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					Interfaces
Quoting/Order Process & Product Info
Conference Line 877-388-9625; Entry Code 388842




Sean Delaney
VAR Program Manager
May, 2010
Agenda

 Interface Definition and HL7
 Types of interfaces
 What is a Standard Spec Document?
 How does McKesson price interfaces?
 How do I order an interface?
 How to be an “Interface Detective”
 Device integration
What is an interface?

 An HL7 interface engine is an interface or integration
  engine built specifically for the healthcare industry. It
  connects legacy systems by using a standard messaging
  protocol.
 Because hospitals and other healthcare providers
  usually have different systems for different aspects of
  services, they are often unable to communicate with
  each other. HL7 gets around that problem by providing
  the framework for the exchange, integration, sharing and
  retrieval of electronic health information. These
  standards and the most commonly used throughout the
  world.
What is HL7?

 Health Level Seven (HL7), is an all-volunteer, non-profit
  organization involved in development of international
  founded in 1987 to produce a standard for hospital
  information systems. HL7, Inc. is a standards
  organization that was accredited in 1994 by the
  American National Standards Institute (ANSI) healthcare
  standards.
 HL7 and its members provide a framework (and related
  standards) for the exchange, integration, sharing, and
  retrieval of electronic health information. v2.x of the
  standards, which support clinical practice and the
  management, delivery, and evaluation of health services,
  are the most commonly used in the world.
[Source: Wikipedia]
Interface Direction
Always in relation to EMR (PP patient records)




  Inbound                                   Outbound
  HL7 Data                EM                HL7 Data
                            R
Types of interfaces
Lab Results - generated from an LIS system


 Inbound Lab Results (~$3,500)
   ─   Discrete, Quantitative information (i.e. numbers or
       positive / negative values etc.) that have patient
       identifiers built into results.
   Examples:
        • Urinalysis
        • Cholesterol Results
             Satisfies No. 10 on MU criteria “Incorporate clinical lab-test results into
              EHR as structured data”
Types of interfaces
Text Results

 Text Results (~$3,500)
  ─   Textual reports of Lab results and/or patient
      information that have patient identifiers built into
      results.
  Examples:
       • Pathology reports
            Skin tab pathology report
       • Hospital Discharge Summaries
            OB Discharge Summary
Types of interfaces
X-Ray or imaging results – generated from an RIS system


 Imaging or Radiology reports (~$3,500 - $5,000)
   ─   Textual X ray Reports
        Example:
             Broken Ankle imaging report
   *Usually identical as “Text Results” lab configuration


 Imaging or Radiology Images (less common)
   ─   EMR Can not support DiCom Images in their original format
   ─   Images must be converted to a supported file (i.e. .BMP, .GIF,
       .JPEG)
Types of interfaces
Demographics Bridge


 Demographics Bridge (~$3,500)
   ─   A one way, outbound, interface that transfers new and/or updated
       patient demographics from Practice Partner into a 3rd party system.
       This is an HL7 interface.
 Standard (GA’d) Demographics Bridges
   ─   Quest 360 Bridge (~$1,250)
       This interface provides demographic information from Practice Partner
       Patient Records/Appointment Scheduler (Version 7.5+) or Medical
       Billing Windows to Quest Care360 laboratory ordering modules.
   ─   LabCorp Bridge (~$1,250)
       This interface provides demographic and insurance information from
       Practice Partner Patient Records and Medical Billing (Version 8.1.1+) to
       the Labcorp web based order management system.
Types of interfaces
Outbound Lab Orders Interface


 Outbound Lab Orders interface (~$5,500)
   ─   Outbound HL7 interface from Practice Partner Lab
       Order Entry system (CPOE) to 3rd party or in-house
       LIS system. *(It sends the lab orders directly to Labcorp)*
        • Difficult to Implement
        • Very Few GA’s interfaces
        • Eliminates the need for Demographics Bridge
        • Must be used with EMR Order Entry (CPOE) module
        • Totally awesome.
Types of interfaces
Outbound Clinical Repository


 Immunization Registry Interface (~$2,000)
   ─   Outbound immunization registry from Practice Partner EMR to State-run
       immunization programs
   ─   Huge benefit for Pediatricians
        • New York
        • Washington state
        • Georgia
        • Florida
 Other Clinical Repository Interfaces are available
  through a custom quote (~$10,000)
Commonly Asked…
General Availability (GA’d) Interfaces: HL-7 Lab

    Inbound Results          Outbound Orders          Demographics
  (to Practice Partner)   (from Practice Partner)        Bridge


•Dyna-Care             •Labcorp Orders              •Labcorp
•Fletcher Flora                                     Demographics
•Labone                •Labdaq Orders               Bridge
•LabCorp
•LabDaq                •Labpak Orders               •Quest
•Memphis Pathology                                  Demographics
•American Esoteric Labs                             Bridge
•OML
•PAML
•Quest
•Tricore
•Unilab


                                                                     12
Standard Spec Documents
From McKesson Services


 The Standard Spec Document is a word
  document specifying our HL7 segments and
  requirements for specific interfaces.
      *Required and used with McKesson Services for
                   Non-GA’d interfaces.*
  ─   Eliminates “Scoping call”
  ─   Eliminates Questions of compatibility.
  ─   Puts Interface responsibility on practice / physician.
  ─   Eliminates “Can you interface with my *BLANK* ?” question.
Standard Documents
        Outbound Billing
      INT-CHG-OUT-RT-3P     Inbound Lab or Rad Text
                               INT-TXT-IN-RT-3P
         Inbound Demo
       INT-DEM-IN-NA-PP
                              Inbound Scheduling
                              INT-SCH-IN-RT-PP
        Outbound Demo
      INT-DEM-OUT-RT-3P
                             Inbound Transcription
         Outbound Orders       INT-TXT-IN-RT-3P
      INT-LAB-OUT-RT-XRAY




                                                      14
Interface Pricing Example
3 Elements on a price quote when using McKesson Services
(Including Interface implementation Shadowing)

 1st Element
    ─     Item: McKesson Implementation Services
    ─     Example: Standard Results (Lab/Rad/Text)
     ─    Cost: $2,088
   2nd   Element
    ─     Item: Software (Also known as PP Connect)
    ─     Example: Standard Results (Lab/Rad/Text)
     ─    Cost: $1,400
   3rd   Element
    ─     Item: Annual Maintenance
    ─     Example: Standard Results (Lab/Rad/Text)
    ─     Price: $210
                                                      ─   Total: $3,698
    Interface Pricing Example
    2 Elements on a price quote WITHOUT using McKesson
    Services
 1st Element
     ─    Item: McKesson Implementation Services
     ─    Example: Standard Results (Lab/Rad/Text)
     ─    Cost: $2,088
   2nd   Element
     ─    Item: Software (Also known as PP Connect)
     ─    Example: Standard Results (Lab/Rad/Text)
     ─    Cost: $1,400
   3rd   Element
     ─    Item: Annual Maintenance
     ─    Example: (Lab/Rad/Text)
     ─    Price: $210
                                                      ─ Total:   $1,610
Interface Quoting Process
Without Using McKesson Services
Interface Quoting Process
Using McKesson Services




                            18
Interface Detective!
Process Map for interface sleuthing
Types of interfaces
3rd Party Practice Management System interfaces


 Can be done with Practice Partner EMR (Patient records) Only
    ─   Must be Full Service Total Practice Partner dealer
 Necessary Interfaces / Bridges
    ─   Demographics Inbound interface (~$3,500)
         • Sends patient Information from PM to EMR
    ─   Scheduling Inbound (~$3,500)
         • Sends daily Scheduling from PM to EMR
    ─   Billing codes outbound (~$3,500)
         • Sends Billing Codes from EMR to PM
*All Prices Contingent upon receipt of McK standard Spec Documents for each *
 Total is $10,500+ from McKesson alone
 McKesson PM system priced $2,000 – $5,000.
Commonly Asked…
Available Interfaces – 3rd Party Devices
         Welch Allyn                MidMark


                ECG

       Vital Spot Device 420
               & 520
   *NOTE:
   Vitals                          Glucometer
   • Spot version 2.18-102
   • VSM2 versions 5-16 and 5-17
   • CVSM version 3.11
   ECG
   CardioPerfect Suite version
   1.2.3 w PP 9.3.x




                                                21
“Can you interface with my *BLANK* ?

Answer:
     “Sure – Just have your *BLANK* sign this document and we can
   interface with them for the retail pricing provided they can sign this
   document with no scoping call.
     If you can not sign this document without speaking with one of
   my interface analysts, then I can not guarantee we can implement
   this interface in a reasonable amount of time and with in the
   confines of our retail pricing.”
Can you interface with my *BLANK* Device?
Device Integration

 Answer:
  ─   Not really.
  ─   Why?
       • Expensive
       • Time consuming (long, wait list)
       • High risk
  ─   Who can?
       • Ellkay inc.
             Michael Fishweicher, VP Business Development
             Ellkay.com
             tel. 1.201.791.0606
             MichaelF@ellkay.com
 Relay Health and Practice Partner
 Connectivity
Results Distribution Services (RDS):
Results delivery include external labs,
hospital lab, pathology and radiology
results and transcription reports.


Demographics: Patient demographic
information includes patient name,
address, age, sex, phone, marital
status, SSN, PP site identifier and
email address (if included).


Patient Online Indicator: ADT message
from RH to PP representing that the
patient has enrolled to use the Patient
Portal. This indicator is stored in
patient’s medical record.




                              Proprietary & Confidential/ For Internal Use Only   24
Where can I find Information?

 The greatest place on earth
http://www.medisoft.com/download/training/project
  process/EHRImplementationFlow.pdf
Next Session!
Every Tuesday & Thursday barring Natural Disaster, Travel and/or my wife


    Specialties with the Practice Partner EMR
   Tuesday, May 25th & Thursday, May 27th
       ─ Where to concentrate time and Why?
            “What do I ask with an Ophthalmologist interested in my system?”
            “What is an Ambulatory Surgery Center (ASC) and do we fit?”
            “What features is a Pediatric group interested in?”
            And More!!!!!
    Template Creation in our EMR
   Tuesday June 1st & Thursday June 3rd.
        ─ Dot Codes, insert Codes and Letter Codes
        ─ Tips and tricks
    Coming soon –
      ─ Health information Exchanges (H.I.E’s) !
      ─ Competition!
      ─ Competing with hospital employed groups!
Questions?

				
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posted:9/20/2012
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