Medication History Service and Lab Connectivity

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Medication History Serviceand Lab Connectivity
VITL Project Showcase

• VITL Summit
• Thursday, September 25, 2008

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• Why RxHx?
• Immediate clinical results
• Technologically simple
• First step of HIE

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Who is using RxHx?

• Currently in use at RRMC, NVRH and BMH
• 30,000 inquiries run with 20,000 successful
  matches

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What is the Medication History Service?

• Allows providers in the ER to immediately access
  a patients medication history from the previous
  year.

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How does it work?
Request submitted by registration to VITL Data
Center
12 seconds
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Sample Report
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Why a complete medication history is so important

• Creates an accurate starting point for diagnosis
• Can explain presenting symptoms
• Can improve patient care by reducing likelihood
  of medication errors
• Allows the ER to immediately see what medications
  a patient has been prescribed and compare that
  with what they SAY they are currently taking.

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Additional RxHx Benefits

• Satisfies JCAHO reconciliation requirements
• Identifies drug seekers

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A View from the ER Irene Fortin, RN, Nurse
Manager RRMC Emergency Department
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EHR Connectivity a Step on the Continuum of
Health Information Exchange
HIE
Connectivity
Electronic Health Record
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VITL EHR Connectivity Services
Allows an EHR to connect with another electronic
system to send or receive data securely
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Suite of Services for Connectivity Lab
Results Lab Orders Radiology
Results Radiology Orders Immunization
Reporting Continuity of Care Document
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Hospitals
Pharmacies
Primary Care
Other HIEs
Specialists
Nursing Homes
Patients
Public Health
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EHR/Lab Connectivity Service Projects

• Currently connected
• Northwestern Medical Center

To be Connected Fall 2008 Southwestern Vermont
Medical Center Rutland Regional Medical
Center Brattleboro Memorial Hospital
Seven practices with more than 75 physicians to
be connected by early 2009
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Messaging Service Overview
Results Returned to Ordering Physicians EHR
LOINC Translation
Lab Order Placed from Physician Office
VITL Data Center
HL7 Lab Results Message
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Lab Results MessagingGetting Started

• VPN established to VITL HIE
• a) Re-use existing VPN
• Map lab dictionary
• a) Order codes mapped to CPT codes
• b) Result codes mapped to LOINC codes
• 3. Results interface set up
• Lab and practice do testing/verification
• Timeframe 45 days
• modified version of CPT code set

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Standardized Interfaces

• VITLs network built to comply with national
  standards for interoperability
• Core Technical Standards
• Messaging Standards -- HL7
• Semantic Standards -- LOINC
• Process Interoperability

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Privacy and Security

• Data sent over VPN or alternative
• GE Data Center certified by EHNAC (Electronic
  Healthcare Network Accreditation Commission)
• VITL/GE do not keep copy of results
• Results returned to only provider who ordered
  test, not accessible by others

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THANK YOU!