Hennepin County Medical Center (HCMC), Minnesota's premier Level 1 Adult and Pediatric Trauma Center, has been successfully sending immunization records to the Minnesota Department of Health (MDH). "This first-in-the-nation Direct project for clinical exchange is an important milestone for Minnesota and a key step toward the seamless electronic movement of information to improve care and public health," said James Golden Ph.D, Minnesota's State Government HIT Coordinator. Recognizing Minnesota's leadership in delivering high-quality, cost-effective healthcare, U.S. Senator Amy Klobuchar said that "this is the type of innovation that can help strengthen our health care system by reducing waste and improving quality. We need to continue to improve our health care system by continuing to integrate information technology to better serve patients and providers."
Ability, a company headquartered in Minneapolis, serves as the health information services provider, or HISP, that connects HCMC to the Minnesota Department of Health. In its role as a HISP, Ability will expand this pilot project to additional providers and other states, including the Oklahoma State Department of Health, which has already committed to participation in the program.
MedAllies, a Health Information Service Provider or HISP, will launch a Direct pilot project to demonstrate the delivery of critical clinical information across transition of care settings in a "push" fashion that supports existing clinical workflows in the Hudson Valley of New York. MedAllies will implement the full Direct Project infrastructure, including both the required SMTP backbone, as well as support for the Cross-Enterprise Document Reliable Interchange (XDR) elective protocol. MedAllies is working with many stakeholders, including EHR vendors Allscripts, Siemens, NextGen, Greenway, eClinicalWorks and Epic, and clinicians in both ambulatory and hospital settings.
The three initial use cases include:
Technical integration with leading EHR and Hospital system vendors is underway with pilot exchange alpha sites beginning to go live in Q1 2011.
The Rhode Island Quality Institute (RIQI), the only organization in the nation to be awarded the Health Information Exchange, Regional Extension Center, and Beacon Community grants, has delivered a Direct Project pilot with two primary goals:
"This recognition shows that Rhode Island continues to be a nationwide leader in improving health care with better information technology," said Senator Sheldon Whitehouse. "Health care providers communicating with each other in a secure and cost-efficient way helps patients get better sooner with less hassle and confusion."
Discussing RIQI's collaborative approach to health information technology, Laura Adams, President and CEO of RIQI said "Direct allows the Quality Institute to be on the cutting edge - providing health information exchange via currentcare, delivering the efficient rollout of technology through the Regional Extension Center, and enabling and measuring real patient outcome improvements in our Beacon Community." Throughout the pilot, RIQI has worked with a number of key partners, including Arcadia Solutions (program manager and systems integrator), Inpriva's Health Information Service Provider solution that supports the security, trust, and Rhode Island-specific consent laws, InterSystems, and Polaris Medical Management's EpiChart.
In this project, CareSpark, a non-profit regional health information exchange supported by the Tennessee State HIE, and the U.S. Department of Veterans Affairs (VA) seek to demonstrate Direct Project-based health information exchange between a federal agency and providers in a private-sector HIE. The main focus will be on facilitating an improved process for exchanging referrals and consultation reports between VA providers and private-sector providers in east Tennessee and southwest Virginia. It will demonstrate two Direct Project user stories: the primary care referral to specialist and the specialist who sends summary care information back to the referring provider. Text-based mammography interpretation reports will be exchanged utilizing source code made available from the Direct Project workgroups. The project scope will also demonstrate the routing of mammography referrals from the VA to the private sector provider. It is also the intent of the participants that this project once fully vetted could be expanded to additional VA sites. The pilot will exchange information between two different Health Information Service Providers, or HISPs: the VA and CareSpark.
Redwood MedNet provides health information exchange services in rural Northern California. The Redwood MedNet Direct Project pilot has one goal: to deploy directed secure messaging for production data delivery in support of meaningful use measures. Three meaningful use messaging patterns are in development.
The project will establish a standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients. As an HIE in a rural area, participants in the Redwood MedNet directed messaging project include small practices, community clinics and small hospitals, as well as the State immunization registry. The discharge summary may also incorporate use of a patient controlled health record (PCHR).
Medical Professional Services (MPS) is a clinically-integrated, multi-specialty IPA in Connecticut with approximately 400 physician members. Along with several partners, MPS is working to demonstrate successful exchange of laboratory results back to the ordering provider and exchange of referral information and summary care information between providers, a local hospital (Middlesex Hospital) and a multi-site Federally Qualified Health Center (Community Health Center, Inc.). Electronic exchange of data is a challenge in this setting because of the diversity of MPS physician practices, EHRs and HIT tools in place.
The goal of this pilot is to enable MPS physicians to receive lab results back from Middlesex Hospital and Quest Diagnostics, to exchange referrals with Middlesex Hospital, and to exchange referrals and summary care information among MPS primary care and specialty physicians, and to share health information electronically with patients in support of Meaningful Use incentive requirements. Results and referral information will be exposed through MedPlus, eClinicalWorks, Covisint, or through a secured email client. Physicians will have the ability to securely send lab results, care summaries, and other health information to their patients via Microsoft HealthVault Message Center - a secure email messaging solution.
A broad set of stakeholders in South Texas are planning to use the Direct Project to improve the health status of persons in South Texas with diabetes, including gestational diabetes. Participants come from the medical community (CHRISTUS Health, the Health Information Network of South Texas, the Driscoll Children's Health Plan, Corpus Christi Medical Center, the Public Health Department, and Nueces County Medical Society), community-based social service organizations, colleges, and employers (the Coastal Bend Diabetes Community Collaborative, The Salvation Army, United Way, and others). The main goal is to connect the OB-GYNs, pediatricians, hospitals, and the State of Texas' Newborn Registry so they can share information (referrals, lab results, discharge summaries) in real time with their care teams to improve health outcomes. Additionally, the project's participants hope to provide patients themselves with better information so they can better manage their chronic diseases. This will be accomplished using Direct by enabling the following use cases:
Cerner Corporation is transforming healthcare by eliminating error, variance and waste for healthcare providers and consumers around the world. Cerner's Direct Project pilot has a single goal:
The pilot will provide initial focus on report distribution between acute care and community-based providers. Additional scenarios and endpoints will be added as the pilot progresses.
As of February 25, 2011, Heartland Regional Medical Center (St. Joseph, MO) is sending production clinical information to Living Community of St. Joseph (a long term care facility). Direct is being leveraged as a replacement for traditional ad hoc fax communications, representing primarily lab results and discharge summaries to facilitate transitions of care for the residents of that facility.
Medicity, Krysora, and Gorge Health Connect, Inc. (GHC) are launching a Direct Pilot in Oregon. GHC is a health information exchange service provider in the Columbia River Gorge area of Oregon. Members of GHC include hospitals, federally-qualified health clinics, primary care providers, specialists, mental health services, and county health departments covering a four-county area in north-central Oregon. The Oregon Direct Project Pilot is focused on providing secure transport of health information to members and non-members based on existing referral patterns. This pilot is focused on supporting the following Direct Project User Stories: