PROJECT BRIEF: Health Information Network of South Texas

Sponsor(s)/Contact(s): Organization Name and Contact Name

Primary Sponsors:
CHRISTUS Heath and the Texas Health Information Network Collaborative (THINC), the FCC Rural Health Care Pilot Program for Texas, both represented by Hank Fanberg, executive director of THINC and system director of technology advocacy, CHRISTUS Health (hank.fanberg@christushealth.org).

Additional sponsors include the regional HIE for South Texas, the Health Information Network of South Texas (HINSTx) and Driscoll Children’s Health Plan, both represented by Mary D. Peterson, MD, CEO, Driscoll Children’s health Plan and Chair, HINSTx.


Objectives


Description

  • CHRISTUS Health, HINSTx and THINC plan to deploy the full NHIN Direct infrastructure, leveraging the regional HIE and referral patterns to demonstrate the user stories selected for our pilot
  • Medicity will provide the required SMTP backbone and other components.
  • Support for our NHIN Direct project will come from the Nueces County Medical Society, the Driscoll Children’s Health Plan, County Public Health officials and the Coastal Bend Community Diabetes Collaborative. These organizations do not exchanging health information but are critical to attaining community wide support and physician support of the project.
  • The regional HIE, the Health Information of South Texas whose board of directors includes representatives of the aforementioned organizations will be closely involved in the project as well. Enabling point-to-point exchange of structured information is a first step for our regional HIE.
  • The potential geography is great, as we plan to connect to Level I trauma centers in San Antonio, some 120 miles away. We also plan to connect with subspecialties that are lacking in our geography.
  • CHRISTUS Health currently uses the Novo Grid to send lab results to members of the medical staff and has enabled bi-directional ordering capabilities as well. The lab results protocols will need to accommodate and conform to the NHIN Direct standards.
  • South Texas health status surveys by the Department of State Health Services indicate that the area exceeds both state and national norms for the incidence of diabetes, childhood obesity and heart disease. Texas leads the nation in the number of uninsureds and the percent of its population enrolled in Medicaid. Many areas of South Texas are designated as medically underserved and health manpower shortage areas. Family income is lower than the national and state average.



Participants

  • Medicity is the HISP for this project
  • CHRISTUS Health Spohn Region, six hospitals: three urban and three rural
  • Texas Health Information Network Collaborative (THINC), the FCC Rural Health care Pilot program for Texas, provides broadband connectivity to rural health facilities
  • Driscoll Children’s Hospital
  • Driscoll Children’s Health Plan
  • Corpus Christi Medical Center (Four hospital health system)
  • Health Information Network of South Texas, the regional HIE
  • Various primary care providers especially family medicine and pediatricians. Commitments from seven primary care providers and two specialty groups have been obtained. We plan to expand that number as we move forward.
  • The specialty practices are cardiology and endocrinology
  • Level II Trauma Center Hospital Emergency Department as many referrals to physicians originate from the hospital ED.
  • State of Texas Newborn Registry
  • EMR vendors of the various practices which include:
    • AthenaHealth
    • eClinicalWorks
    • NextGen
    • EncounterPro





Resources Anticipated Being Available for Pilot

  • HISP Services provided by Medicity
  • Internet connectivity support from HINSTx, THINC and CHRISTUS Health
  • Interface engineer support from CHRISTUS and Medicity
  • EMR vendors adoption of NHIN Direct reference code
  • Regional HIE HINTSx will provide program management support and community support
  • Additional support from national vendors to be determined




Success Metrics

  • Successfully exchange information using NHIN Direct protocols to connect between primary care providers and specialists, specialists and the hospital, the hospital emergency department and primary care and specialty providers in support of meaningful use
  • Incorporate patient participation through the deployment of a PHR
  • Percent of referrals from the primary practice to other providers that are sent electronically using NHIN Direct
  • Percent of lab results send from hospital to physician electronically using NHIN Direct
  • Subjective survey of physicians regarding the impact of automating referrals, discharge summaries and reporting new born test results to the State of Texas’ newborn registry.
  • Attempt to quantify financial impact to providers and to the community
  • Number of transactions per physician
  • Number of transactions by type
  • Ability to enable providers to meet meaningful use stage 1 criteria (specific measures to be determined)
  • Timely information shared among maternity and newborn services







Other Information

Key Stakeholders

The geography for our pilot program is South Texas, with its center being Corpus Christi. The area south and west of Corpus Christi is rural or frontier, extending to the US border with Mexico. The population is majority Hispanic. Corpus Christi’s highest level of acuity is Level II Trauma. Level I Trauma is available in San Antonio, 120 miles to the Northwest. San Antonio is home to one of the nation’s largest concentration of US military bases including WiIford Hall.
CHRISTUS Health is the largest not for profit health system in Texas and the most diverse.
Key providers include:
1. CHRISTUS Health Spohn Hospitals (6 hospitals, three urban and three rural)
2. Driscoll Children’s Health Network ( 1 children’s hospital and a network of 45 pediatricians, two-thirds of which are rural)
3. Corpus Christi Medical Center Corp (four hospital health system)
4. Cardiology practice, urban
5. Three Pediatric practices, two urban one rural
6. Four family medicine practices, two urban and two rural
7. Three Obstetricians
8. Hospital based laboratory and radiology services
9. Hosptital emergency departments
10. Local pharmacy chain
11. U.S. Navy Clinic, urban
12. Endocrinology group in San Antonio, urban
13. Wilford Hall (not confirmed) US Military hospital in San Antonio
14. State of Texas Newborn Immunization registry
Key Technology enablers include:
1. Medicity as HIE partner and HISP
2. GE Centricity EMR
3. EClinicalWorks EMR
4. NextGen EMR
5. AthenaHealth EMR
PUBLIC ORGANIZATIONS:
1. Health Information Network of South Texas, a regional designated Texas HIE
2. Texas Health Services Authority
3. Gulf Coast (TX) Regional Extension Center
4. West Texas Regional Extension Center
5. State of Texas Newborn Registry
6. Health Access San Antonio, a regionally designated Texas HIE
KEY INTEREST GROUPS
1. Nueces County Medical Society
2. Texas Medical Society
3. Texas Hospital Association
4. Texas Catholic Hospital Association
5. Texas Health Services Authority
6. Coastal Bend Community Diabetes Collaborative