Tennessee

Project Overview | Data and Functionality | Technical Design and Architecture 

Project Overview

MidSouth eHealth Alliance (MSeHA) is a non-profit organization that seeks to improve the health care system of Tennessee by focusing on health care quality, safety, and efficiency for the citizens its participating organizations serve.

Partners

This partnership includes the following key partners: Baptist Memorial Healthcare Corporation, Christ Community Health Services, Memphis Managed Care/TLC, Methodist Healthcare including LeBonehur Children's Medical Center, Saint Francis Hospital and St. Francis Bartlett, St. Jude Children's Research Hospital, The Regional Medical Center (The MED), The Health Loop Clinics, and UT Medical Group.

Scope

Shelby, Tipton, and Fayette counties -- including the City of Memphis.

Stakeholders

Stakeholders include patients, providers, payers, State government, local government, and the public health community.

Goal

The principal goal is to facilitate and evaluate the use of a provider-based health information exchange model focusing on short-term impact of technologies on emergency departments and other settings including public and child health. Although used only in restricted settings (e.g., emergency departments), data come from multiple sources and are fairly comprehensive in scope. An extensive evaluation plan is in place.

State and Local Involvement

MSeHA receives State and local support. The State has an ex-officio seat on the MSeHA Board. In addition, Shelby County has board members representing the Mayor's office and Public Health. The MSeHA is also represented on the Statewide eHealth Council, which is attached to the Department of Finance and Administration for administrative purposes. The State chief information officer (CIO) works closely with the Chair of the eHealth Advisory Council to ensure coordinated efforts in the use of healthcare information technology across the State.

Funding

• Agency for Healthcare Research and Quality SRD Contract ($4.8 million)
• State of Tennessee ($7.2 million; tied to AHRQ contract)
• Vanderbilt University (in-kind donation of technology and staff resources)

Data and Functionality

MSeHA is piloting or planning to exchange the following types of data:

• Patient identification/demographics
• Encounter data: date of service, physician, and reason
• Laboratory results
• Dictated Reports
  • Imaging studies
  • Cardiology studies
  • Discharge summaries
  • Operative reports
  • Emergency room summaries
  • History & physicals
  • Diagnostic codes
  • Some medication history (claims)
• Allergies

Initially, MSeHA willprovide the following functions and services:

• Data display (read-only)
  • Clinical and administrative data from multiple sources, including inpatient, outpatient, and the emergency department:
    1. Encounter data,
    2. Laboratory results (many LOINC encoded),
    3. Radiology results,
    4. Dictated reports, and
    5. Some allergy data.
  • Some medication history via claims data; currently working on NCPDP (National Council for Prescription Drug Programs) data

Technical Design and Architecture

The technology is provided by Vanderbilt University, which allows participant to "publish" information in a wide number of formats to a "vault" owned by the publishing entity. Data are sometimes translated into more standardized formats (e.g., LOINC), but the original data are retained as well. Information across vaults is integrated using the business rules of each participant and the overall organization. This approach allows for low participation costs and supports a gradual evolution to standards of true interoperability.

Data is housed at Vanderbilt and pushed via VPN connection. Most is real time; four feeds are batched every 24 hours. The emergency department (ED) is the principal focus for early efforts, because it presents a financial return to participating hospitals. The ED is also a national and statewide priority.

Data Exchange Standards Used

The goal is to lower the barrier of participation by taking data in whatever format is available and translating it into a more standard format. With the use of this standard format and data from across institutions, the value of evolving to these standards will become more self-evident to the delivery community and will be adopted.

• HL7 (Health Level 7) - the project uses version 2.x
• LOINC (Logical Observation Identifiers, Names, and Codes) - the project has normalized approximately 42 labs comprising 65 percent of total clinical labs received. This process is ongoing.