Interlinked Registries A proposed project leading to a balloted IHE profile for Interlinked Registries (ILR) based on the HL7/OMG Human Services Directory (HSD) specification

Project overview  A new IHE profile for Interlinked Registries (ILR) will be developed, balloted and tested  The co-sponsors of the work item are HI-PPP (PEPFAR) and Canada Health Infoway  The work item will be generally based on the HL7/OMG Human Services Directory (HSD) specification  Both co-sponsors plan to support project teams at the 2014 Connectathon to demonstrate interoperability with each other and with other participants 2

Overview of this Presentation  Who needs this profile?  Developed country user stories  Developing country user story  Who is supporting this work?  Canada Health Infoway  Health Informatics Public-Private Partnership (HI-PPP, funded by PEPFAR)  What “underpins” the work item?  HL7/OMG HSD service functional model  Infoway “Interdependent Registries” discussion paper  What is the Plan? 3

User Story 1  David Lambert sees his family physician, Dr. Black, regarding a recent knee injury.  Dr. Black diagnoses the problem as a torn ACL and decides to refer David to an orthopedic surgeon.  Dr. Black uses his EMR to search for orthopedic surgeons; a list is returned sorted by available consult timeslot (soonest to latest) and by location (closest to farthest).  After discussing the options with David, Dr. Black chooses Dr. Bone from the list and a “pending referral” is automatically created.  David returns home. Later that day, Dr. Bone’s office reviews the pending referral and accepts it. A “scheduled referral” message is communicated to Dr. Black and to David. 4

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User Story 2  Alicia is a female veteran in Baltimore who has returned from her 2 nd tour in Afghanistan; she is being discharged from active service into civilian life  Alicia’s medical records and care continuity is transferred from DoD to VHA  VHA wishes to establish primary care for Alicia at a VA Care Center supporting the VA’s female veteran primary care model  The VHA care coordinator queries for VA facilities in the Baltimore area which have embraced the model and refers Alicia to a female primary care physician, Dr. Veteran, at the “model” facility closest to where Alicia lives 6

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User Story 3  Mosa is a young pregnant woman; she is being seen by a community health worker, Grace, who is conducting Mosa’s 2 nd antenatal care (ANC) visit.  Grace records ANC observations using SMS on her mobile phone.  Mosa’s blood pressure reading is high; she should be referred to see a clinician.  The cloud-based mHealth application queries an interlinked registries service to determine the closest facility (geo-coded Facility Registry) offering maternal care services (Resource Registry) within a specific timeframe (Provider Registry / Facility Registry calendar).  An SMS reply from the mHealth service indicates to Grace that maternal clinics operate on Tuesdays and Thursdays at the health facility closest to Mosa’s village.  Grace prepares a referral note for Mosa. Mosa is automatically added to the patient queue for the next maternal clinic at the facility. 8

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Who is supporting this work?  Canada Health Infoway  SMEs  Standards Collaborative Jurisdictional partners IHE Canada  HI-PPP funded by PEPFAR  Regenstrief Institute InSTEDD Mohawk College DHIS Project – University of Olso Jembi (South African NGO) Columbia University – Earth Institute  Rwanda Ministry of Health – RHEA Project 10

What “underpins” the work item?  HL7/OMG Health Services Directory (HSD) Functional Specification  Detailed use cases and service functional spec  Data dictionary  Infoway Interdependent Registries Discussion Paper  Addresses challenges faced by jurisdictional implementations  Cornerstone of next iteration of Canada’s EHRS blueprint 11

What are the strategic implications?  Aligned with IHE strategy…  Provider & Patient ID  Workflow Enablers  Aligned with IHE’s international evolution  “IHE Africa”  Specification of IHE in national norms & standards 12

Standards  HL7/OMG HSD service functional model – Location Registry – Provider Registry – Organization Registry – Resource Registry – Provider | Organization – Provider | Location – Organization | Location – Resource | Location – Provider calendar – Resource calendar – Organization calendar  HPD profile  HL7 v2/v3 messaging; SOAP; BPEL; hData; json; REST 13

What is the Plan?  Facility Registries Extension & Development project (FRED)  PEPFAR funded; Rwanda and Tanzania are current “customers”  Team is in place and work is underway  Evolve scope to include support for referral workflows  Align FRED work with Infoway’s e-Health Blueprint  Embrace standards  Leverage IHE profiles; IHE community  Develop work product as IHE Profile  Demo at Connectathon

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Architecture Example 1 (RHEA) 16 Organization Registry Resource Registry Interlinked Registries Referrals Queue management Resource planning Existing IHE Profiles New IHE “Interlinked Registries” Profile POS Systems HPD

Provider Registry Facility Registry Architecture Example 2 17 Organization Registry Resource Registry Interlinked Registries Referrals Queue management Resource planning Existing IHE Profiles New IHE “Interlinked Registries” Profile POS Systems HPD Client Registry

18 Calendar