2. Western Wayne Physicians Southeast Michigan Health Information Exchange

3. The Oakwood Node (Adapters) generates the CCD The Oakwood Node (Adapters) receives Discharge Summary Data Oakwood Node (Adapters) Request Discharge Summary Data A03 Trigger is generated based on patient referral Oakwood Node CCD Generator MPIMPI PD – QD - RD XDS.b Repository CCD Generator ADT-A03 Origination Trigger ADT-A03 Origination Trigger Oakwood discharges patient with WWP as PCP Discharge Data Response Discharge Data Request ADT Discharge Trigger

4. Oakwood Node CCD Generator MPIMPI PD – QD – RD XDS.b Repository CCD Generator ADT-A03 Origination Trigger ADT-A03 Origination Trigger Oakwood discharges patient with WWP as PCP Discharge Data Response Discharge Data Request ADT Discharge Trigger CCD Generator CCDGenerationFrameworkCCDGenerationFramework MDHT Runtime Libraries Semantic Translation Service SNOMED LOINC RxNorm Framework translates and constructs a CDA conformant CCD Framework receives proprietary format clinical data from Oakwood EHR The Oakwood Node (Adapters) generates the CCD CCDGenerationFrameworkCCDGenerationFramework MDHT Runtime Libraries Semantic Translation Service SNOMED LOINC RxNorm The Oakwood Node (Adapters) generates the CCD SEMHIE NwHIN Node SEMHIE NwHIN Node XDS.b Repository Provider Registry PD, QD, RD MPIMPI SEMHIE Node submits the CCD to the Western Wayne EHR SEMHIE Node identifies recipient via Provider Registry SEMHIE Node receives the CCD from Oakwood Node Discharge Summary CCD Submission SEMHIE NwHIN Node SEMHIE NwHIN Node XDS.b Repository Provider Registry PD – QD – RD MPIMPI Western Wayne Physicians Discharge Summary CCD Retreive Document Query Document Allscripts retrieves the CCD and displays in EHR App Allscripts queries for the CCD from Western Wayne Node Western Wayne Node Receives CCD SEMHIE Node submits the CCD to the Western Wayne EHR Western Wayne Physicians MPIMPI XDS.b Repository PD – QD – RD

5. Real-Time Transition of Care Leveraging NwHIN Based HIEs Allscripts retrieves the CCD and displays in EHR App Allscripts queries for the CCD from Western Wayne Node Western Wayne Node Receives CCD SEMHIE Node submits the CCD to the Western Wayne EHR SEMHIE Node receives the CCD from Oakwood Node The Oakwood Node (Adapters) generates the CCD The Oakwood Node (Adapters) receives Discharge Summary Data Oakwood Node (Adapters) Request Discharge Summary Data A03 Trigger is generated based on patient referral Western Wayne Physicians Document Response Document Request Western Wayne Physicians MPIMPI XDS.b Repository PD – QD - RD CCDGenerationFrameworkCCDGenerationFramework MDHT Runtime Libraries Semantic Translation Service SNOMED LOINC RxNorm SEMHIE NwHIN Node SEMHIE NwHIN Node XDS.b Repository Provider Registry PD – QD – RD MPIMPI Oakwood Node CCD Generator MPIMPI XDS.b Repository PD – QD - RD ADT-A03 Origination Trigger ADT-A03 Origination Trigger Discharge Data Response Discharge Data Request ADT Discharge Trigger TOC Pilot Host Systems Integrator Technology Partners