Through 2009, MHC operated as a collaborative with the Charter organizations contributing in-kind resources and funds as required to advance MHC’s Mission and Vision. Simultaneously, these Charter members continued their own HIE technology and services deployments and collaborated to ensure physician satisfaction with the solutions provided and efficient utilization of resources.
MHC has standardized its HIE platform using technology from Medicity, Inc and is an exclusive partner of Medicity for HIE solutions in the state of Michigan. Our members leverage discounted Medicity software through MHC along with access to the MHC HIE network of providers. The MHC solution platform consists of two primary components:
- Novo Grid – Medicity’s Novo Grid platform is the foundational clinical messaging platform that moves transactions between electronic medical record systems and other tools across the healthcare community. Currently it offers electronic delivery and/or receipt of results, laboratory orders, scheduled orders, and referrals across organizations and settings of care.
- Proacess / Meditrust Platform – This major solution component aggregates and organizes patient encounter and clinical information and presents a summarized community-wide “view” of the patient’s records to physicians and other clinicians at the point of care.
Platform Components
The following core technology components from Medicity comprise MHC’s current production technology platform.
MediTrust/Nexus
DataStage(s). A DataStage is a dynamic data repository engineered to accommodate diverse types of clinical information. The information contained in a DataStage can be interfaced with and queried, viewed, and printed through the ProAccess Community Health Record application suite or published to a provider’s EHR/EMR/Other provider database.
Nexus Engine. Nexus is the engine that drives the efficient exchange, transformation, and normalization of information utilizing healthcare industry standards such as HL7 and CCD, and using other popular data-exchange formats like XML. The Nexus Engine includes a set of adaptors which are configured to queue, manage, validate, translate, de-identify, pseudonymize, and transmit information as needed.
Nexus Manager. The Nexus Manager extends administrative rights to the Nexus Engine through a web-native application accessed securely via a standard internet browser. Nexus Manager enables delegated administrators to monitor the status of designated interface connections.
Identity Management Services. Identity Management Services are built on patent-pending technologies that automate the matching of patients across disparate systems, while also managing patient-consent status and patient relationships with providers. In concert with the DataStage, Identity Management Services create a patient record that includes clinical data from many sources. Identity Management Services contain pointers to all organizations with a patient’s clinical data, which allows that patient data to be retrieved efficiently, while ensuring that protected health information is safeguarded according to the custodial organization’s policies. Pseudonymization services are included for initiatives like public health reporting. Tools to merge, unmerge and link patients within and across facilities are provided with Identity Management Services.
Data Retention Services. Data retention services enable the preservation of data previously received for a patient but not included on the current message. Retaining the primary care physician, patient demographic information, originating system order ID, and financial class are common examples where retention services are utilized.
Terminology Services. Terminology Services are used to standardize and map data from proprietary sources to industry-standard vocabularies and formats, such as mapping proprietary lab terms to LOINC. This service enables viewing a patient’s longitudinal health record received from multiple sources in the community.
Provider Directory. The Provider Directory enables searches for community providers and maintains provider’s security certificates.
MediTrust Gateways. Various Gateway components exist to exchange data with external data sources such as other HIEs, personal health records, payers, research organizations, and government entities.
ProAccess Community Health Record (MHC’s Virtual Integrated Patient Record – VIPR)
ProAccess Community Health Record is the community-wide longitudinal clinical application in Medicity’s clinical application suite. Built on the foundation of the MediTrust platform, ProAccess Community Health Record optimizes the display of electronic clinical data. It is designed to adapt to the workflow of most physician offices and provides convenient, personalized access to complete clinical data. The ProAccess Community Health Record currently includes the following functionality:
- Patient Search
- Longitudinal Patient View. The longitudinal patient view includes aggregated patient information from data sources at disparate health systems. The view is extended as additional data sources are available. Depending upon data sources, the longitudinal view may include:
- Break-the-Glass.
- CCD Exchange. Leverages a combination of the Grid and ProAccess to enable a user to create, send, and receive a CCD.
| . Demographic and face sheet data | |
| . Clinical claims summary and aggregated claims views | |
| . Inpatient and ambulatory medication history | |
| . Lab results in several formats (trending tables, tables, and graphs) | |
| . Encounter documentation including physician and nursing notes, vital signs, chief complaint, provider encounter date, and insurance data | |
| . EEG and EKG reports and image viewing | |
| . Immunizations | |
| . Allergies | |
| . Medical Diagnosis and Problems List | |
| . Medical Treatments and Procedures | |
| . Past Hospitalizations | |
| . Ambulatory Encounters |
Novo Grid/iNexx (MHC’s HIE Command Center).
The Novo Grid forms a secure network to distribute and exchange health information—including results, orders, admission/discharge/transfer (ADT) data, transcribe reports, problems, medications, allergies CCD Documents, referrals and demographic data—across acute and ambulatory care settings. This platform seamlessly integrates health information across the care continuum, while at the same time creating a patient care “social network” among participating providers—such as primary care physicians, specialists and ancillary service providers—enabling them to more effectively communicate, collaborate and coordinate patient care.
Results Delivery.
Results are delivered via the Novo Grid either to a Results Inbox which allows providers to receive a unified view of results and reports from multiple organizations across the community via one system login in their office or directly and discretely into the provider’s EMR system.
Laboratory Ordering.
Laboratory orders can be electronically sent and managed within an office either from an MHC ordering solution or directly from the provider’s EMR system. The solution also provides a consistent and consolidated way for Laboratories to collect and manage all inbound electronic order activity from a variety of sources across the community. Both the office and laboratory are kept in synch as changes are made on either side.
Scheduled/Radiology Ordering.
Radiology orders or other procedures that need to be scheduled can be electronically sent and managed within an office. The solution also provides a consistent and consolidated way for Diagnostic Centers to collect and manage all inbound electronic order activity from a variety of sources across the community. Both the office and diagnostic center are kept in synch as changes are made on either side.
Virtual Care Team Record.
A collaborative patient care record shared by providers in a community specifically connected via a referral network and used to deliver coordinated patient-centered care. This small network of providers, connected by referral activity around a specific patient, becomes the “virtual care team” for that patient and are automatically kept in synch as updates are made by anyone on the care team.
Referrals.
Allows providers to electronically send patient referrals to other MHC network providers. The patient’s Virtual Care Team Record is securely delivered as part of the referral.
Standard Reports.
Includes a variety of management reports used to monitor system use, patient data access, and report distribution activities. Examples include: User Login Activity, Patient Chart Access, Break-the-Glass, Results Delivery, Patient Merge, and CCD Activity reports.
HIE Analytics/Operational Data Mart.
The Operational Data Mart consists of MS SQL Server populated with operational data and associated MS SQL Server Reporting Services. In addition to standard reports, ad hoc reports can be created and executed by MHC-authorized personnel.
