Slide Presentation from the AHRQ 2008 Annual Conference
On September 8, 2008, Thomas Duarte made this presentation at the 2008 Annual Conference. Select to access the PowerPoint® presentation (215 KB; Plugin Software Help).
MidSouth eHealth Alliance (MSeHA)
Thomas Duarte, Executive Director, MSeHA
- 501(c)3 organization serving the Memphis area of ~1.1 million citizens.
- 25% of Shelby County citizens are at or below the poverty line.
- Began as a TN funded planning project in August 2004.
- Awarded an AHRQ Regional Demonstration contract, Sept 2004.
- Received additional funding from the State of Tennessee.
- 5 year grant.
- MSeHA to accomplish in years 1-3:
- Data sharing.
- Documentation of lessons learned.
- MSeHA to accomplish in years 4-5:
- Evaluate the impact on patient treatment and care.
- Board was formed in 2005.
- Baptist Memorial Health Care Corporation (5 facilities including MS).
- Methodist Healthcare including Le Bonheur Children's (7 facilities).
- The Regional Medical Center (The MED).
- St. Francis Hospital (2 facilities).
- St. Jude Children's Research Hospital.
- Christ Community Health Clinics (4 facilities).
- Shelby County/Health Loop Clinics (11 facilities).
- UT Medical Group (400+ clinicians).
- Participants identified data elements and agreed to provide clinical and demographic information from inpatient, outpatient and emergency room (ER) encounters.
- Began in the ER and expanded to include hospitalists and ambulatory sites.
- No minimum data sets.
- Participants encouraged to send what they could.
Why the Emergency Department?
- Access to data.
- Ability to impact patient treatment and care.
- Reduce duplication of tests.
- Potential to show ROI.
- Use data to gain sustainability model.
- Data feeds include IP, OP, ER and Claims information.
- Data includes:
- Patient identification and demographics.
- Lab results.
- Encounter data.
- Medication history (claims).
- Dictated reports:
- Discharge, imaging, cardio, H&P, Diagnostic codes, etc.
Data Summary: Since May 2006
- Patient medical record numbers = 1.14 million.
- Patient records with clinical data = 874,000.
- Total records with ICD-9 codes & clinical data = 915,000.
- Number of text reports:
- Imaging = 2.41 million.
- H&P = 3.35 million.
- Discharge Summaries = 87,483.
- Anatomic Pathology = 314,365.
- Patient encounters/month = 151,910.
- Clinical lab results/month = 2.97 million.
How It Happened
- Participant costs: ~$25-35K/year/site (less for subsequent sites).
- Participant resources:
- Commitment to NOT let the MSeHA interfere with participant initiatives.
- CEO commitment and champion for Regional Health Information Organizations (RHIO)/Health Information Exchange (HIE).
- Implementation support (Vanderbilt Center for Better Health):
- Signing up users.
- Training/support/site management.
- Privacy & security.
- Establishment of "Work Groups."
- Make the data easily accessible and secure.
- Provide ease of search for patients.
Below text is a screen shot of "Recent Ed Registrations at Methodist University Hospital" showing DOS, MRN number, Lastname, Firstname, MH-Univ., and Other Sites.
- Provided standardized mapping of lab results (Logical Observation Identifier Names and Codes [LOINC]) to aggregate clinical data from multiple participants.
- CMP ( Comprehensive Metabolic Panel) [Graph].
Below the text is a screen shot of sample (CMP) Comprehensive Metabolic Panel test results.
- Get the participants to the table.
- Begin with a narrow focus.
- Identify data where there is agreement on.
- Focus on policies and procedures for a single use of information:
- Create a flexible system that can be used in different workflows.
- Take as much data as you can you may need it later.
- Early wins are possible.
- Site visits for feedback, issue resolution and system usage.
- 14 hospital ER's.
- Hospitalists in 3 health systems.
- 4 primary care Safety Net clinics.
- 11 primary care Safety Net/Public Health clinics.
- Obtain funding.
- Identify population segments that will benefit from implementation.
- Demonstrate the benefits.
- Identify the potential customers.
- Benefits to payors, employers:
- Disease management.
- Specific populations.
- Pain management.
- Workman's comp.
MSeHA Goals & Focus
- Improve outcomes.
- Reduce hospitalizations.
- Eliminate unnecessary diagnostic tests.
- Reduce ER visits.
- Control costs.
- Have greater Primary Care Physician (PCP) involvement.
MSeHA Evaluation Goals
- Improve the quality of care by improving access to data at point of care.
- Demonstrate the impact of the MSeHA in the ED.
- Demonstrate how the MSeHA improves community healthcare delivery.
- Incomplete information increases admission rates and length of stay.
- Lack of data impacts ED efficiency and ambulatory care.
- Incomplete data at point of care impacts test ordering.
- Incomplete data at point of care impacts clinical outcomes.
Current as of January 2009
MidSouth eHealth Alliance. Slide Presentation from the AHRQ 2008 Annual Conference (Text Version). January 2009.
Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/about/annualmtg08/090808slides/Duarte.htm