Appendix LI nterfaces by hMWX4B78

VIEWS: 33 PAGES: 15

									                                                 EHR Current State




Electronic Health Record (EHR) covers a longitudinal health record that provides
clinicians access to clinical details captured from one or more encounters. It covers a wide scope of
Department of Health Services (DHS) business functions and interacts with a wide variety of health
applications. A patient centric health index (e.g., Medical Record Number (MRN)) is assigned to each
patient and used to associate with any electronic information communication about the patient.

In LA DHS, EHR data is captured and stored in five (5) types of clinical applications.

1. Patient Administration and Management Systems are populated from
   patient encounters and provide a directory of the following info:

 a) Patient demographics
 b) Patient access and utilization

2. Diagnostic & Treatment systems are populated from pharmacy, lab and
   radiology applications and provide a directory of the following info:

 a) Patient medications ordered/prescribed, administered and refilled.
 b) Lab order and results that are related to Clinical Lab, Pathology, Blood Bank,
    or any specialty lab
 c) Radiology order and results that are related to general and specialty imaging

3. Specialty Care Systems are populated from healthcare systems that are
   designed for specialty areas. Such as:

 a) OR - Operating Room
 b) ICU - Intenstive Care Unit
 c) ED - Emergency Department
 d) OB - Obstetrics
 e) Anesthesia
 f) Cardiology


4. Medical Devices & Other Systems are populated from clinical databases
  stored in medical devices (e.g., Pyxis non-profile). For some facilities, the clinical
  information stored in the medical devices may not have bi-directional interface
  to the e-gate engine.

5. Clinical Content Systems are populated from all of the above systems,
   Patient Charting Systems and Transcription Systems.

6. Other Project Delivery (PDD) Existing /Future Projects
                                             DHS Clinical Application Interfaces by Network Clusters
                                                      Patient Administration and Management Systems


                                                             System Interfaces                                            Network Clusters
     Patient Adinistration &
          Management                    Interfaced                                                    Harbor- OliveView                           MLK     HD
                                                             Direction        Interface Message                            LACUSC       Rancho
                                        Application                                                   UCLA      UCLA                             (MACC) (MACC)

Affinity Patient Scheduling          None              N/A                HL7 - Scheduling              X        X            X           X        X      X
                                     All clinical
Affinity Patient Registration                          Outbound           HL7 - ADT                     X        X            X           X        X      X
                                     systems
QuadraMed Affinity Patient
Accounting
Patient Utilization - InterQual                                                                        Due
                                     Affinity          Inbound            HL7 - ADT                                           X           X
(CERMe McKesson)                                                                                      7-1-11
iMedConsent (Facilities access via
                                                                                                        X        X        In Progress     X        X      X
Web only)

iMedConsent (Application loaded on
                                   Affinity            Inbound            HL7 - ADT                                           X
server at LAC with ADT interface)


RPS - Physician Referral             Affinity          Inbound            Physician referral within     X        X            X                    X      X
                                                                          and out of DHS network




                                                                                 page 2 of 15
                                                            DHS Clinical Application Interfaces by Network Clusters
                                                                                    Diagnostic Treatment Systems

                                                       System Interfaces                                                         Network Clusters
    Diagnostic &
                             Interfaced                                                                    Harbor-     OliveView                       MLK       HD
 Treatment Systems                               Direction                  Interface Message                                    LACUSC      Rancho
                             Application                                                                    UCLA         UCLA                         (MACC)   (MACC)

                       Affity HIS          Inbound            HL7 Patient demographics provider, ADT          X           X
                       Affinity HIS        Outbound           Formulary MFN                                   X           X
                       Affinity HIS        Outbound           Charge Master MFN                               X           X
                       Affinity HIS        Inbound            HL7 Physician Master MFN                        X
                                                              Pharmacy orders, dispensing data
                       Affinity HIS        Bi-directional                                                     X           X
                                                              (ORU/RSLT)
I/P Pharmacy - Affinty Affinity HIS        unidirectional     RDF                                             X
                                                              Pharmacy orders, dispensing data
                       Pyxis Medstation    Bi-directional                                                     X           X
                                                              (ORU/RSLT)
                       Pyxis Connect       Inbound            HL7 Physician Orders                            X           X

                       Pharmacy Onesource Outbound            HL7 - ADT                                                   X

                     Lab                   Inbound            Lab result (RSLT)                               X           X
                     Affity HIS            Inbound            HL7 Patient demographics provider, ADT          X                    X           X
                     Pyxis Medstation      Outbound           Pharmacy orders, dispensing data                                     X           X
I/P Pharmacy - PSCAS Pyxis Connect         Inbound            HL7 Physician Orders (scanned image)                                 X           X

                       Pharmacy Onesource Outbound            HL7 - ADT                                                            X           X

                       Affinity HIS        Inbound            HL7 Patient demographics provider, ADT          X                    X           X        X        X
                       Per-Se              Outbound           NCPDP (claims -CHP/ADAP)                        X           X        X           X        X        X
   O/P & MACC          P2000               Outbound           Pharmacy orders, dispensing data             LB only                 X           X        X
 Pharmacy - PSCAS      Pyxis Medstation    Outbound           Pharmacy orders, dispensing data             Not Avail      X        X           X        X        X

                       Pharmacy Onesource Outbound            HL7 - ADT                                                   X        X           X        X        X

                       IVR refill          Bi-directional     Proprietary - Phone Refills                     X           X        X           X        X        X
    O/P & MACC
  Pharmacy - Visual
                       DAA                 Outbound           NCPDP (claims-Medicare Part D)                                                   X        X
    SuperScript

                       Affinity HIS        Inbound            HL7 - ADT                                       X           X        X           X        X        X
                       Affinity HIS        Inbound            HL7 Physician Information                       X           X        X           X        X        X
                       Affinity HIS        Bi-directional     HL7 Orders                                      X           X        X           X        X        X


                       Affinity HIS        Outbound           HL7 Results                                     X           X        X           X        X        X


                     Blood Bank
                                           Bi-directional     HL7 ADT, Orders, Results, Phys                              X                             X
                     (Sunquest)
Sunquest Lab (Mysis)
                     Lifeline              Bi-directional     HL7 ADT, Orders, Results, Phys                                       X
  ELIS System:       Hemocare (System                         HL7 ADT, Orders, Results, Phys (System has
                                           N/A                                                                                     X
 HDHS - LAC+USC has been sunset)                              been sunset)
  MLK - RLANRC       HCLL (Mediware)       Bi-directional     HL7 ADT, Orders, Results, Phys                  X                In Progress
                     CoPath                Bi-directional     HL7 ADT, Orders, Results, Phys                              X         X          X        X
   Stand Alone
    Systems:
  HUMC - OVMC
                                                                                                   page 3 of 15
                                                                   DHS Clinical Application Interfaces by Network Clusters
                                                                                           Diagnostic Treatment Systems
 Sunquest Lab (Mysis)
                                                             System Interfaces                                                              Network Clusters
   ELIS System:
    Diagnostic &
  HDHS - LAC+USC                Interfaced                                                                             Harbor-    OliveView                       MLK         HD
 Treatment Systems                                    Direction                   Interface Message                                         LACUSC      Rancho
   MLK - RLANRC                 Application                                                                             UCLA        UCLA                         (MACC)     (MACC)

     Stand Alone           Telcor POCT            Bi-directional     HL7 ADT, Orders, Results, Phys                                  X        X           X         X         X
      Systems:             Apollo PathPACS        Bi-directional     HL7, ADT, Orders, Results, Phys                                 X
    HUMC - OVMC            Quest Diagnostic       Bi-directional     HL7, Orders, Results                                 X          X        X           X         X         X
                           Focus Diagnostics      Bi-directional     HL7, Orders, Results                                 X          X        X           X         X         X
                           Public Health Labs     Bi-directional     HL7, Orders, Results                                 X          X        X           X         X         X
                           Public Health Labs     Outbound           HL7 Reportable Results                               X          X        X           X         X         X
 I/P Pharmacy - Affinty
                           ForwardAdvantage                          Formatted results. Part of Sunquest
                                                      Outbound                                                                                X           X         X         X
                           faxing from Sunquest                      functionality.

                           Lane faxing from                          Formatted results. Part of Sunquest
                                                      Outbound                                                                       X
                           Sunquest                                  functionality. Sunquest current product.
                           Eclipsis (Emtek)       Bi-directional     HL7, Orders, Results, Query                                              X


FUJI Radiology                                         Inbound
                                                                                   ADT, ORM, ORU                                              X
Information System (RIS)                              Outbound

Philips iSite Clinical
Webviewer (for                   Affinity HIS          Inbound                     ADT, ORM, ORU                          X          X    In Progress
Cardiology)
Philips Xcelera Echo --                                Inbound
                                 Affinity HIS                                      ADT, ORM, ORU                          X          X        X
Cardiology System                                     Outbound
MUSE Cardiology                                                                  Only DICOM images                        X                   ?
                           Affinity HIS           Inbound            HL7 ADT, Cath lab order (ORM/ORD)                    X                   X
WITT Cath lab
                           Affinity HIS           Outbound           Cath lab Results (ORU/RSLT)                          X                   X
                                                                     HL7 ADT, Hemodynamic monitoring order
                           Affinity HIS           Inbound                                                                                     X
WITT Biomedical                                                      (ORM)
                   Affinity HIS                   Outbound           Hemodynamic Clinical Result (ORU/RSLT)                                   X
                   Affinity HIS                   Inbound            HL7 ADT, Vascular Order (ORM)                                            X
Vascular Lab
                   Affinity HIS                   Outbound           Vascular Result (ORU/RSLT)                                               X
                   Affinity HIS                   Inbound            HL7 ADT, Mammography order (ORM)                                         X
Penrad Mammography
                   Affinity HIS                   Outbound           Mammography Results (ORU)                                                X
MRS (Mammography) Affinity HIS                    Bi-directional     Mammography Results (ORU), ADT, ORM)                            X        X
Magview                                                                                                                                                             In
Mammography        Affinity HIS                   Bi-directional
                                                                                                                                                                 Progress
Interface
Echo lab (Phillips Affinity HIS                   Inbound            HL7 ADT, Echo Cardiogram order (ORM/ORD)             X          X        X
Xcelera)           Affinity HIS                   Outbound           Echo Cardiogram Result (ORU/RSLT)                    X          X        X

Fuji PACS (Radiology)      Affinity HIS           Inbound            HL7 Patient Demographics updates, ADT                X          X        X           X         X         X

                           Affinity HIS           Inbound            HL7 Radiology Orders, ORM                           X           X        X           X         X         X
                           Affinity HIS           Inbound            HL7 Radiology Results, ORU                          X           X        X           X         X         X
                           Affinity HIS           Outbound           Radiology Orders Complete, ORM                      X           X        X           X         X         X
                           Affinity HIS           Bi-directional     HL7, Orders, Results                              *Partial      X                    X                   X




                                                                                                                page 4 of 15
                                                              DHS Clinical Application Interfaces by Network Clusters
                                                                                       Diagnostic Treatment Systems

                                                        System Interfaces                                                            Network Clusters
    Diagnostic &
                               Interfaced                                                                        Harbor-   OliveView                     MLK       HD
 Treatment Systems                               Direction                    Interface Message                                      LACUSC   Rancho
                               Application                                                                        UCLA       UCLA                       (MACC)   (MACC)

MRI -- InSight            Affinity HIS       Inbound            ADT, ORM, ORU                                       X         X        X         X        X        X
                          Affinity HIS       Inbound            HL7 ADT, ORD                                        X         X        X
Philips
Electrocardiogram --
                          Affinity HIS                          RSLT (API)
TraceMaster.
                                             Outbound                                                               X         X        X
 I/P Pharmacy - Affinty
Varian - Radiation
                          Affinity HIS       Inbound            HL7 ADT                                                                X
Oncology




GE CPN OB/GYN             Affinity HIS       Inbound            HL7 ADT                                                                X




GE CPN OB/GYN
                          Affinity HIS       Outbound           HL7 MDM                                                                X
Centricity Perinatal



GE CPA Anesthesia
                          Affinity HIS       Inbound            HL7 ADT and SIU                                                        X
System



nSpirehealth -
                          Affinity HIS       Bi-directional     HL7 ADT, ORM and ORU                                                   X
Pulmonary PFT Test




Eclipsys CCU System       Affinity HIS       Inbound            HL7 ADT                                                                X


MDSINFO, NISS
                          Affinity HIS       Inbound            HL7 ADT, ORM and ORU                                                   X
Neonatal ICU System
                          Affinity HIS       Inbound            HL7 ADT, ORD/ORM                                    X                  X
Olympus Endoscopy
                          Affinity HIS                          RSLT/ORU
                                             Outbound                                                               X         X        X
Verilink - Provider
Advantage Medi-Cal        Affinity HIS                          Non HL7 - Affinity point-to-point interface
Eligibility
                                                                                                                              X
Medication                Enterprise Data                       XML
                                             Outbound                                                              ??         X        X                  X        X
Reconcilliation.          Repository                            http call for meds dispending orders




                                                                                                          page 5 of 15
                                                              DHS Clinical Application Interfaces by Network Clusters
                                                                                        Diagnostic Treatment Systems

                                                            System Interfaces                                                     Network Clusters
    Diagnostic &
                               Interfaced                                                                     Harbor-   OliveView                      MLK        HD
 Treatment Systems                               Direction                      Interface Message                                 LACUSC    Rancho
                               Application                                                                     UCLA       UCLA                        (MACC)    (MACC)

Affinity Patient Charting                    (internal to
                          Affinity HIS                             Patient Charting & Nursing Orders             X         X        X         X         X         X
& Nursing Orders                             Affinity)

                        Enterprise Data                            XML planned.
  Automated Decision                         Inbound
                        Repository                                 HL7 Interface pending
      Support and                                                                                              Pilot      Pilot   planned   planned   planned   planned
                        Affinity HIS         Inbound               ADT, ORM, ORU planned.
 Documentation Tools
 I/P Pharmacy - Affinty Affinity HIS         Bi-Directional        Planned.




                                                                                                       page 6 of 15
DHS Clinical Application Interfaces by Network Clusters
              Diagnostic Treatment Systems




                        page 7 of 15
DHS Clinical Application Interfaces by Network Clusters
              Diagnostic Treatment Systems




                        page 8 of 15
DHS Clinical Application Interfaces by Network Clusters
              Diagnostic Treatment Systems




                        page 9 of 15
DHS Clinical Application Interfaces by Network Clusters
              Diagnostic Treatment Systems




                       page 10 of 15
                                                                                                   DHS Clinical Application Interfaces by Network Clusters
                                                                                                                                        Specialty Care Systems


                                                                        System Interfaces                                                                  Network Clusters
     Specialty Care Systems
                                                                                                                                 Harbor-    OliveView                             MLK           HD
                                   Interfaced Application             Direction                    Interface Message                                       LACUSC      Rancho
                                                                                                                                  UCLA        UCLA                               (MACC)       (MACC)


                                   Affinity HIS/ORSOS       Outbound                   HL7, ADT, MFN                                X           X             X           X         X



Mckesson - ORSOS (Surg Sched)                                                          HL7 DFT (Case Mix and Revenue            X    Rev
                                   ORSOS/Affinity           Inbound                                                                             X             X           X     In progress
                                                                                       Maximizer                                Mgmt Only


                                   ORSOS/Pharmacy           Inbound                    Batch FTP (text)                                                       X



Mckesson - Ansos/OneStaff (Nurse
                                                                                              Batch processing 3/day                X           X             X           X         X           X
Sched)




                                   Affinity HIS             Inbound                    HL7 - ADT                                 Planned     Planned          X


    Wellsoft - Emergency Care
                                   Affinity HIS             Outbound                   HL7 - ADT, ORM. ORU, MDM                  Planned     Planned          X


                                   Affinity HIS             Inbound                    HL7 - MDM                                 Planned     Planned          X



Varian - Radiation Oncology        Affinity HIS             Inbound                    HL7 - ADT                                                              X



GE Centricity Obstetrics           Affinity HIS             Inbound                    HL7 - ADT
                                                                                                                                                              X

                                   Affinity HIS             Inbound                    HL7 ADT, ORM                                                           X
GE Muse (Cardiology)
                                   Affinity HIS             Outbound                   Cardiology result (ORU)                                                X


Sandman Pulmonary PFT                                       Outbound                   ORU, ORM                                                               X



MDS System NICU                    Affinity HIS             Inbound                    ADT, ORM, ORU                                                          X




Eclipsys ICU
                                   Affinity HIS             Inbound                    HL7 - ADT                                                              X
Critical Care



                                   Affinity HIS             Inbound                    HL7 - ADT                                                              X
Anesthesia (GE Centricity)
                                   ORSOS                    Inbound                    HL7 - SIU                                                              X


RTIS.net (Rancho Therapy
                                   Affinity HIS             Inbound                    SQL Connect to Patient Scheduling                                                  X
Information System) Homegrown



                                                                                       PDF, XML
                                   Enterprise Data                                     http call for Encounter Summary Sheet,
                                                            Inbound
                                   Repository                                          remote procedure call for MLK patient
                                                                                       demographics
 Advanced Triage and Emergency
                                                                                                                                                X                                   X
 Medicine Management (ATEMM)




                                                                                                                                                    page 11 of 15
                                                                              DHS Clinical Application Interfaces by Network Clusters
                                                                                                                Specialty Care Systems
 Advanced Triage and Emergency
                                                                                                                     X                       X
 Medicine Management (ATEMM)
                                                                    Currently through SQLConnect.
                                 Affinity HIS      Inbound
                                                                    ADT, ORM, ORU in progress


                                 Affinity HIS      Bi-Directional   Planned for Physician Orders.

                                 Enterprise Data                    PDF, XML
                                                   Inbound
                                 Repository                         http call for Encounter Summary Sheet
  Disease Management Registry
                                                                    Currently through SQLConnect.           X        X             X     X   X   X
            (DMR)                Affinity HIS      Inbound
                                                                    ADT, ORM, ORU in progress
                                 Affinity HIS      Bi-Directional   Planned

Planned Systems
TLC Discharge planner            Affinity HIS      outbound         ADT                                              X             X     X




                                                                                                                         page 12 of 15
                                                                                            DHS Clinical Application Interfaces by Network Clusters
                                                                                                        Medical Device Other Systems


                                                                        System Interfaces                                                           Network Clusters
  Medical Devices and Other Systems
                                                                                                                         Harbor-     OliveView                              MLK       HD
                                       Interfaced Application         Direction                Interface Message                                    LACUSC       Rancho
                                                                                                                          UCLA         UCLA                                (MACC)   (MACC)

                                                                                                                           X
Pharmacy - Pyxis Medstation           PSCAS, Affinity Pharmacy   Bi-directional     Med order and dispensing             Only IP         X             X               X     X        X
                                                                                                                         Pharm]

Pharmacy - Pyxis Connect              PSCAS, Affinity Pharmacy   Outbound           Physician medication order (image)      X            X             X               X

Pharmacy - Pyxis Anesthesia           ORSOS                      Inbound            OR schedules                                                       X

Pharmacy C2Safe                       PSCAS, Affinity Pharmacy   Bi-directional     Narcardic order and dispensing          X            X             X               X

Pharmacy - P2000                      PSCAS                      Bi-directional     Med order and dispensing             LB only                       X               X     X


IVR refill                            PSCAS                      Bi-directional     Med outpatient refill                 TBD            X             X               X     X


PHILIPS Patient Monitoring System                                                                                           X            X             X



NICU Fetal Monitoring                                                                                                               planned 08/11      X




                                                                                                                                page 13 of 15
                                                                                                               DHS Clinical Application Interfaces by Network Clusters
                                                                                                                                                  Clinical Content Systems


                                                                              System Interfaces                                                                        Network Clusters
            Clinical Content
                                                   Interfaced                                                                           Harbor-   Olive View                                MLK            HD
                                                                       Direction                    Interface Message                                              LACUSC       Rancho
                                                   Application                                                                           UCLA       UCLA                                   (MACC)        (MACC)

                                                                                       PDF (Scanned Paper of Health Records),
Quantim Clinical Documentation/EDM           Various Systems     Inbound                                                                   X      In Progress         X           X       In Progress   In Progress
                                                                                       XML



Quantim Applications and Modules             Affinity HIS        Inbound               HL7-ADT, MFN                                        X          X               X           X           X         In Progress


                                             e-Gate/                                                                                       X
                                                                 Inbound               HL7 - ADT, order (ORM)                                         X               X                       X
Medquist Transcription                       Affinity HIS                                                                               No ORM
                                             e-Gate/                                   HL7 - Result (ORU) and
                                                                 Outbound                                                                  X          X               X                       X
                                             Affinity HIS                              Transcription (MDM)

Medquist Transcription -- Radiology          e-Gate/
                                                                                                                                        Planned    Planned          Planned     Planned    Planned       Planned
Speech Recognition                           Affinity HIS


                                             e-Gate/
                                                                 Inbound               HL7 - ADT                                                                      X
RapidText Transcriptions & Captioning        Affinity HIS
(System will be sunset)
                                             e-Gate/
                                                                 Outbound              HL7 - Transcription (MDM)                                                      X           X
                                             Affinity HIS

Lanier Cquence (digital dictation solution
                                                                                                                                                                      X
for electronic trans of voice documents)




Inpatient Clinical Pathways                  Affinity            Inbound               Currently through Affinity query to CentralPro      X          X               X           X




                                             Encounter Summary                         PDF, XML
                                                                 Inbound
                                             Sheet (ESS)                               http call for Encounter Summary Sheet



                                                                                       Currently through SQLConnect.
                                             Affinity HIS        Inbound
                                                                                       ADT, ORM, ORU in progress

       Enterprise Data Repository                                                                                                          X          X               X           X           X             X


                                             PPP - PMS - i2i     Webservice            HELA. Planned.




                                             OMC - PMS           Bi-Directional        HWLA. Planned. 270/271


                                                                                                                                                                      X                       X
Teletracking Bed Management

                                                                                                                                                                      X
HillROM Bed System (bed locating device)
                                                                                                                                          X
                                                                                                                                        XML and
                                                                                                                                                      X                                       X             X
CARDIFF -- IDC (Outpatient Encounter                                                                                                    PDF to
Form)                                        Affinity            Outbound                                                               Quantim




                                                                                                                                                                page 14 of 15
                                                                        System Interfaces                                         Network Clusters

                    Other Systems                         Interfaced                         Interface     Harbor-   Olive View                         MLK        HD
                                                                         Direction                          UCLA       UCLA
                                                                                                                                  LACUSC     Rancho
                                                                                                                                                       (MACC)    (MACC)
                                                          Application                        Message
                                                                                            HL7, Orders,
PEMRS (Probation, Sheriff, DHS, and DMH)                   Sunquest     Bidirectional                                               X
                                                                                              Results
3M Financial Coding (for DHS facilities). LAC+USC will
implement Coding and Compliance by 12/2011 resulting in                                                                             X
3M being sunset
                                                                                                           I/F via
CERMe (software license renewal)                                                                           MIDAS
CERME TAR                                                   Affinity                           ADT                                  X
RightFax & Maintenance and Support, Central Pharm., and
                                                                                                             X           X          X           X        X         X
JCHS Pharm.
E-mHUB -- Interface inbound/outbound to DCFS                                                                 X           X          X          N/A       X         X
FrameWork LTC (Probation)
Enterprise Data Repository                                  Affinity    unidirectional        adt, adq       X           X          X           X        X         X
FUTURE SYSTEMS
EMPI                                                                                                       Planned    Planned     Planned    Planned   Planned   Planned
Infection Control System (ICS)                                                                             Planned    Planned     Planned    Planned   Planned   Planned

								
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