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Washington State’s

”Thin
-
Layer”

Health Information


Exchange

Sue Merk

Vice President and

HIE Global Technical and
Operations Project Director

Objectives

•
IDENTIFY

-

key differences between this “thin
-
layer” HIE model and more traditional approaches
to HIE

•
REVIEW

-

standard and non
-
standard transactions
available for use with the HIE

•
EXPLAIN

-

translator role of the HIE in connecting
file transport and real
-
time transaction systems as
the community spans old and new communication
protocols

•
UNDERSTAND

–

the value of the HIE Meaningful
Use Metric Service to Washington Medicaid EHR
Incentive program participants


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“Thin
-
Layer” HIE

•
Focus on the EXCHANGE of data

•
Protocol translation

•
Simplified connectivity

•
Standards based transactions

•
NO repository

•
NO applications

•
NO MPI
-

record matching

•
Lower cost of entry & sustainability

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Standard Transactions

•
CCD

•
HL7
–

Labs, radiology, ADT

•
ePrescribing

•
Immunizations
–

2 way

•
Eligibility and benefits (270/271)

•
Community Referral Form

•
CROWNWeb
–

ESRD reporting

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Referral Form

Non
-
Standard Transactions


Protocols used by HIE

•
XDS
–

cross enterprise document
sharing = real time query and response

–
SOAP and SAML on each message

–
Designed for repository systems

•
XDR

–

eXternal Data Representation =
data sharing between different systems

•
EBXML
-

E
lectronic
B
usiness E
x
tensible
M
arkup
L
anguage.

•
X12
–

traditional EDI (eligibility, claims)

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Understanding Protocols

•
HIE experience to date
–

no two
trading partners are alike

•
Repository applications and HIEs
use ONLY newer xdr and xds
protocols

•
Vast majority of systems are still
capable of exchanging
documents using FTP and
traditional EDI

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Protocol Translation

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File System

XDR

XCA

XDS

“PUSH”
”

“PULL”
”

SFTP

Query/Response

“EDI”

FTP

HIE Translation Engine




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Referral Form

Non
-
Standard Transactions


HIE Meaningful Use

Conformance Service

•
Test for conformance with
standards

•
Test statistical sampling to verify
Threshold Conformance for MU

•
Monthly reports on transactions
and trading partners

•
Standard reports for Medicaid EHR
Incentive program reporting

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Meaningful Use Thresholds


EHR population in 2012

•
Problem Lists = 80%

•
Allergy list = 80%

•
Medication Lists = 80%

•
Advanced Directives = 50%

•
Patient demographics = 50%

•
Vital signs = 50%

•
Smoking status = 50%

•
Summary of Care = 50%

•
Lab results into EHR = 40%

•
E
-
Rx = 40%

•



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Find out more by visiting
our website

http://www.onehealthport.com/hieindex.php

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