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GE Healthcare

GE Healthcare. eHealth Solutions. Data Dictionary February 22, 2012. AGENDA. Architecture / Data Sources Data Types: Demographics & Clinical Monthly Metrics HIE Data Dictionary. GE eHealth Information Exchange. Patient ID Manager. Key Components. Document Repositories.

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GE Healthcare

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  1. GE Healthcare eHealth Solutions Data Dictionary February 22, 2012

  2. AGENDA • Architecture / Data Sources • Data Types: Demographics & Clinical • Monthly Metrics • HIE Data Dictionary

  3. GE eHealth Information Exchange Patient ID Manager Key Components Document Repositories Document Registry • PRIMARY CARE PHYSICIANS • Practice Management • EMR • PATIENT • Personal Health Records • LAB • Results • PAYERS • Claim Data • PUBLIC HEALTH • Registries • HOSPITAL 2 • EMR/PM’s • Lab • PACS Archive • PHARMACY/PBMs • RX History • SPECIALTYPRACTICE • Practice Management • EMR • HOSPITAL 1 • EMR/PM’s • Lab • PACS Archive

  4. Patient Identity Feed IHE PIX Patient ID Manager • PRIMARY CARE PHYSICIANS • Practice Management • EMR • PRIMARY CARE PHYSICIANS • Practice Management • EMR Name Site MRN % • PATIENT • Personal Health Records John Doe PCP 111 99 John Doe Specialty 222 99 MRN 111 J. Dow Hospital 2 333 30 • LAB • Results MRN 333 • PAYERS • Claim Data MRN 222 • PUBLIC HEALTH • Registries • HOSPITAL 2 • EMR/PM’s • Lab • PACS Archive • HOSPITAL 2 • EMR/PM’s • Lab • PACS Archive • PHARMACY/PBMs • RX History • SPECIALTYPRACTICE • Practice Management • EMR • SPECIALTYPRACTICE • Practice Management • EMR • HOSPITAL 1 • EMR/PM’s • Lab • PACS Archive

  5. Patient Identity Cross-Reference IHE PIX Patient ID Manager • PRIMARY CARE PHYSICIANS • Practice Management • EMR Name Site MRN % • PATIENT • Personal Health Records John Doe PCP 111 99 John Doe Specialty 222 99 J. Dow Hospital 2 333 30 PIX RESPONSE: MRN 222 • LAB • Results PIX QUERY: MRN 111 • PAYERS • Claim Data • PUBLIC HEALTH • Registries • HOSPITAL 2 • EMR/PM’s • Lab • PACS Archive • PHARMACY/PBMs • RX History • SPECIALTYPRACTICE • Practice Management • EMR • SPECIALTYPRACTICE • Practice Management • EMR • HOSPITAL 1 • EMR/PM’s • Lab • PACS Archive

  6. Publish Documents Patient ID Manager IHE PIX REGISTER DOCUMENT Document Registry • PRIMARY CARE PHYSICIANS • Practice Management • EMR • PATIENT • Personal Health Records • PRIMARY CARE PHYSICIANS • Practice Management • EMR • LAB • Results PUBLISH • PAYERS • Claim Data • PUBLIC HEALTH • Registries • HOSPITAL 2 • EMR/PM’s • Lab • PACS Archive • PHARMACY/PBMs • RX History • SPECIALTYPRACTICE • Practice Management • EMR • HOSPITAL 1 • EMR/PM’s • Lab • PACS Archive • CCD • Allergies • Problems • Meds • Etc, Etc.

  7. Query for Documents Patient ID Manager IHE PIX Document Registry • PRIMARY CARE PHYSICIANS • Practice Management • EMR • PATIENT • Personal Health Records RETRIEVE REQUEST • LAB • Results RETRIEVE DOCUMENT 1 • PAYERS • Claim Data REQUEST DOCUMENT 1 • PUBLIC HEALTH • Registries • HOSPITAL 2 • EMR/PM’s • Lab • PACS Archive • PHARMACY/PBMs • RX History • SPECIALTYPRACTICE • Practice Management • EMR • SPECIALTYPRACTICE • Practice Management • EMR • HOSPITAL 1 • EMR/PM’s • Lab • PACS Archive • CCD • Allergies • Problems • Meds • Etc, Etc.

  8. Technical Diagram of Data Sources ADT MDM ORU ADT MDM ORU

  9. AGENDA • Architecture / Data Sources • Data Types: Demographics & Clinical • Monthly Metrics • HIE Data Dictionary

  10. Data Type Patient Demographics “R” Required

  11. Document Example XD*LAB

  12. Document Example XDS*SD

  13. AGENDA • Architecture / Data Sources • Data Types: Demographics & Clinical • Monthly Metrics • HIE Data Dictionary

  14. Monthly Metrics: # of Patients

  15. Monthly Metrics: # of Clinical Documents

  16. AGENDA • Architecture / Data Sources • Data Types: Demographics & Clinical • Monthly Metrics • HIE Data Dictionary

  17. Schemas / Tables / Data Elements Schemas (HIE+MPI has ~5), plus POL, CDT, CCD, etc 1 Column Definitions Tables each schema has 11 to 168 tables 2 Columns = Data Elements Each table has ~10 columns (or data elements) 3

  18. Sample Data Elements

  19. Data Dictionary: Example #1

  20. Data Dictionary: Example #2

  21. HIE Standards: HITSP/IHE standards-based HIE HITSP/IHE XD*Lab (GE) Transformer Service (GE) Publish Lab Result HL7 2.x ORU (FH & OH) MSH|^~\&|QDXPT|OH||STJOHMC.3|20091115205600||ORU^R01|R31061680326.3.2|P|2.2 PID|1||401017564||TESTS^PATIENTS^K^^^||19750103|F|||1313 Mockingbird Lane^^LONGVIEW^ WA^98632||""|||||80897339|572-12868 PV1|1|E|ED NA-NA|E|||31543^TRAN^MIMI^^^^MD||26837^MELGAR^GERARDO^R^^^MD||||||||31543^TRAN^MIMI^^^^MD|PH||||||||||||||||||||||||||20091115 ORC||8257603248^PLW-OIF|||||||||||||||^SJMC^^SJMC OBR|1|8257603248^PLW-OIF|LA93264515|31305^OML|S|200911152015|200911152015|||KENDUL||||200911152026|GNL^BLD|31543||||LA93264515|SJMC^PeaceHealth Lower Columbia Region^Clinical Laboratory S|200911152056||HM|F||^^^200911152015^^S|||||||||200911152008 OBX|1|TX|300500^GLUCOSE|1|103|mg/dL|70-99|H|||F||||SJMC|WANBRU OBX|2|TX|300600^UREA NITROGEN (BUN)|1|22|mg/dL|6-20|H|||F||||SJMC|WANBRU OBX|3|TX|300700^CREATININE|1|0.7|mg/dL|0.44-1.03||||F||||SJMC|WANBRU OBX|4|TX|310100^SODIUM|1|139|mEq/L|135-145||||F||||SJMC|WANBRU OBX|5|TX|310200^POTASSIUM|1|4.2|mEq/L|3.5-5.2||||F||||SJMC|WANBRU OBX|6|TX|310300^CHLORIDE|1|107|mEq/L|95-109||||F||||SJMC|WANBRU OBX|7|TX|310400^CO2 CONTENT|1|26|mEq/L|22-32||||F||||SJMC|WANBRU OBX|8|TX|301100^CALCIUM|1|9.0|mg/dL|8.6-10.2||||F||||SJMC|WANBRU OBX|9|TX|312000^SGOT(AST)|1|24|IU/L|15-41||||F||||SJMC|WANBRU OBX|10|TX|310900^ALBUMIN|1|3.7|g/dL|3.5-5.0||||F||||SJMC|WANBRU OBX|11|TX|311700^ALKALINE PHOS|1|92|IU/L|30-110||||F||||SJMC|WANBRU OBX|12|TX|311400^BILIRUBIN,TOTAL|1|0.2|mg/dL|0.1-1.2||||F||||SJMC|WANBRU OBX|13|TX|310800^PROTEIN,TOTAL|1|6.8|g/dL|6.2-8.4||||F||||SJMC|WANBRU OBX|15|TX|311800^SGPT(ALT)|1|27|IU/L|15-54||||F||||SJMC|WANBRU OBX|17|TX|300720^GFR CALCULATED|1|>60|mL/min|>60||||F||||SJMC|WANBRU NTE|1||*estimated GFR calculated using MDRD Study equation. NTE|2||*serum creatinine affected by gender, age, race, diet, body habitus, NTE|3|| medications and creatinine method. NTE|4||*eGFR not validated in acute renal failure, extreme body size, NTE|5|| diseases of skeletal muscle, severe malnutrition, pregnancy, NTE|6|| patients with normal renal function or children. NTE|7||*multiply by 1.21 in African American patient. NTE|8||Stages of chronic kidney disease (CKD): NTE|9|| 30-59 ml/min-stage 3 NTE|10|| 15-29 ml/min-stage 4 NTE|11|| <15 ml/min -stage 5

  22. HIE Standards: HITSP/IHE standards-based HIE HITSP/IHE XD*Lab Transformer Service Lab Result HL7 2.x ORU Consume

  23. HIE & Analytics Patient ID Manager REGISTER DOCUMENT Document Registry (DRR) ANALYTICS CDR Labs • PRIMARY CARE PHYSICIANS • Practice Management • EMR • PATIENT • Personal Health Records • PRIMARY CARE PHYSICIANS • Practice Management • EMR Parsed • LAB • Results PUBLISH • PAYERS • Claim Data • PUBLIC HEALTH • Registries NOTE: The CFRHIO HIE Architecture allows for secure document exchange (“document” is a generic term to describe payloads that may contain freetext or discrete data (Labs, CCDs) or images (PDF, JPG, DICOM)) between authorized parties (the HIE enforces the consent policy). Policy Questions: 1. Does Patient Consent / Authorization allow for data to be used for research? 2. Does it need to be De-Identified or Pseud-onomized (which can limit its value)? 3. Who owns the aggregated data (and assumes risks / benefits)? Allergies • HOSPITAL 2 • EMR/PM’s • Lab • PACS Archive • PHARMACY/PBMs • RX History • SPECIALTYPRACTICE • Practice Management • EMR • HOSPITAL 1 • EMR/PM’s • Lab • PACS Archive Problems • CCD • Allergies • Problems • Meds • Etc, Etc. • CCD • Allergies • Problems • Meds • Etc, Etc.

  24. GE Healthcare eHealth Solutions Bill Howard eHealth Solutions Software Architecture 802.310.2780 Bill.Howard@GE.com

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