ICA  

Situation Analysis:

1. The Memphis area in west Tennessee is a highly competitive health care market with the largest concentration of underinsured and uninsured individuals in the state. The safety net population represents 37% of all patients within the metropolitan and surrounding areas, putting a significant strain on the state-run TENNCARE Medicaid program.
   

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2. The hospital emergency departments and clinics were struggling to provide quality care in the absence of patient history and knowledge of chronic conditions and current medications. This created an environment where diagnostic tests were being replicated, potentially unnecessary treatments were being ordered, and costs to clinics and hospitals were increasing, as were administrative tasks.
   

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3. The Memphis health care facilities include 16 hospitals with 14 emergency rooms and 16 primary care sites, with clinical information residing in a diverse set of health care information systems, including:

Approach:

The community health leadership and the state of Tennessee recognized the need to improve outcomes; reduce hospitalizations; eliminate unnecessary diagnostic tests; reduce number of ED visits; control costs; and allow primary care physicians greater patient care management. In collaboration with Vanderbilt Medical Center”s Regional Informatics team under an AHRQ grant, a plan was developed to gather individual data from participating entities, create a useable integrated format, and deliver the information back to the hospital and ambulatory clinics. The informatics team developed a solution as a demonstration project and provided support for several years. However, there was a need to export the solution to an isolated environment outside the infrastructure of the Vanderbilt Medical Center”s data center. The MidSouth eHealth Alliance chose ICA to build that environment and port the application and data to a secure hosting facility.

Solution ICA Developed for the Client:

ICA has created an aggregated database environment which is accessible at the point of care for all participants in the MidSouth eHealth Alliance (MSeHA) via a secure, two factor authenticated, Web-based portal. This portal provides patient identification and demographic data, encounter data, discharge data, dictated reports, lab results, radiology reports, medication history and other pertinent clinical results. The data is received, parsed and housed in each participant”s own secure data vault, and is matched according to patient identifiers across the MSeHA environment. The patient-matching feature allows a consolidated, longitudinal patient record to be created from across the individual, secure data vaults through a single user interface to the point of care.

ICA created and hosts the environment in a secure facility and maintains all aspects of the application”s operations, including network connectivity, firewalls, physical security, maintenance, data backup and failover capabilities, as well as disaster-recovery preparedness and business continuity.

Impact of the ICA Solution:

Accomplishments to Date:

1. An aggregated longitudinal medical record is available at all 14 emergency departments and all participating primary-care locations.
2. The aggregated database now exceeds 3+ years of data.
3. Data is now readily available for use by approved MidSouth eHealth Alliance members when treating/caring for patients.
4. Current statistics include more than 2.1 million total records contained in the MSeHA database; 3.9 million encounters (140,000/month); 1,050,000 total patients; 370,000 monthly ICD-9 discharge codes; and 2.4 million monthly lab results.

Rollout of other capabilities will include:

1. MidSouth eHealth Alliance is successfully using the CareAlign™ Suite throughout their members and they are continually looking to add additional value to the project through expansion and functionality roll out.