
• Neighborhood Health Plan of RI Chris Koller
• Univ. of RI College of Pharmacy Donald E.
  Letendre, PharmD
• Rhode Island Medical Society Michael Macko, MD
  
• RI State Nurses Association Pamela McCue, RN
• Quality Partners of Rhode Island Marcia Petrillo
  
• Hospital Association of Rhode Island Edward
  Quinlan
• Edwards and Angell, LLP Sheldon Whitehouse,
  Esq.,

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The Quality Institutes Strategic
Agenda
Technology Infrastructure Safety in Care
Delivery Evidence Based Medicine
Statewide Electronic Prescribing
Rhode Island Health Improvement Initiative (RIHII)
Statewide Connectivity and Electronic Health
Record Adoption
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Current Funding Sources

• The People Around the Table
• Sales of Services
• Grants and Contracts

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• Collaboration between RIQI and KIDSNET

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Getting to know you

• Initial meeting- RIQI KIDSNET- Spring 03
• KIDSNET Linked RIQI with NHII- Summer 03
• RIQI pilots SureScripts-2003
• RIQI sponsor LHII forum -Spring 04
• RIQI develop AHRQ Planning grant- Spring 04
• HEALTH approached to submit AHRQ state
  demonstration project

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• RIs HIT State Demonstration Project

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Goal of State HIT Demo Project

• Create, implement and evaluate a Master Patient
  Index as the backbone of an interconnected
  information system putting the right information
  into the hands of clinicians and their patients
  when and where it is needed.

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It Principals

• Data is shared but stored where it resides
• Access to data is controlled by the patient
• Patients will consent to participate
• Data will be stored and presented in a patient
  centric manner
• Data will be accessed and transmitted in a secure
  manner
• Patient identified data will only be used for
  clinical care
• Data used for quality measurement will be
  aggregated and de- identified  

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• What is a Master Patient Index?

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Master Patient Index

• Central demographic database
• Stores unique patient identifiers of data sharing
  partners
• Requires unique patient master key  
• Requires unique provider identifier key
• Requires data sharing partners to have secure
  connection
• Serves as single authentication portal to each
  data sharing partner system

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Methods

• Phase 1- MPI created and serves as ASP and
  provide access to each data sharing partners
  individual system
• Phase 2- Common interface developed so patient
  information presented in a unified,logical
  manner, add other data sharing partners
• Phase 3- include decision support , add other
  data sharing partners

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Initial MPI Data Sharing Partners

• HEALTHs KIDSNET
• HEALTHs Millenium- clinical laboratory system
• Lifespans Lifelinks- EMR plus Lifespan,
• SureScripts - electronic information exchange
  between physicians and pharmacies
• Rhode Island Health Center Associations patient
  registry and data warehouse
• East Side Clinical Laboratorys web-based
  reporting system
• Medicaids paid claims database (evaluation
  only) 

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Components of MPI project

• Technical design and development of the MPI
• Health care provider engagement, training and
  participation
• Consumer education and engagement
• Well-defined and rigorous evaluation
• Technical Assistance, and Coordination with other
  Health Information Technology (HIT) efforts
  within the state.
•  

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What registries have to offer RHIOs

• Expertise and Experience in
• Design/development of integrating health data
• Matching records and de-duplication
• Understanding Provider enrollment and engagement
• Confidentiality, Security, State laws, Data
  sharing policies
• Consumer engagement, consenting process
• Data capture and data quality controls
• Support and ongoing maintenance needs of systems
• Data standards, PHIN
• Data transfer policies and issues
• Populating Immunization data into EMRs

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What RHIOs have to offer Registries

• Demographic and Immunization data to populate
  registry
• Promote uniform way to share data with broader
  set of users push the standards
• Promote use of EMRs in physician offices
• Single method to share data for all users
• Improve ability to share data between registries
• Ability to look at immunization data in
  combination with other health care data
• Resources Cost sharing
• New Partnerships

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• Registries and RHIOs
• Partners?
• Competitors?
• Who Knows?
• You choose!!!!

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Contact Information

• Amy Zimmerman, MPH
• Rhode Island Department of Health
• 401-222-5942
• amyz_at_doh.state.ri.us