Data Expansion

IAIMS funding for I3 will be used to implement designated technical aspects of the information management system, drive utilization and resources, create visibility and awareness for the project, create a community of interest and, perhaps most importantly, build on our existing community wide participation to continue to evolve the project into a third generation IAIMS.

Enhance Global Doctor File

The Project Director will work with the hospitals (medical staff office, laboratory and radiology) and physician groups to obtain copies of their master files on a regular basis. The data manager will use these files along with other sources including the Health Professions Bureau database, yellow pages, the county and state medical society databases, commercially available databases and direct contacts with office staff to maintain an up-to-date, comprehensive database of all physicians in the community that includes contact information and accessible information resources. We will take advantage of evolving work around the national provider identifiers and associated structures announced by HHS as a final rule (23-January-04).

The Global Doctor File is essential for enhanced results reporting, Context Sensitive Information/Access to Knowledge Resources and for the public health alerts. Without complete and accurate global doctor file information, we won't be able to deliver data to the ordering provider for enhanced results reporting or to the right class of providers for the public health alerts. A complete and accurate global doctor file is particularly important to the Context Sensitive Information/Access to Knowledge Resources since it controls which resources the provider has access to.

We will track the number of records added or updated. We expect that 99% of all physicians in the MSA will have complete up-to-date data in the global doctor file by the end of year two.

Expand Outpatient Pharmacy Data

Expanding Outpatient Pharmacy Data requires negotiating a contract with RxHub which is nearly complete and then creating an interface to the RxHub resource which will be completed during the first half of year 2 with some ongoing support and maintenance in years 3 and 4.

Facilitates the enhanced results reporting (need the drug data to include on the report), also provides additional opportunities for fostering access to context sensitive information since drug information is the most often sought.

We expect that 60% of patients will have a medication history available through RxHub. We will track the number of patient encounters for which we can retrieve a drug history.  We anticipate (with separate funding) studying the effects of various interventions to improve formulary compliance and patient safety using this data.

Data from Provider Practices

Most large practices (over 70% of all practices and 95% of large practices according to our survey) use electronic scheduling and billing.  We will utilize outbound HL7 interfaces where available, but rely on "report" or batch data capture where necessary. In addition, we will configure and train them to use the JAVAGrabber to enter their reports into the system.

Use of a clinical information resource is, in part, dependent on the data available in the resource. We will create interfaces to these systems in order to (a) capture a minimal data set about ambulatory encounters, provider, location, ICD-9 coded diagnoses, CPT-4 coded procedures, visit level and reason for visit when available and (b) capture information about upcoming appointments in order to establish that a physician and patient have a clinical relationship.

Our goal is to capture encounter data from 90% of targeted primary care practices. We will focus on specialty care encounter data one specialty at a time starting with cardiology as we are able. We will track the number of practices interfaced and the volume of encounters for which data are stored.

Links to Hospital Portals

Most hospitals have developed a "portal" strategy and are promoting their portal as the primary physician access method to the system. In order to simplify physician access we will provide links from the capable hospital portals to the system without requiring providers to authenticate themselves again.