ThSisU Advisory Committee Meeting
Thursday, June 15, 2017, 4:00 p.m. – 5:30 p.m.
Utah Department of Health, 288 North, 1460 West, Room 128, Salt Lake City, Utah
GoToMeeting: https://global.gotomeeting.com/join/275925701
Dial +1 (646) 749-3112 Access Code: 275-925-701
Pending Minutes
Participants: Sid Thornton (Co-Chair), Matt Hoffman (Co-Chair), Wu Xu, Jeffrey Duncan, Cameron Copper, Gerald Mattson, Connie Tohara, Mark Fotherinigham, Deepthi Rajeev, Frank C Overfelt, Jingran Wen
1. Welcome and Introduction (Sid Thornton, Co-Chair)
a) Self-introduction of all the participants.
2. Approve May Meeting’s Minutes (Sid Thornton, Co-Chair)
a) The May meeting pending minutes was reviewed by the Committee.
b) Sid Thornton suggested following up with David Fletcher’s project. This item was listed on the to-do list.
c) Sid Thornton made a motion to approve the May meeting Minutes, and the motion was passed unanimously. The Minutes is approved as read.
d) The approved May meeting Minutes is sent out to all the committee members by email, and updated on the ThSisU website (http://phi.health.utah.gov/thsisu).
3. HCA and External Images (Gerald Mattson, HCA)
Gerald gave the introduction of Hospital Corporation America (HCA), its clinical informatics framework, and HCA enterprise master patient index. He gave a use case proposal in which medical images would be shared among trusted institutions using ThSisU common model and architecture.
a) HCA has 170 hospitals in the U.S. and 6 in the U.K. with more than 20 million patients annually. 7 hospitals in Utah.
b) Different care systems and transaction systems are adopted within HCA, and information moves among systems.
c) HCA enterprise master patient index (EMPI) correlates patients IDs across systems and consolidates into one easily assessable view. Integrated source systems include Meditech, eClinicalWorks, PatientCareLink, Cerner, Epic, NextGen, and MyHelathOne. Integrated consuming systems include myhealthdirct, caradigm, DoseWatch, IngeniousMed, PatientCareLink, and MyHealthOne.
d) Use case proposal: to be able to share medical image among trusted institutions to reduce the cost and time of care and to improve healthcare quality. HCA and other institutes send the medical image information to broker, e.g. UHIN, and institutions are able to query the positive patient identification through the broker. Requests for image could come from the consuming institution and the images from participation institution only if specific patient matching criteria is matched per prior agreement. The process should be automated.
e) Matt pointed out that 75% of the HIEs in the country have the viewer or ability to share medical image.
f) Sid pointed out the Healtheway project (National eHealth Exchange) is working on the national standard/specification for just-in-time sharing image, and this image sharing use case will be just ready to adopt in a standard way. Sid also pointed out that Intermountain would be interested in adoption the standard.
g) Any inter-state policy problems resulting in patient identification and information sharing in the current HCA workflow? No such problems within HCA using patient treatment consent.
h) Sid recommended to take the medical image use case back to the ThSisU planning committee to build it out as one of the target use cases.
4. ThSisU Common Components in ePOLST design (Matt Hoffman, UHIN and Sid Thornton, Intermountain Healthcare)
Matt gave a high-level introduction of UHIN ePOLST history, current status, and architecture.
a) ePOLST Advisory Board was created in 2010, and in 2014 the Beacon Grant completed.
b) Most POLST are stored in PDF format.
c) UHIN hosts a record locating service. Most updated information is manually matched to the MPI. UHIN ePOLST system is able pull POLST information across a document query.
d) Some considerations: digital signature; most current version, integration of date of death, and future analysis.
Sid gave the introduction of the ePOLST common componentw that can be adopted across the ThSisU community.
a) The goal of Intermountain ePLOST project is to make sure the patients’ wishes are identifiable, and to automate the process.
b) The same component and the same technology, as adopted in the ePOLST use case, will be leverage across all the ThSisU use cases. The business logic will be driven by each use case.
c) Sid will continue to report back to the ThSisU group with the progress of the ePOLST project.
5. ThSisU Standard (Jeffrey Duncan, UDOH)
Jeff gave an introduction of ThSisU standards using the death notification as an example. The Rule R380-77, the gateway for fact of death (FOD) notifications, standards used in FOD, and other related standards were covered in his presentation.
a) R380-77 defines the minimum amount of personally identifiable information necessary to disambiguate and validate identities across organizational information systems.
b) Standards used in FOD: XCPD (Cross-Community Patient Discovery) and XDR/XDS (Cross-Community Document Reliable Interchange).
c) Other standards: PIX (Patient Identity Cross-Referencing) and PDQ (Patient Demographic Query).
6. Other Issues (Sid Thornton, Co-Chair)
None.
7. To do:
a) To follow up the DTS project (David Fletcher)
b) To follow up ePOLST project (Sid Thornton and Iona)
c) To follow up on the standards (Jeffrey Duncan)
d) Sid made a motion to draft the ThSisU standards proposal document (Jeffrey Duncan and Sid Thornton)
8. Next Meeting – Thursday, July 20, 2017 at 3:30 P.M. in Room 128 at Cannon Health Building, Utah Department of Health. Things will be discussed in the next meeting:
a) Updates - UPDB project updates – Sid Thornton
b) Medicaid 90/10 funding – Iona Thraen
c) UHIN provider directory – Matt Hoffman
9. ThSisU advisory committee meeting is fully open under the Open and Public Meetings Act. The meeting is recorded. All the materials are available to public. All the decisions will be public available for public comments. All the information about ThSisU is posted at http://phi.health.utah.gov/thsisu/.
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