Secure Architecture For Exchanging Health Information

Secure Architecture For Exchanging Health Information

Protecting Privacy   /  Saving Lives 

History and Technology of SAFE Health

SAFE Health was conceived in the summer of 2003 by the leading healthcare organizations in Central Massachusetts who have a history of partnerships and collaboration.  In 2004 we received a $1.5 million grant from the Agency for Healthcare Research and Quality (AHRQ), a division of Health and Human Services, which facilitated the development of SAFE Health.  Larry Garber MD, an Internist and Medical Director for Informatics at Fallon Clinic, is the Principal Investigator for this grant. Val Slayton MD, MPP, MBA is the Chief Medical Officer of HealthAlliance Hospital and their Principal Investigator on the SAFE Health project. Our intent under SAFE Health is to improve clinical outcomes, maximize patient safety, enhance service to patients, and reduce healthcare costs while maintaining patient privacy and security. 

SAFE Health uses a unique architecture that has been internally developed at Fallon Clinic, winner of the prestigious 2009 Association of Medical Directors of Information Systems (AMDIS) Award.  Clinicians from Fallon Clinic and UMass Memorial Health Care System (including HealthAlliance Hospital Leominster campus which was recently named as one of the "Most-Wired" hospitals in the United States) in collaboration with Fallon Community Health Plan (FCHP) have been extensively involved in defining the clinical requirements to be satisfied by this technology.  SAFE Health utilizes a unique hybrid consent architecture to leverage the advantages of patient opt-in consent for “pulling” of aggregated patient information, as well as the Notice of Privacy for “pushing” patients’ clinical information for order/result transactions.  This novel authorization model maximizes the appropriate flow of clinical information between distributed federated databases (proxy edge servers) and integration with Electronic Medical Records (EMRs) and existing physician workflows. The system is also capable of handling the consent of minors that automatically expires on their 18th birthday, as well as for emancipated minors that don't have an expiration date. 

SAFE Health uses a central Enterprise Master Person Index with name normalization and probabilistic matching to minimize the chances of mismatching patients between organizations.  The system also has extensive audit trails to help monitor patient privacy.

SAFE Health is currently live with patient consent-controlled exchange of healthcare information between Fallon Clinic and HealthAlliance Hospital Leominster campus Emergency Department. This includes visit notes, medication list, allergies, problem list, immunization history, code status, advance directive status, Primary Care Physician (and phone number), vital signs, and recent test results. Fallon Clinic also is "pushed" test results and discharge summaries from St. Vincent Hospital and Milford Hospital.  All of this clinical information files directly into the EMRs so that physicians need look no further than their EMR to find out their patient's medical history and test results.

SAFE Health incorporates a self-sustaining business model based on the low cost of future implementations and maintenance of the Health Information Exchange that results from internally-developed software using the Microsoft .NET Service-Oriented Architecture.  

Timeline

July 2003 - SAFE Health conceived

October 2004 - $1.5 Million AHRQ Grant awarded

May 2005 - SAFE Health testimony to Senator Moore's Massachusetts Joint Committee on Healthcare

June 2005 - Presentation at AHRQ's Patient Safety and Health Information Technology Conference

June 2005 - Testimony to the NCVHS Privacy and Confidentiality Subcommittee

November 2005 - Presentation at WEDI 2005 on "Payer's Role in RHIOs"

January 2006 - Presentation at "Developing the Quality and Business Case for a RHIO in Utah"

November 2006 - Presentation to Idaho Senator Compton's Health Quality Planning Commission

February 2008 - Presentation at Mass Health Data Consortium's Healthcare IT Conference

March 2009 - Presentation at HealthAlliance Hospital Grand Rounds

April 2009 - Presentation to the Mass Medical Society Committee on Information Technology

April 2009 - Testimony to the Mass  Healthcare IT Council

June 24th, 2009 - SAFE Health went live, starting to transfer clinical data with patients' consent between Fallon Clinic and HealthAlliance Hospital Leominster campus Emergency Department