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GE Healthcare Building Connected Communities: Interoperability for Integrated Care HIMSS 2013 Interoperability Show Case Agenda: Building connected communities • Digitization & Connectivity of Data: Accessing and integrating information from multiple sources – We need interoperability standards! • Connecting your data is not enough: You need to connecting your process and culture – Building your value based delivery environment • Building Connected Communities : Where GE is heading 2 Care Management Models 5/24/2017 GE today GE Capital GE Energy Oil and Gas Healthcare Energy Management Aviation Power and Water Transportation Home and Business Solutions 3 Care Management Models 5/24/2017 GE Healthcare IT & Performance Solutions • A leading provider of IT solutions for hospitals, specialty departments, and physician practices • Headquartered in Barrington, IL with over 4500 employees operating in 57 offices world-wide • A part of GE Healthcare a $17B unit of GE (NYSE: GE), a diversified infrastructure and finance company taking on the world’s toughest challenges 4 Care Management Models 5/24/2017 Healthcare Challenges 5 Care Management Models 5/24/2017 The Clinical Knowledge-Processing Burden “Current medical practice relies heavily on the unaided mind to recall a great amount of detailed knowledge – a process which, to the detriment of all stakeholders, has repeatedly been shown unreliable” Knowledge processing requirement This gap injures patients Knowledge processing capacity Crane and Raymond The Permanente Journal Winter 2003 Volume 7 No.1 Kaiser Permanente Institute for Health Policy Many years ago Today 6 Care Management Models 5/24/2017 Healthcare is facing a perfect storm Big Data Workflow Cloud Mobile Vocabularies Rise of disruptive and acceleration technology represents threat or opportunity Collaboration High levels of legacy and proprietary technology Product rather than care specific orchestrations Current state fosters low productivity with high cost of customer ownership HTML5 Learning & NLP Virtualization Inability to address Enterprise/Regiona l and CXO/RHA needs Complexity/TCO from overlapping products and technology Future demands a different game plan … from business models to product boundaries and technology 7 Care Management Models 5/24/2017 Agenda: Building connected communities • Digitization & Connectivity of Data: Accessing and integrating information from multiple sources – We need interoperability standards! • Connecting your data is not enough: You need to connecting your process and culture – Building your value based delivery environment • Building Connected Communities : Where GE is heading 8 Care Management Models 5/24/2017 Why Participate in Standards? The Health IT market is not dominated by any one vendor. Any where we go, our products need to interoperate with other: • Modalities • RIS and PACS • EHR and Departmental Systems • Analytics • Clinical Decision Support 9 Care Management Models 5/24/2017 Emerging Trends in Standards 1. Patient Engagement • e.g., View/Download/Transmit 2. Mobile Health • • Largely driven by Patient Engagement But also telemedicine and remote monitoring 3. Analytics • • Quality Measurement Critical for Accountable Care 10 Care Management Models 5/24/2017 INTEGRATED CARE: Far beyond an inpatientcentric model … Integrated Care “Promise” “Practical” market problems Evidence-based care Hospital Patient engagement Quality measurement & improvement Future needs? Ambulatory Payer Consumer Fiscal management Care coordination workflows Population health … new healthcare delivery ecosystems required 11 Care Management Models 5/24/2017 Holistic approach to Data Knowledge Workers Knowledge Repository Maps HL7 XDS ATNA PIX PDQ CDA Models Rules Constraints Queries Forms Multi-Patient View Multi-Patient View Interface Manager 1 Interface (e.g. HL7) to Model Transforms 2 Standard Models & Terminology Codes Coded, Computable Clinical Data Terminology Translation, Decision Support & Business Rules 3 Unified Data Repository of Models & Terminology Based Data Applications Assembled from User Generated Alerts, Queries and Forms 4 5 Configured by Knowledge Workers Shareable & Reusable Assets OPEN SOA Architecture Overview Our approach is anchored by an OPEN Services Oriented Architecture which allows applications and internal components to be loosely coupled while interacting with Infrastructure, Business, and Interoperability Services Patient Registry Security & Auditing Provider Registry Workflow Location Registry Content Managemen t Interoperability Services Business Services Infrastructure Services Analytics & Reporting Session Managemen t Diagnostics & Monitoring Decision Support Terminology Patient Admin HL7 Messaging Clinical Data Services Document Services SOA with embedded Enterprise Service Bus (ESB) Lab Informatio n System Lab Clinician Hospital / Physician Office EMR Radiology Informatio n System Physician / Provider Radiologist External Application ESB Access Point Qualibria Component Pharmacy System Pharmacist Patient Review & Visualizati on Future ContentDriven Apps Physician / Provider Point of Service Qualibria Component ESB Access Point Qualibria Application External Application Physician / Provider Transforming data into insight: Advanced processing & Information fusion Clinical Data Fusion - Terminology Services: The Terminology Foundation contains services and rich management tools for code mapping, browsing and querying: •Load external code systems, including: SNOMED-CT, LOINC, ICD-9, ICD-10, CPT, RxNorm, HL7 Vocabularies, HCPCS, Genomics Ontologies, NCI Metathesaurus, Open Biomedical Ontologies, etc. Many entry forms for one concept • • • • myocardial infarction MI S/P MI 1987 hx of heart attacks 4500 Elemental terms available today Centricity Practice Solution (EMR) Research: MQIC is a unique, de-identified patients – aimed at helping identify and inform industry best practices MQIC Database 30 million patient records 173 million office visits 1.3 billion documents • • • • Benchmark a case, or your practice, against nearly 30 million unique patients Identify financial inefficiencies and opportunities to help reduce costs helping identify and inform industry best practices Designed with physicians for optimal efficiency Imaging IT and HIE: GE with our CARADIGM partnership Metrics Government Agencies Data Analysis Reporting Tools Patient Consent Patient eHealth Community Desktop (HIE & DICOM Viewer) Radiologists Prior Studies eHealth Registry 2.0 Hospitals Images & Reports (XDS Registry) CentricityTM Enterprise Archive 4.0 (DICOM Archive & XDS Repository) Master Patient Index Images & Reports General Practitioners Specialists Imaging Centers 16 Care Management Models 5/24/2017 CENTRICITY CLINICAL ARCHIVE 17 Care Management Models 5/24/2017 Agenda: Building connected communities • Digitization & Connectivity of Data: Accessing and integrating information from multiple sources – We need interoperability standards! • Connecting your data is not enough: You need to connecting your process and culture – Building your value based delivery environment • Building Connected Communities : Where GE is heading 19 Care Management Models 5/24/2017 Connecting your data is not enough: You need to connecting your process and culture Capacity Safety Performance • Reducing variation • Reducing adverse events • Managing costs • Balancing supply and demand • Increasing transparency and accountability • Improving workflow • Developing leaders • Creating a culture of continuous improvement Asset Management Care Delivery • Improving utilization • Moving from care silos to systems • Increasing staff productivity • Reducing operating costs • Continuous population management • Integrating clinical decision support and informatics 20 Care Management Models 5/24/2017 GEPS: Connecting your data is not enough: You need to connecting your process and culture Capacity Management Transform the flow of patients to optimize utilization and decrease cost GE Healthcare Performance Solutions Strategy, Leadership & Performance Transformation Create market leaders by activating strategy and unlocking potential Asset Management Enable immediate asset availability at high utilization to support patient care Advanced Analytics Pinpoint and help mitigate the risk of patient harm Enabling Technologies Patient Safety Clinical Transformation Enable redesign and transformation of care delivery 21 Care Management Models 5/24/2017 GE Interoperability: IHE Bone Health Radiology PACS, Mammography and RIS Surgical & Clinical Information Systems Nuclear Medicine & PET IHE Computed Tomography (CT) Nuclear Medicine & PET IHE X-ray & Mammo Acquisition Systems IHE Ultrasound 22 Care Management Models 5/24/2017 Agenda: Building connected communities • Digitization & Connectivity of Data: Accessing and integrating information from multiple sources – We need interoperability standards! • Connecting your data is not enough: You need to connecting your process and culture – Building your value based delivery environment • Building Connected Communities : Where GE is heading 23 Care Management Models 5/24/2017 Quality of Life Building Connected Communities: Shift Left The Continuum of Care>>> Highest Questions? Quality of Life Lowest Cost of Care Health & Wellness Home Care Residential Care Acute Care Cost of Care