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					Secure Architecture For Exchanging
       Health Information
     in Central Massachusetts

                      Larry Garber, M.D.
                    Peggy Preusse, R.N.
                          June 9th, 2005
Central Mass Health Information Organization:
  Fallon Community Health Plan: largest payer in
  central Massachusetts, 172,000 members
  Fallon Clinic: group practice with 240 physicians,
  26 sites, and over 1 million patient visits per year
  UMass Memorial Health Care: 1,500 physicians,
  12,000 employees, multiple hospitals, primary care
  practices, ambulatory outpatient clinics, long term
  and home care facilities, and a 700-member faculty
  group practice


                                                         2
Objective
 Build and operate a regional health information
 exchange infrastructure to securely enable real
 time aggregation and presentation of patients’
 health information from multiple different
 organizations with integrated decision support in
 order to improve patient safety, quality of care,
 and efficiency of healthcare delivery.




                                                     3
High Level Design Goals
 Preservation of data and transaction ownership
 Secure
 Protects patient privacy
 No central clinical data repository
 No central demographic repository
 Scalable and high performance
 Interoperable with other local health information
 infrastructures and the National Health Information
 Infrastructure.
 No rip and replace – leveraging existing systems
 Integrates into physician workflow
                                                   4
Levels of Participation
 Portal access – web browser access to display
 patient information
 Practice management system – medical
 summary prints out automatically when patients
 arrive
 EHR integration – One or two-way integration
 with existing information systems to display patient
 information within those systems and supply data to
 the SAFE Health network.
 Clinical information supplier– Ancillary systems
 or health plans that feed patient data to SAFE
 Health network.                                     5
Architecture




               6
Electronic Health Record Portal




                                  7
Development Status
 Developed:
   Federated distributed MPI with probabilistic matching
   Clinical messaging with HL7 and Web services
   User Authentication
   Audit trails and transaction logging
 In Progress:
   Support industry standards HL7 CDA, CCR, etc…
   Clinical data repository for local organizations
   Web portal
   Smart data routing to minimize network traffic
   Data subscription/publication                           8
Some Design Issues
 Patient matching
 Data standards
 Patient Opt-out
 Audit trails
 HIPAA vs. State regulations
 Interstate issues



                               9
Timeline
 Proof of concept – completed
 Alpha pilot with Technophiles– Fall 2005
  Textual notes
  Billing diagnoses
  Medication History
 Beta pilot – Winter 2006
  Limited # of diverse MD’s
 Live – Summer 2006
 Expand to Allergies, Radiology, Labs, etc…
                                              10
Q&A
For more information, please visit:
 http://www.safehealth.org
Contact info:
 Fallon Clinic
 630 Plantation Street
 Worcester, MA 01605
 (508) 852-0600
 Lawrence.Garber@Fallon-Clinic.com
 Peggy.Preusse@Fallon-Clinic.com
                                      11

				
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