Why is an interoperability platform even necessary?
Healthcare providers have typically deployed a wide range of clinical technologies from different vendors, each with its own structure, nomenclature and underlying logic. While this strategy allows the organization to select best-in-class applications, patient data is not easily exchanged between these incompatible systems. The need for an interoperability layer will only increase as hospitals and IDNs expand, participate in ACOs, and join regional, state or national health information networks.
How is the technology able to aggregate data from so many different systems?
The dbMotion semantic interoperability platform’s infrastructure incorporates data from multiple sources in a variety of formats, and harmonizes the data into a uniform, aggregated, usable structure. Once the information is available in this foundation, dbMotion can display or share it with other applications or relevant consumers. This level of flexible information exchange successfully positions healthcare organizations to address current and future healthcare challenges, such as Meaningful Use compliance, quality measures and disease management.
Can we still utilize our EHR?
Yes. The dbMotion platform is not intended to replace the EHR or other clinical technologies. It can be configured to operate in the fore- or background, allowing clinicians to navigate within their preferred EHR solutions. If the user desires, he or she can use dbMotion’s Clinical Views, Collaborate or EHR Agent – user-friendly, intuitive, customizable applications that display integrated patient records at the point of care.
How can the system help clinicians improve care quality?
By providing real-time information from multiple facilities at the point of care, the dbMotion Solution improves caregiver decision-making, reduces the margin for error, increases patient safety and enables quality healthcare. It facilitates data exchange for many activities including electronic prescribing, lab result reporting, disease registries, quality data submission and medication management; continuity of care record (CCR) data exchanges; and patient/provider communications. dbMotion promotes enterprise-wide collaboration of caregivers and care settings for improved clinical outcomes, quality patient care and health system effectiveness.
How does the dbMotion Solution support population health efforts?
dbMotion enables proactive patient population monitoring and care with a virtual patient record that supports disease management and public health initiatives, facilitates quality measurement and tracking, reduces disparities, and enables care management and outreach. The platform enables physicians to perform health surveillance in real time and target dynamic patient populations that require ongoing monitoring and management. It also provides automatic alerts and notifications of patient statuses, and generates patient lists categorized by specific conditions.
How does dbMotion control the flood of information delivered from many different EHRs?
The system structures views based on user profiles, personal preferences, and advanced sorting and filtering functions. It offers a wide range of viewing formats for facilitating care such as aggregate views (summary pages, annual reviews, etc.), and detailed drill-down views into each medical domain (allergies, medications, etc.).
What is the EHR Agent?
dbMotion’s EHR agent identifies important data that is missing from the local EHR and could be useful during an encounter such as an imaging test or alert or allergy notification. Operating in the background, the system queries the entire HIE workspace—EHRs and data repositories at other sites—for usable information that can help complete the patient record. If relevant information is found, a visual indication appears in the clinician’s view. With one click, the provider can see an “exception view” and choose to import the data into the local EHR and incorporate it into a real-time clinical decision.
Can the system be configured to fit within a clinician’s workflow?
Yes. Powerful applications like the dbMotion EHR Agent and dbMotion Collaborate streamline daily clinical workflows and facilitate coordinated care and clinical collaboration. They help clinic- and hospital-based physicians manage patients, review patient statuses, plan patient care, and communicate and share patients’ medical events – from within their existing workflows.
How are privacy and security concerns addressed?
The platform’s security layer defines the aggregate of technical and administrative safeguards that prevent prohibited access to electronically protected health information (ePHI) by unauthorized parties inside or outside the organization. Its comprehensive approach to security management includes authorization, authentication, patient consent and secure data transfer, and sophisticated business processes can be applied to define information access. Its services are used throughout the system’s layers, with safeguards implemented through sub-systems, each dealing with a different aspect of information security, enabling adherence to a broad array of security standards including HIPAA.
Can an interoperability platform create clinical efficiency?
Yes. With patients’ entire medical histories at their fingertips, physicians and nurses will spend less time searching for patient information, allowing them to focus their time more effectively on direct patient care. With information readily available, delays are minimized, which accelerates the care cycle and improves patient care delivery. And by reducing redundant and unnecessary testing—helping meet quality measures and reimbursement guidelines and increasing physician and patient satisfaction—the solution promotes unprecedented levels of coordinated care.
How does dbMotion create integrated patient records?
dbMotion creates an integrated virtual patient record by securely sourcing medical information across diverse technologies and harmonizing the data for meaningful interpretation and use. This data is then incorporated into a single entity—the virtual patient object (VPO)—which is the data object used to mobilize the integrated data to its consumers such as dbMotion’s web-based Clinical Views or third party applications such as EMRs and PHRs. To facilitate system-to-system understanding, an interoperability platform enables a healthcare organization to share and make sense of data being exchanged. Semantic interoperability preserves the original meaning of the data—regardless of its format—to ensure its integrity in the host system so that the receiving systems can understand and make appropriate use of the incoming data.
How does using service-oriented architecture (SOA) facilitate connectivity?
The dbMotion Solution is based on service-oriented architecture (SOA), which uses software services to collect and share data across disparate clinical systems. dbMotion logically and securely connects data to form integrated patient records—without necessitating the replacement of existing systems. SOA platforms promise to elevate healthcare computing with easy-to-use applications and access to a single, comprehensive view of meaningfully organized patient data anywhere and anytime—even via mobile devices. The multi-tiered architecture is flexible and scalable to adapt easily to the changing demands of any sized health delivery network and diverse IT environment, on a local, regional or national level. Its inherent modularity allows for flexible deployment approaches for managing and sharing medical information.
What are the configuration possibilities?
A centralized dbMotion implementation uses a singular, persistent repository to store data originating from an organization’s clinical and administrative systems. This configuration is a foundation for system scalability, supporting data acquisition from newly added systems and facilities, allowing uniform system management policies for different enterprise members. It also enables easy connections with external HIEs, networks, independent clinical systems and data providers.
A federated dbMotion configuration has more than one physical location (node) for data storage. It serves the needs of multi-stakeholder organizations in which data ownership is distributed. This dbMotion configuration provides solutions to the complex issues of data collection, diverse facility security policies, and management of user and role definitions for each of the health network’s decentralized nodes.
The hybrid dbMotion architecture sets the foundation to easily scale an organization’s health information exchange. The hybrid approach combines the characteristics of both the centralized and federated architectures to accommodate enterprises that have a mix of centralized and decentralized nodes. For example, an organization can begin with a centralized approach for its internal requirements, and as the need emerges to connect with independent data providers, autonomous nodes can be added.
How are patients and records identified?
With patient data typically dispersed over a wide array of disparate clinical and operational systems, languages and data structures, the only way to maintain a unified medical record without the need to adapt these different environments is to focus completely on the patient. The unified medical schema (UMS) data model is an important cornerstone of the dbMotion Solution. It defines all the relevant information elements – and the logical relationships between them – that constitute the dbMotion patient record. With logical relationships there is no dependence on the type, structure or quantity of the clinical and operational systems from which this information is aggregated. The schema is an independent information model designed to define, structure, link and rationalize all patient medical record data within the healthcare enterprise, working with all clinical information systems regardless of how and where the data is generated.
The schema is based on the HL7 V3 Reference Information Model (RIM), which supports current enterprise data requirements and serves as a platform for a broad spectrum of future requirements. This serves as the basis for the abstraction between the physical layer (data layer) and the logical layer (business layer). All data is mapped and converted to the UMS with data integration layer tools, creating the unified medical record.
What are the different architectural layers of the dbMotion platform?
1. Data Integration Layer
The Data Integration Layer is responsible for data acquisition from clinical and operational systems and its transformation into the unified medical schema (UMS). Clinical data, irrespective of source or format, is mapped to the UMS, establishing relationships between discrete, patient-specific data elements. This layer aggregates medical information from differently coded systems using libraries of clinical terminologies, content mapping tools and other elements that integrate, orchestrate and harmonize data.
2. Data Layer
The Data Layer is dbMotion’s clinical data repository (CDR), a persistent database responsible for managing and storing patient information retrieved by the data integration layer. The CDR resides within each organization’s physical domain, with data ownership, security and privacy controlled and defined by the organization. This layer also provides a single interface, based on the UMS, for all data retrieval requests, regardless of the original data format, location and collection process.
3. Communication Layer
The Communication Layer is responsible for collecting clinical data from the various dbMotion nodes and/or other remote data providers such as pharmacies. Upon request, the communication layer collects the relevant data and forms the building blocks of a virtual patient object (VPO). In a federated dbMotion implementation, the Communication Layer’s catalog maps the various data sources of disparate nodes and manages the network’s information flow.
4. Business Layer
The Business Layer supplies medical data to its consumer—either a clinical viewer/portal or any third party application or service. The brain behind the platform’s processes and a key enabler of its SOA capabilities, this layer aggregates, analyzes and integrates medical information according to the consumer’s request using embedded business rules related to data, user role and profile, organization and more. This results in an integrated virtual patient record that can be delivered in various formats.
5. Presentation Layer
The Presentation Layer presents integrated medical information at the point of care via dbMotion’s web-based clinical viewer, a physician-focused application that hosts functionalities such as a patient-oriented inbox, alerts, creation of care notes, monitoring of admitted patients, creation of tasks regarding medical events, and clinical reminders. Its framework can be integrated into third party applications (EHRs, portals, etc.), ensuring that data is delivered within caregivers’ preferred environments and workflows. It also enables data to be consumed by dbMotion’s Clinical Analytics Gateway (CAG) and PHR Gateway, other research or analytical applications, decision support systems and business intelligence applications.
What is dbMotion’s approach to standards?
The adoption of standards provides developers of new technologies a consistent data framework that can reduce development time and costs and speed innovation. The UMS, based on HL7 V3 and the Reference Information Model (RIM), is dbMotion’s data model that, with its vocabulary domain, forms the foundation for semantic interoperability. The UMS enables the aggregation and integration of clinical data into a virtual patient object (VPO) used to mobilize the integrated data to “consumers” such as dbMotion’s web-based Clinical Views, Collaborate, EHR Agent and third party applications such as EMRs, physician inboxes, clinical decision support systems and PHRs.
What security provisions are included in the platform?
The system includes complete end-to-end security features including authorization, authentication and patient consent, as well as secure data transfer, encryption and digital signatures. The security layer defines the aggregate of technical and administrative safeguards that prohibits access to electronically protected health information (ePHI) by unauthorized parties inside or outside the organization.
Is the interoperability platform scalable?
The multi-tiered architecture is flexible and scalable to adapt easily to the changing demands of any sized health delivery network and diverse IT environment on a local, regional or national level. The dbMotion architecture’s inherent modularity allows for flexible deployment approaches for managing and sharing medical information—centralized, federated or any hybrid configuration.
Does the dbMotion platform meet meaningful use requirements?
Yes. The dbMotion platform helps providers meet the 15 requirements of Meaningful Use Stage One. dbMotion’s inpatient EHR system version 4.2 has been certified by the U.S. Office of the National Coordinator – Authorized Testing and Certification Body (ONC-ATCB) for the American Recovery and Reinvestment Act (ARRA) 2011/2012 EHR Modular Certification through the Certification Commission For Health Information Technology (CCHIT).
What is the EHR Agent?
dbMotion’s EHR Agent identifies important data that is missing from the local EHR and could be useful during an encounter such as an imaging test or allergy notification. Operating in the background, the system queries the entire HIE workspace—EHRs and data repositories at other sites—for usable information that can help complete the patient record. If relevant information is found, a visual indication appears in the clinician’s view. With one click, the provider can see an “exception view” and choose to import the data into the local EHR and incorporate it into a real-time clinical decision.
Why does my organization need an interoperability solution?
Healthcare providers have typically deployed a wide range of clinical technologies from different vendors, each with its own structure, nomenclature and underlying logic. While this strategy allows the organization to select best-in-class applications, patient data is not easily exchanged between these incompatible systems. The dbMotion interoperability platform creates a unified record from sources generating patient data, no matter what format they are stored in or where they are located. dbMotion makes possible a data-sharing strategy that allows unrelated information systems to access the patient data needed and to present them to caregivers in the format they prefer.
What does semantic interoperability offer to today’s healthcare organizations?
To facilitate system-to-system understanding, an interoperability platform enables a healthcare organization to share and make sense of data being exchanged. dbMotion’s semantic interoperability solution preserves the original meaning of data—regardless of format or nomenclature—to ensure its integrity in the host system and manage “information overload”, while the receiving systems understand and make appropriate use of the incoming data.
Does the dbMotion interoperability platform facilitate health information exchange (HIE)?
Yes. Through dbMotion’s proven service-oriented architecture (SOA)-based platform, local, regional and national healthcare providers have the flexibility to integrate medical data from a range of technologies and data structures. Once the information is available in a semantically interoperable foundation, dbMotion can display or share it with other applications or relevant “consumers,” such as dbMotion’s web-based Clinical Views, Collaborate, EHR Agent or third party applications, including electronic medical records, personal health records and clinical decision support systems. This level of flexible information exchange successfully positions healthcare organizations to address current and future healthcare challenges such as Meaningful Use compliance, quality measures, accountable care and disease management.
How can the dbMotion interoperability platform strengthen and expand my referral base?
Many hospital admissions are generated by unaffiliated community health centers, physician practices and ancillary service providers. However, provider organizations have little foundation for building relationships if their core clinical systems cannot exchange data. The dbMotion Solution makes it easier for other facilities and practices to communicate and collaborate. Referring physicians can pull data from a patient’s record at their convenience, granting them access to details beyond a discharge summary, for instance, to glean information from the full hospital stay. The ability to connect with outlying provider organizations, regardless of the EHR system they utilize, is a very powerful marketing asset.
What clinical benefits can my organization expect with the dbMotion interoperability platform?
By providing real-time information from multiple providers and clinicians at the point of care, the dbMotion Solution improves caregiver decision-making, reduces the margin for error, increases patient safety and enables quality healthcare. It facilitates data exchange for many activities including electronic prescribing, lab result reporting, disease registries, quality data submission, medication management, continuity of care record (CCR) data exchanges and patient/provider communications.
What is the benefit to patients?
The most obvious benefit is increased safety and quality of care. When clinicians have comprehensive and current information at their fingertips, care is enhanced. In addition, engaging patients with personal health records (PHRs) is mandatory to meet Meaningful Use Stage Two and is increasingly viewed as an important tool to help patients become more deeply invested in their own health. PHRs place valuable information at patients’ fingertips, motivating them to improve their lifestyle and follow provider recommendations. To be truly effective, however, PHRs must be comprehensive and current. While portals and interface engines represent a first step, they have limited ability to produce or consume data, or deliver it accurately and in real time—much less in a format understandable to patients unfamiliar with intimidating clinical descriptors. dbMotion’s PHR Gateway makes relevant ambulatory and inpatient export information accessible to PHRs.
How can the dbMotion platform help improve operations, both clinical and financial?
dbMotion’s platform aggregates and harmonizes data, not only within multiple provider repositories, but also from payer claims databases. This enables greater depth of quality metrics, including monitoring of physician and nurse performance, identifying gaps in care, providing real-time clinical surveillance, developing internal benchmarks, improving outcomes, and gaining control over utilization rates. dbMotion helps organizations comply with various quality initiatives, including CMS’s PQRS quality measures and private health plans’ pay-for-performance reporting requirements.
Hospital leadership benefits from an organizational view of the data when it is combined with analytical tools—a dashboard with information such as the variety of conditions, number of patients, average severity and clinical outcomes, and cross-factoring including length of stay, readmission, mortality rates, and the number of hospital-acquired complications. This will help executives compare their institutions’ performances to those of institutions with similarly adjusted benchmarks.
How does the dbMotion Solution prepare my organization for emerging care and reimbursement models such as the patient-centered medical home (PCMH) and accountable care organization (ACO)?
The industry is moving to an environment in which care is coordinated and/or integrated across all elements of a complex healthcare system. dbMotion’s interoperability platform supports diverse care delivery environments and EHR technologies by facilitating the means to collect and distribute medical and claims data in a timely, accurate, relevant and complete manner at the point of care or in the back office – wherever and whenever it’s required. This ability to cohesively unite previously fractured provider organizations is fundamental to helping PCMHs and ACOs achieve the highest levels of care quality and better manage associated costs.
What if my organization wishes to connect with a regional, statewide or even national health information network?
dbMotion’s platform is highly flexible and scalable, allowing a healthcare organization to exchange data within its own network or connect with a larger regional, state or national initiative. The dbMotion Solution’s semantic platform ensures interoperability with a virtually unlimited number of standards-based EHRs and other clinical systems to facilitate the flow of patient information on a wide scale—a hallmark of the future of healthcare.
Does the dbMotion platform meet meaningful use requirements?
Yes. The dbMotion platform helps providers meet the 15 requirements of Meaningful Use Stage One. dbMotion’s inpatient EHR system version 4.2 has been certified by the U.S. Office of the National Coordinator – Authorized Testing and Certification Body (ONC-ATCB) for the American Recovery and Reinvestment Act (ARRA) 2011/2012 EHR Modular Certification through the Certification Commission For Health Information Technology (CCHIT).
Can I expect to achieve ROI?
The dbMotion Solution improves clinical quality, eliminates errors and creates staff efficiency, all leading to positive financial outcomes. Further, a connectivity solution allows healthcare organizations to leverage existing EHR and clinical technologies and avoid costly replacements and workflow disruptions.
Why dbMotion?
The proven dbMotion Solution is a robust platform for interoperability, medical data intelligence and health information connectivity. It works with all forms of data architecture, vendor and proprietary systems, and enables the implementation of interoperability in a phased approach. The platform gives healthcare providers access to integrated patient information across the continuum of care and in real time, facilitating clinical decision-making and improving patient outcomes by bridging the gaps that previously prevented physicians and other caregivers from obtaining meaningful, actionable data.
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