An example of interoperability from a NextGen Healthcare senior R&D manager

Although HIMSS17 seems like a whirlwind ago, the impact of the Interoperability Showcase still resonates. As the dust settles, I wanted to sit down with our Senior R&D manager David Venier to get his insight into one of the User Cases NextGen highlighted. Here is that interview.

User Case 1: NextGen^® Ambulatory EHR clinical workflow in childhood asthma treatment

Scenario:

Angela recently moved to a new state. She must register her daughter Wendy for school and provide health records. Angela must bring her daughter to the emergency department during an asthma attack.

This scenario demonstrated some of the following: Document sharing, discharge summaries, medical summaries, medication administration, public health, structured data capture.

Data Sharing Connections

HIE, community, primary care provider, emergency department, public health, peds, chronic care management

NG: What was the goal in this user case scenario?

The goal of this use case was to show how a patient could transition from their current care environment to a new environment in a new state. When entering their new care environment, the patients' previous healthcare provider could communicate with her local healthcare providers and organize care. Once the provider communication is complete, the use case picks up to show how data can be exchanged across the internal environment of a hospital as well as the patient being transitioned out of the inpatient environment for treatment and follow up by her new primary care provider. Through the scenario, the connected systems we are able share data captured in their respective systems and make that data available for use in the other connected systems. This allowed us to show how we can use the data captured by other systems to improve the care of the patient in disparate treatment environments.

NG: What connectivity points were the most challenging to pull in?

The connectivity points which were most challenging to pull in do not relate to the high-level specifications regarding exchange of data but rather the low-level information which systems read from those exchanges. By using IHE standards NextGen was able to work as a plug and play system within the environment demonstrated. However, when doing the data exchange to show how the clinical information could be extracted from a C-CDA document and imported as discrete data in our EHR, we had to spend time with the other connected systems to make sure the proper terminology codes were used for the data exchange. Once this was done, all systems could use the IHE standards to exchange the data and then the HL7 CDA standards for the clinical data extraction.

NG: What was the crowd response?

As we performed the demonstrations and had a chance to interact with the people who were viewing it, they were impressed with how easily the data can flow from one system to another and the way that users can interact with that data to make it actionable discrete data in each of the systems that were connected. It is one thing to exchange documents between connected systems but it is the ability to take those documents, extract relevant clinical data from them, and import that information into a system that makes the promise of data exchange a value add to users. As the final stop in the use case we were able to show how this can work and the benefits of pulling in medications and allergies discretely (along with other data) to be used for drug interaction checking when prescribing new medications. When people saw this portion as the culmination of the use case it helped in the understanding of why these types of exchanges can be valuable.

NG: Were there other User Cases?

Additionally, in the HIMMS interoperability showcase, we participated in the "Accountable Care – Opioid Management"" and "On the Road to Cancer Care 2020" use cases. Through our use cases, our goal is not only to demonstrate how the NextGen EHR can operate within the boundaries of the use case, but to demonstrate at a community level how NextGen is committed to finding ways to improve care for patients. As we look forward to HIMSS 2018 we will be analyzing the use cases available and will select and join those which we feel can help us perform the demonstrations to the ends previously mentioned.

NG: What were the biggest takeaways?

As we look back on our participation in this use case and the other uses cases we participated in, our impression is one of community. The Interoperability Showcase is an environment of knowledge sharing and openness between all participants. Each year we have the opportunity to be part of the use cases, we see similar people every year and through this process make great contacts not only with the vendor community but also with those we are trying to serve. This provides us with a wonderful environment which can hopefully effect positive change in the industry. As we move forward we look to continuing our participating in the Interoperability Showcase and using this process to not only improve our products in the interoperability landscape but improve ourselves through our interaction with all individuals we encounter.