1. Brian E. Dixon, MPA, PhD Candidate Health IT Project Manager Regenstrief Institute, Inc. Bi-Directional Communication Enhancing Situational Awareness in Public Health and Clinical Practice 1 TUESDAY, 12:30 – 12:50PM

2. Bi-directional Communication Purpose Demonstrate how health information exchange (HIE) can facilitate efficient and effective dissemination of information to clinicians that keeps them informed of public health threats in their communities Situational Awareness Recognition of an Emergent Threat Raise Awareness of Threat Action in Response to Threat HIMSS 20102

3. Health Information Exchange NHIN-Enabled Health Information Exchange Outpatient RXs Physician Offices Ambulatory Centers Local Public Health Departments State Public Health Agencies Imaging Centers Hospitals Laboratories HIMSS 20103

4. Health Information Exchanges (HIEs) HIEs provide common infrastructure to connect medical providers and public health organizations Minimizes duplicative technical connections as well as healthcare services Common infrastructure can be reused over time for new services and applications: Maximizes initial investments HIMSS 20104

5. The Indiana Network for Patient Care (INPC) 15 year old HIE operated by the Regenstrief Institute – Partner with the Indiana Health Information Exchange Facilitates data exchange between – 35+ Hospitals – Independent and Reference Laboratories – Public Health Departments (State and local) – 100+ clinics and imaging facilities Indianapolis metropolitan area, Lafayette, and Evansville HIMSS 20105

6. DOCS4DOCS ® (D4D) »Delivers laboratory and other clinical messages from one organization to the patient’s responsible provider (PCP) Managed by the Indiana Health Information Exchange »Delivered in three formats Fax Electronic inbox (Web-based application) Integration with the Electronic Health Record (EHR) system »6 million messages each month to 13,000+ physicians HIMSS 20106

7. Results Delivery – An Illustration HIMSS 20107

8. DOCS4DOCS

10. Expanding D4D to Support Public Health »D4D delivers ISDH laboratory reports to providers throughout the state »Marion County Health Department (MCHD) partnered with Regenstrief and IHIE to notify physicians of important, emergent situations involving public health threats Salmonella exposure at local restaurant »System went live in May 2009 Utilized several times for H1N1 updates HIMSS 201010

11. DOCS4DOCS

12. Process Diagram Hospitals, IDNs Health Information Exchange IN Physician Practice Generate H1N1 Alert HIMSS 201012

13. Bi-directional Communication Methods Clinical messaging is a “push” technology – Message authored by Public Health entity – Message integrated into clinical workflow using established systems and processes for communication Other methods to support bi-directional communication – Decision Support (Infobutton) – Query public health knowledgebase for alerts relevant to a given patient’s demographics (e.g., age, home address, chief complaint) – Case Reporting – Pre-populate notifiable condition reports with HIE data to increase rate of “spontaneous” reporting HIMSS 201013

14. DOCS4DOCS Reporting Form

15. Thank You 15 The participation of any company or organization in the NHIN and CONNECT area within the HIMSS Interoperability showcase does not represent an endorsement by the Office of the National Coordinator for Health Information Technology, the Federal Health Architecture or the Department of Health and Human Services.