PIC HIE: Implementation Toolkit

AAPCHO is pleased to introduce the Pacific Innovation Collaborative Health Information Exchange (PIC HIE): Implementation Toolkit. This toolkit is a guide for community health centers interested in joining the PIC Health Information Technology Network. Please note that organizations interested in joining the network, must meet PIC network membership criteria listed in the section entitled Pacific Innovation Collaborative Network Membership Criteria. Since this toolkit is a working document that may be updated from time to time, please refer to this site for the most updated version.

We encourage you to send us your feedback or additional resources for this toolkit, as it will be continually updated. To reach us, e-mail AAPCHO at research@aapcho.org.

General Information

About the Pacific Innovative Collaborative
The Pacific Innovative Collaborative is a network of eight community health centers and two health plans in Hawaii and Washington. The network has enabled health centers to collect and store patient data in a central location, and optimize their limited resources to share HIT models and practices. Clinical and process measure data from all sites are sent to regional database repositories in Oahu, Hawaii and Seattle, Washington. AAPCHO serves as the central repository, electronically collecting data from these regional databases. The graphic below illustrates how the information is provided and is securely shared among sites.

The Pacific Innovation Collaborative (PIC) Health Information Exchange (PIC HIE): Implementation Toolkit will help your health center get started in utilizing Health Information Technology to collect information that may improve and monitor patient care at your clinics. It contains an array of useful information for health centers wishing to join the network, including:

  • Functional requirements and specifications for CHCs
  • An implementation readiness assessment form
  • Project timeline
  • A PIC Report Manager training guide
  • HIT-related fact sheets
  • Additional resources and references

Network Membership Criteria

Pacific Innovation Collaborative (PIC) Network Membership Criteria

  • AAPCHO membership
  • Health organization serving Asian Americans, Native Hawaiians, and/or Other Pacific Islanders
  • Electronic medical record in place at prospective health organization
  • Commitment of in-kind services from prospective health organization
  • Commitment to the mission and vision of the Pacific Innovation Collaborative
  • Approval from project Chief Information Officer John Williams
  • Approval from at least 50% of other PIC member health organizations
  • Approval from AAPCHO Executive Committee Board of Directors

Functional Requirements

Pacific Innovation Collaborative (PIC) Functional Requirements
This document outlines required specifications of the PIC central repository – software, tools, and systems – in order for information to be transmitted successfully into the reporting system. This reporting system will generate reports from a central data repository where sites can compare aggregated data across health centers. Key clinical measures are also outlined.

Functional Specifications for Health Centers

Functional Specifications for Health Centers
This document outlines the parameters and procedures that health centers must adhere to for each project measure in order for data to be collected uniformly. It is imperative that health centers interested in joining the network have an IT staff member who can monitor and troubleshoot the transfer of clinical data to the central repository.

Implementation Readiness Assessment Form

Implementation Readiness Assessment Form
This document will help you assess your readiness to participate in the network. If your health center would like to participate in the PIC project, please print and complete this assessment form and e-mail to PIC Project Coordinator, Heather Law.

Planning Phase (3 Months)

Goal: Create draft project plan

  • Create draft project plan

Goal: Develop Reporting Requirements

  • Determine required methods of report distribution and report generation

Goal: Develop Functional Specifications

  • Select interface protocol
  • Select appropriate transmission and connection protocols
  • Select VPN authentication and encryption protocols
  • Select minimum and optimal bandwidth specifications for your site, regional aggregation sites, and data repository

Goal: Assess Impact on Existing IT Infrastructure

  • Determine if your site will require upgrades to bandwidth capacity, upgrades to hardware, or additional equipment
  • Determine if your site will require upgrades to existing firewalls to support VPN communication
  • Determine if your site will require upgrade to server hardware or an additional server
  • Complete Implementation Readiness Evaluation

Goal: Determine Regional Data Aggregation Site

  • Determine site for hosting regional data repository as appropriate
  • Configure interface between site and regional data repository

Goal: Configure Central Data Repository Site

  • Confirm AAPCHO as site for hosting central data repository
  • Configure interface between site and central data repository

Testing Phase (1 Month)

Goal: Test Regional Site Data Transmission

  • Select site for testing
  • Review interface testing

Goal: Test Central Data Repository Data Transmission

  • Deploy and configure hardware/software
  • Review generated reports

Expansion of Infrastructure (2 Weeks)

Goal: Expansion of Data Aggregation for Remaining Health Centers

  • Review interface testing
  • Review generated reports

Implementation Phase (8 Months)

Goal: Measures Reporting

  • Test interface of datasets between site databases and regional aggregation site
  • Test interface of datasets between regional aggregation site and central data repository
  • Review interface testing
  • Review generated reports
  • Train site end users on PIC Report Manager access and utilization

Goal: Evaluation Phase

  • Generate reports from central data repository
  • Review reports and performance outcomes
  • Conduct data integrity review and implement changes as needed
  • Complete project evaluation form and review

Report Manager Handbook

Report Manager Handbook
This handbook provides information and instructions on how to use the online report manager. PIC network members can access the report manager to generate reports on quality measures and compare de-identified patient and encounter data across project sites.

Health Information Technology (HIT) Fact Sheets

These AAPCHO fact sheets summarize the various ways that Health Information Technology (HIT) projects benefit health centers.

Enabling Services Health Information Exchange at Hawaii Community Health Centers
This fact sheet examines how health information technology (HIT) and health information exchanges (HIEs) are used to measure the impact of enabling services on diabetes outcomes.

“Incentivizing the Outcome: Paying for Population Health at Hawaii FQHCs” Pay-For-Performance Project
This fact sheet outlines the project’s role in examining whether a team-level Pay-for-Performance incentive program improves health outcomes, emergency room, and hospitalization measures for low-income Asian American, Native Hawaiian, and other Pacific Islander populations served by project health centers.

The Pacific Innovation Collaborative (PIC)
This two-page fact sheet outlines the Pacific Innovation Collaborative Health Information Technology project that intends to design and develop electronic infrastructure for community health centers in Washington and Hawaii.

Appendix: References

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  2. Blumenthal, D. (2009). “Stimulating the adoption of health information technology.” New England Journal of Medicine 360(15): 1477-1479.
  3. Blumenthal, D. (2010). “Guiding the health information technology agenda. Interviewed by David J. Brailer.” Health Affairs (Millwood) 29(4): 586-595.
  4. Blumenthal, D. (2010). “Launching HITECH.” New England Journal of Medicine 362(5): 382-385.
  5. Blumenthal, D. (2011). “Meaningful use: an assessment. An interview with David Blumenthal, M.D., National Coordinator for Health Information Technology, Office of the National Coordinator. Interview by Mark Hagland.” Healthcare Informatics 28(1): 40, 44.
  6. Blumenthal, D. and M. Tavenner (2010). “The meaningful use regulation for electronic health records.” New England Journal of Medicine 363(6): 501-504.
  7. Bowens, F. M., P. A. Frye, et al. (2010). “Health information technology: integration of clinical workflow into meaningful use of electronic health records.” Perspectives in Health Information Management 7: 1d.
  8. Bratzler, D. W. (2010). “The Oklahoma Health Information Technology Regional Extension Center.” Journal of the Oklahoma State Medical Association 103(9): 414-418.
  9. Buntin, M. B., S. H. Jain, et al. (2010). “Health information technology: laying the infrastructure for national health reform.” Health Affairs (Millwood) 29(6): 1214-1219.
  10. Carrier, E., M. N. Gourevitch, et al. (2009). “Medical homes: challenges in translating theory into practice.” Medical Care 47(7): 714-722.
  11. Conn, J. (2011). “‘Age of meaningful use’. HIMSS convention delivers with hot IT topics.” Modern Healthcare 41(9): 12-13.
  12. Detmer, D. E. (2010). “Engineering information technology for actionable information and better health – balancing social values through desired outcomes, complementary standards and decision-support.” Studies in Health Technology and Informatics 153: 107-118.
  13. Fontaine, P., T. Zink, et al. (2010). “Health information exchange: participation by Minnesota primary care practices.” Archives of Internal Medicine 170(7): 622-629.
  14. Friedman, C. P., A. K. Wong, et al. (2010). “Achieving a nationwide learning health system.” Science Translational Medicine 2(57): 57cm29.
  15. Goldstein, M. M. and D. Blumenthal (2008). “Building an information technology infrastructure.” Journal of Law, Medicine and Ethics 36(4): 709-715, 609.
  16. Jarousse, L. A. (2010). “What you need to know about meaningful use.” Hospitals and Health Networks 84(10): 5 p following 32, 32.
  17. Jha, A. K. (2010). “Meaningful use of electronic health records: the road ahead.” Journal of the American Medical Association 304(15): 1709-1710.
  18. Jimenez, A. (2010). “E-learning supports EHR implementations. In addition to meaningful use, we need to define meaningful training.” Health Management Technology 31(11): 22-23.
  19. Kern, L. M., D. Blumenthal, et al. (2008). “Quality measures for capturing the effects of health information exchange.” AMIA Annual Symposium Proceedings: 1001.
  20. Klein, K. (2010). “So much to do, so little time. To accomplish the mandatory initiatives of ARRA, healthcare organizations will require significant and thoughtful planning, prioritization and execution.” Journal of Healthcare Information Management 24(1): 31-35.
  21. Mador, R. L., N. T. Shaw, et al. (2008). “Whose record is it anyway? Putting patients’ interests at the heart of the implementation and use of electronic medical records.” Healthcare Quarterly 11(4): 90-92.
  22. Manisundaram, A., T. Williams, et al. (2010). “”Meaningful use”. What is it and why should I care?” Maryland Medicine 11(3): 9-12.
  23. Maxson, E., S. Jain, et al. (2010). “The regional extension center program: helping physicians meaningfully use health information technology.” Annals of Internal Medicine 153(10): 666-670.
  24. Maxson, E. R., S. H. Jain, et al. (2010). “Beacon communities aim to use health information technology to transform the delivery of care.” Health Affairs (Millwood) 29(9): 1671-1677.
  25. McCartney, P. R. (2011). “Meaningful use and certified electronic health records.” MCN American Journal of Maternal/Child Nursing 36(2): 137.
  26. Murer, C. G. (2010). “Meaningful use rules proposed electronic health record incentives under HITECH act.” Rehab Management 23(3): 32-33.
  27. Ralston, J. D., K. Coleman, et al. (2010). “Patient experience should be part of meaningful-use criteria.” Health Affairs (Millwood) 29(4): 607-613.
  28. Raths, D. (2010). “What will ‘meaningful use’ mean to us?” Behavioral Healthcare 30(8): 20, 22-23.
  29. Starling, P. and J. M. Fuchs (2010). “HIT Regional Extension Center: your guide to “meaningful use”.” Journal of the Arkansas Medical Society 107(1): 12-13.
  30. Vest, J. R. and J. Jasperson (2010). “What should we measure? Conceptualizing usage in health information exchange.” Journal of the American Medical Informatics Association 17(3): 302-307.
  31. Vest, J. R., H. Zhao, et al. (2011). “Factors motivating and affecting health information exchange usage.” Journal of the American Medical Informatics Association 18(2): 143-149.
  32. Webster, P. C. (2010). “United States to compel physicians to make “meaningful use” of electronic health records.” Canadian Medical Association Journal 182(14): 1500-1502.
  33. Wise, P. B. (2010). “The meaning of meaningful use. Several technology applications are needed to qualify.” Healthcare Executive 25(3): 20-21.

Appendix: HIT Glossary

HIT Glossary
A helpful glossary of terms related to Health Information Technology (HIT).