1. CLIQ CLinical InQuiry MaRDI Last update 2/04

2. Information Access Challenge Delays / failures in dissemination of reports/ results to primary care community clinics Unavailability / incompleteness of the paper medical record Inefficiency of access to “basic” clinical information for busy clinicians Difficult to use, non-intuitive systems

3. Silos of Information Paper transcribed reports Laboratory Results Pathology Reports Radiology Reports Patient demographics Cardiology Reports

4. Information Access Solution Efficient communication channel enabling dissemination of results and reports Centralized repository of all electronically available clinical results/reports data Minimize redundant registrations and duplicate medical records Single/common user interface to clinical information –Easy-to-use –Intuitive and efficient Patient-centric approach to information access Scalable, platform independent and available “anywhere”

5. Information Access Solution Laboratory Results Pathology Reports Radiology Reports CLIQ CDR e-Transcribed Reports Patient demographics Cardiology Reports MPI

6. MaRDI = CDR/MPI/IE/ACS Real-time HL7 data interfaces ~ 50, 000 HL7 messages / day ~ 29,000,000 results and reports total Redundant MR registrations –10-20 potential duplicates / day –Daily email report and MPI Merge GUI > 5,200 merged since Apr 2003 96% true positive duplicate identification rate Challenge: Electronic registration systems at CHCs

7. Data Currently Available Demographic / registration data Visit history General laboratory and microbiology results Pathology, radiology, cardiology and EMG reports Operative notes Admission H&P and discharge summaries OP consultation notes OP pharmacy prescriptions Most data types with > 18 months historical data

8. Benefits Efficient access to needed clinical information at CHCs and tertiary facility –Basic information set supporting care decisions in absence of paper medical record –“From 20% in 10 days to 100% in 10 minutes” Enable community-level care delivery model Reduce redundant test ordering and risk to patient Reduce dependence on shadow charts Potentially –Enhance timeliness and quality of care –Improve patient and provider satisfaction –Reduce medical errors –Reduce cost

9. Deployment Current –Medical Center of Louisiana New Orleans –Kenner Family Medicine Clinic –Daughter’s of Charity Carrollton Clinic –Excelth New Orleans East Clinic –Healthcare for the Homeless Clinic –Musician’s Clinic –Orleans Parish Prison –City of New Orleans Clinics Fiscal ’04 –Earl K. Long Medical Center –Leonard J. Chabert Medical Center –Bogalusa Medical Center –PATH Community partners

10. Utilization: July ’03 – Feb ‘04 > 2350 unique clinician users ~ 550 unique users / day ~ 1950 logins / day ~ 2000 unique patient records accessed / day ~ 9175 patient record accesses / day

11. Future Common registration methodology Medical home / PCP “implementation” Two-way data sharing with CHCs Near real-time interfacing to clinically relevant “financial” data (CPT, ICD-9) Disease Mgt / Preventive Health reminders Diabetes registry (STEPS) Physician inbox / pushing reminders and events Immunization list