Integration with Microsoft HealthVault
We provide a standards-based gateway service that allows for the easy integration with third-party PHR systems. Specifically, we have a bi-directional gateway for integrating with Microsoft HealthVault. Through this gateway multiple HealthVault compatible systems can exchange data with the HIE. This gateway allows for provider systems to interact with HealthVault using standards-based protocols HL7 and XDS.b. We also separately built a gateway for Cerner Healthe PHR, if such capability is required in the future.
Microsoft HealthVault is one of the most widely used PHR platforms in the country. To date, 50 devices have been enabled, and 70 live applications connected— services on top of HealthVault—PHRs, alert services etc. Over 130 organizations have signed agreements to participate with HealthVault, including leaders such as Aetna, Kaiser Permanente, CVS Caremark, Cleveland Clinic, Mayo Clinic and the Military Health Systems. The HealthVault software developer’s kit has been downloaded over 19,000 times. Additionally, over 600 organizations attended our inaugural Solutions Conference for partners interested in delivering HealthVault-enabled solutions.
With the HealthUnity GHIN administrator tool, the HIE Operator can designate the PHRs that are permitted on their HIE. Then, each provider (edge node) will be permitted access to the appropriate PHR system. This provides a clean, controlled environment that the HIE Operator administrators will appreciate.
We support XDS.b transaction support between the HealthVault PHR and the physician’s EHR.
We support automatic routing as well as other models. Almost immediately upon initial sign up, we send a set of records to the PHR. Thereafter, we can send incremental addenda to these records. We also have a facility to force a full synchronization between EHR / Edge device data and the PHR. Our sophisticated algorithms enable scaling of the system as hundreds of thousands of users access the services.
- Patient initiated prescription renewals
- Sharing of laboratory results with patients
- Online scheduling of appointments
- Billing inquiries
- Consent Management
- Web-visits or other secure, asynchronous communication between patients and their physicians
- Ability for authenticated PHR users to query the HIE
- Ability for providers to identify and push information to patients with specific conditions and diseases
| Patient initiated prescription renewals | Yes, and we can integrate this with your eRx vendor’s solution |
| Sharing of laboratory results with patients | Yes, this can be done in a fully automated mode or by introducing a fixed delay (e.g. 7 days) |
| Online scheduling of appointments | Yes, as a scheduling request. The reason is that providers in the U.S. are reluctant to share their free busy information. |
| Billing inquiries | Yes, through a structured form. |
| Consent management | Yes, the most extensive model in the industry. The individual will be able to see all the providers that he can get data from and also specify the exact list of providers who he permits to have access to his HealthVault data. |
| Web-visits or other secure, asynchronous communication between patients and their physicians | Yes, with our secure messaging infrastructure we can enable this. |
| Ability for authenticated PHR users to query the HIE | Yes, users can query the HIE nodes that have been authenticated and linked. |
| Ability for providers to identify and push information to patients with specific conditions and diseases | Yes, this is typically performed at the EHR level. We also provide some basic capability. |
Remote identity proofing and authentication of PHR users
Remote identity proofing and authentication of PHR users is handled via several built in models. We support three models. The first model involves the patient first registering at the PHR and then requesting access to his records. The requests are queued at the provider edge node. After the request is authenticated and approved by the provider admin, data starts flowing to the PHR. We successfully implemented this model with HealthVault and the Erickson Health Record Bank in Maryland.
In the second model, the patient is invited via an email to a preset email address. The email invitation takes them to the PHR website. Here, the patient answers a set of challenge questions before she can get access to the records. This model was implemented by HealthUnity at LifeBridge Health, St. Agnes hospital with Cerner Healthe PHR.
The third model involves issuing the patient an alpha numeric code along with a secret question at the point of care. The patient takes this information and enters it at the PHR for completing the sign up. A variation of this model has been implemented at the New York Presbyterian Hospital and Health System.
Restricting information flow to or from the PHR
We support several distribution models of clinical data to PHRs built on HealthVault. Before any distribution can happen, an authenticated link should be established between the provider’s EHR chart and the patient’s PHR chart.
- Automated publishing
- Delayed publishing (e.g. lab results that are adverse)
- Case by case publishing
- Summarized Reports publishing
Consumer direct online control over consent
In the context of data shared to and from the health record bank. In the case of a direct provider to provider HIE, we do not recommend enabling the consumer to have direct online control over consent. The providers with whom we have worked are not comfortable with patients directly manipulating consents given at the provider’s site due to legal and regulatory requirements. In this case, we provide a robust consenting solution for their staff to administer. The common actions administered are: consent grant, consent deny and consent revoke actions with appropriate documentation.
Clinician-to-clinician Secure Messaging
The core HIE includes clinician-to-clinician messaging support. Secure messages may include attachments (such as files) as well as structured documents from the Edge Server repository. We provide a simple user interface that is quick to learn so users become productive almost immediately. The address book of secure message participants is managed in the GHIN administrator tool. We support several hundreds of features in secure messaging. To highlight two of these: We support delegation when a physician is on vacation, and support a message box that can be simultaneously viewed by multiple people (e.g. front desk staff all viewing the same queue of messages coming from other providers).