Project Title: Advanced FHIR Capabilities for Advance Care Planning Use Cases to Improve Patient Care
Applicant Name: Western New York Clinical Information Exchange, Inc. (DBA HEALTHeLINK)
Address: 2475 George Urban Blvd., Suite 202, Depew, NY 14043
Contact: Daniel E. Porreca, President/CEO
Phone: 716-206-0993 Email: firstname.lastname@example.org
Area of Interest 1: Exploring the Use of Advanced FHIR Capabilities
Purpose: HEALTHeLINK will demonstrate advanced FHIR capabilities to solve the complex problem of having advance care planning documents aggregated from disparate sources so they are accessible electronically at the point care. Patients’ wishes for medical care (called Advance Directives, ADs) are needed if patients cannot speak for themselves The New York State Department of Health defines AD documents as Health Care Proxy, a Nonhospital Order Not to Resuscitate, and Medical Orders for Life Sustaining Treatment (MOLST). Studies have shown that less than one third of critically ill Emergency Department patients have ADs to guide end-of-life treatment in accordance with their wishes.
Scope: HEALTHeLINK is the NY State designated regional health information exchange (HIE) for Western NY that uses FHIR standards for interoperability and exchange of patient information. The HIE architecture allows for storage and forwarding of data in a unified data infrastructure using the FHIR standards. This architecture allows for the exchange of data via a FHIR gateway.
Goal: Accelerate the adoption of advanced FHIR capabilities by demonstrating HIE Interoperability AD use cases. Objectives:
1: Demonstrate Advanced FHIR for the Onboarding Use Case to aggregate AD meta data and ADs in pdf from existing sources (primary care practices and hospitals) through integration with EHR vendors.
2: Demonstrate Advanced FHIR for the HIE/Interoperability Use Case.
3: Demonstrate Advanced FHIR Real Time Query by adding new AD data sources, such as eMOLST (NY State repository), and My Directives (national AD repository).
4: Demonstrate Advanced SMART on FHIR App and FHIR API Endpoint Use Case (EHR or HIE portal) with primary care providers, hospitals, hospices, and EMS personnel.
5: Demonstrate Advanced FHIR Real Time Trigger for Emergency Departments and Real Time Query for Emergency Departments, Pre-Visit Planning, and AD Use Cases.
6: Develop HIE AD data analytics and reporting for population health activities, research, and targeted community education to increase AD use and reduce disparities.
Results: HEALTHeLINK will demonstrate benefits from the use of the advanced FHIR features, software development using open source code, implementation, testing, and piloting under real-world conditions. Deliverables include: 1) Demonstration of advanced FHIR interoperability capabilities to meet the five use case specifications and enhance AD access at the point of care. 2) Documentation of the software requirements and associated artifacts of the advanced FHIR capabilities to support replication in other development environments. 3) Publication, and dissemination of a report on the selected advanced FHIR capabilities and readiness for industry-wide adoption. 4) Development of reporting analytics for population health, community education and health disparities research. Efforts will accelerate the adoption of advanced FHIR by illustrating the value of the HIE for solving complex problems in health care interoperability.
Key Words: Advanced FHIR, Heath Information Exchange, Advance Directives, Health Disparities.