1. WIRuralRx Jeannie Tichy Software Product Analyst Marshfield Clinic Planning a Rural Prescription Network

2. WIRuralRx: Vision The WIRuralRx partnership will develop a plan for implementing a point-of-care tool that will make accessible real-time, accurate patient-level prescription medication data for any patient receiving health care services at any one of the partnering institutions. Copyright 2005 Marshfield Clinic

3. WIRuralRx: Partnership Initial planning was a collaboration between 3 facilities in a rural area –St. Josephs Hospital –UW Health Wausau Family Practice –Marshfield Clinic Implementation will add a fourth partner –Ministry Medical Group – Plover Family Practice Copyright 2005 Marshfield Clinic

4. Partner clinic without EHR: uses software from the Network Partner clinic with EHR: send and views data via an electronic interface to the Network Partner hospital with EHR: views network data for admissions/ER; at discharge, transfers meds to partners outpatient e-prescribing application Read-only subscribers: do not send data to the Network but can view Network information (e.g. a small hospital ER) WIRuralRx Merge medication lists into one, non-duplicative list with access to multiple types of Network subscribers At discharge, med information cleaned up (reconciled) by outpatient e- prescribing application and then sent via interface to Network Copyright 2005 Marshfield Clinic

5. WIRuralRx: Specific Aims Aim 1: Creation of Network Infrastructure Components –Development of an Electronic Master Patient Index –Development of a Master Medication List –Development of an Inventory of Allergies and other Adverse Drug Reactions (ADRs) Copyright 2005 Marshfield Clinic

6. WIRuralRx: Specific Aims Aim 2: Establishment of Network Regulatory Elements and Membership –Network security –Patient consent –Provider agreements Copyright 2005 Marshfield Clinic

7. WIRuralRx: Specific Aims Aim 3: Establish Essential Capabilities for Interaction with the Network –Data Transfer TO the Network –Data Viewing/Transferring FROM the Network Copyright 2005 Marshfield Clinic

8. WIRuralRx: Specific Aims Aim 4: Decision Support –Basic decision support –Enhanced decision support Copyright 2005 Marshfield Clinic

9. WIRuralRx: Specific Aims Aim 5: Evaluation of Network –Utilization –Contribution to Patient Safety –Effectiveness –Costs Copyright 2005 Marshfield Clinic

10. Electronic Master Patient Index (EMPI) at Marshfield Clinic Definition: A system that maintains demographics and unique patient identifiers from different, independent institutions and maps them to a common identifier. Copyright 2005 Marshfield Clinic

11. EMPI: History Marshfield Clinic developed its EMPI to accommodate for the Regional Early Childhood Immunization Network (RECIN) Software processes combined with timely Health Information Management (HIM) assistance constantly search for, sweep, and remove duplicates from the database, thereby storing the patient identifiers, and up- to-date demographics once and once only. Copyright 2005 Marshfield Clinic

12. EMPI: Components Real-time Deduplicator Batch Patient Integrator (BPI) Batch Examiner Medical Record Data Integrator (MRDI) Copyright 2005 Marshfield Clinic

14. EMPI and WIRuralRx Where are we today? –Effective system but will need changes to accommodate for the WIRuralRx Current system requires a significant amount of manual effort to be effective. Current system does not support demographic information exchange between disparate systems through an interface. –We are utilizing available resources to address issues to produce an efficient and effective EMPI for the WIRuralRx Copyright 2005 Marshfield Clinic

15. Questions? Thank You Jeannie Tichy Marshfield Clinic tichy.jean@marshfieldclinic.org Ryan Ketterer Marshfield Clinic ketterer.ryan@marshfieldclinic.org Copyright 2005 Marshfield Clinic