Louisiana Public Health Information Exchange (LaPHIE) A collaborative project of: LSU HCSD DHH –Office of Public Health Louisiana Public Health Institute Funded in part by HRSA Grant #H97HA08476

Presenters: S usan Bergson – LPHI Jane Herwehe – LSU HCSD Luis Smith – LSU SPH Ml & Telemed Public Health Information Network (PHIN) Community of Practice March 12, 2009

Background: Summer 2005… LA lead the nation in several of communicable conditions. 1 st in syphilis 2 nd in Gonorrhea 5 th in HIV/AIDS 10 th in TB LSU HCSD and OPH sat down to discuss improved methods for leveraging information to be able to better reach and offer intervention for infected individuals with the goal of improving health outcomes and possibly reducing transmission of these communicable diseases.

Project Origin  Recognition of the importance for collaboration  Organizational support from DHH OPH and LSU HCSD ◦ Assistant Secretary of DHH OPH ◦ Chief Medical Office LSU HCSD  Robert Wood Johnson InformationLinks Grant

 Established governance  Executed data sharing agreement  Analysis of legislation related to sharing of public health information  Ethics review by national experts in bio medical ethics, public health ethics and AIDS privacy  Consumer research  Evaluation methodology  Messaging system developed and in production

 Secure bidirectional information exchange between LSU HCSD and DHH – OPH  Purpose: to improve timeliness of disease reporting and access to care and treatment for persons with HIV, syphilis and tuberculosis

 Improves timeliness of OPH follow up if case report and confirmatory results are delivered in real and near time  Standardizes the content and quality of reported information  Allows for “electronic outreach” for those lost to OPH and the care system  Increases opportunities to intervene with patients earlier in the course of illness which can improve patient outcomes and decrease disease transmission

 As of December 31, 2008, 16,430 persons were living with HIV/AIDS in LA  OPH HIV/AIDS Program estimates that 45% of persons living with HIV in LA are “not in care”  Data analysis demonstrates that nearly 1100 persons that OPH considers not in care for HIV and 1500 persons with untreated syphilis are attending care in HCSD facilities for other medical reasons.

‣ Only persons that OPH considers “not in care” for the targeted conditions. ‣ Those that have not received test results and are unaware of infection status ‣ Those that may have received results, but OPH has no laboratory or clinical info indicating monitoring or treatment ‣ Exposed infants in need of follow up

 Connects LSU HCSD clinical information systems with OPH surveillance and treatment information systems  Disease reporting from HCSD to OPH can be real and near time  Important OPH messages can be electronically exchanged with health care providers at the point of care  LSU HCSD intervention information can flow back to OPH

OPH Firewall LSU Firewall ADT Registration CLIQ/EMR Interface Engine OPH Server PPR PRR ADT PPR / PRR Messaging

 Created with input from clinicians and public health professionals  EMR-based messaging  Simple, intuitive design that informs users of recommended actions and allows for recording of actions taken

Radiology Labs OPH Disease Alerts Clinical Reports Registration HL7 Interfaces SQL Server Data Repository IIS Web Farm Clinician Actions CLIQ/EMR GUI Clinician Actions LaPHIE Architecture

 LSU/TU clinicians  UH Infection Control  Delta Region AETC  LSU SPH Medical Informatics & Telemedicine  HCSD CEO, CMO, CIO/CMIO  LIS Core Group  HCSD Programming Support  OPH HIV, STD and TB programs  OPH nurses  OPH epidemiologists  OPH Disease Intervention Specialists  OPH Medical Directors  DHH Legal Counsel  LPHI

Thank you for your attention For more information, please contact: S. Bergson – J.Herwehe – L. Smith –