eVital Records Initiative

What we learnedand what comes next

Today’s objectives

0Healthcare & informatics key terms0Project description0Our findings0Next steps

Collaboration0Centers for Disease Control & Prevention (CDC)0National Association for Public Health & Information Systems0MDH – Office of Vital Records0MDH – Office of Health Information Technology 0MN.IT – MN office of Information Technology0Allina Health0Essentia Health0Unity Hospital

September, 2012 – April, 2014

eVital Records hypothesis

Electronically exchange data from the EHR to MR&C This interoperability would: 0Be more efficient0 Improve accuracy of data0Be more secure0Reduce filing delays

First step: Assessment

What is the current state of birth registration?0Follow process at one hospital0Document each step

Special thanks to Unity Hospital

Current hospital birth registration process

Initial assessment: current status

0Inefficient process0Manual data entry/transcription0Multiple data sources0State unable to assess data quality/validity0Exposure to extra patient health

information

Informatics learning

0Healthcare Informatics = using technology to improve patient health

0 Interface = a link/where things connect or intersect0 Interoperability = useful interaction or movement

How? When? Who?

The eVital Records Project considered0EHR is compiled throughout the patient stay0When should the data move?0How to make the data useful?0What data should transfer?

Our solution: form manager

0Utilize a form manager to package information0Birth registrar will review & forward0Filled form sends data to birth record

Informatics learning

3 Needs for interoperability:0Standards0Data must exist before it can move0Ability to send / Ability to accept data

Multiple systems

Multiple stand-alone systems0Viewed through “portals”0Data transcription0Scanning as images

Next Step: Test & Demonstrate

Proof of Concept demonstrated to several audiences0 30% data mapped0Form Manager received & sent0Vital record populated

Positive Feedback

Great idea!Innovative!Extend to other thingsSend everything this wayThink about bi-directionalityHow soon can we implement?

More informatics learning

0Meaningful Use = an incentive program for electronic health record implementation0 Payments & fines0 Rolled out in stages

0HL7 = Standards0 Methods 0 Data sets 0 Language

New problem: non-discrete data

0EHR created for clinician ease of use0Narratives0 “Smart phrases”

What about demographic data?

Some things are not in EHR:0Mother’s education, place of birth, race0Father’s information0Child’s name

What or who is data source?

Unanswered questions

0What about updates to EHR?0 Corrections0 Lab values, etc.

0What about bi-directional exchange? 0 Name changes

0Who owns the data?0 Right to share it0 Right to correct it

Competing Resources:

0Facilities must comply with MU0Facilities also converting other systems

0 ICD 9 becomes ICD 100 Innovation takes $$ and time

0MDH has resource conflicts, too

Will it happen? Absolutely

OUR VISION:0Mother’s worksheet becomes a tablet or kiosk0Birth registrar counsels parents re: registration0Birth registrar reviews computer form 0Birth registrar combines demographic record with

medical record and submits birth record

Birth registrar becomes a specialized duty

Now is not the time

eVital records is still (slightly) ahead of its time0Other priorities at facilities0Other priorities at MDH0Lack of federal standards / mandates / funds0EHR data availability

Our recommendations

0Align policies0Seek support from ONC0Continue expanding & testing 0Develop informatics-savvy

0 Vital records offices0 Stakeholders

What does this mean to you?

0Short term: continue the great work0Long term:

0 Improved prenatal clinic to hospital communication0 Increased structured data in EHR0 Technology advances for parents’ reporting of

demographic data0 Specialized birth registrars

In summary

The eVital Records project is complete0Tested electronic exchange of data from EHR to MR&C0Documented current process0Proposed future process0Noted potential barriers

Thank you!eVital Records Initiative