In order to advance our collective knowledge of how to incorporate activity management workflows into health information systems of various types, we incorporated examples of the VA developed activity management workflows for eHMP into Cerner COTS platforms. We look forward to contuing our broad collaboration in this area to improve the efficiency and effectiveness of care.
The VA’s electronic Health Management Platform (eHMP) utilizes a knowledge driven process management approach to support activity management workflows to improve the efficiency and effectiveness of care provided to Veterans. Initial examples of workflows that have been created being lab order follow-up, consultation and request activity. By encoding this knowledge in industry standard formats the VA has created the potential for portability of the activity management workflow knowledge.
Cerner has a comprehensive vision for Population Health Management built on the HealtheIntent™ platform. HealtheIntent is a multi-purpose, programmable platform designed to scale at a population level while facilitating health and care at a person and provider level. This cloud-based platform enables health care systems to aggregate, transform and reconcile data across the continuum of care. A longitudinal record is established, through that process, for individual members of the population that the organization is held accountable for; helping to improve outcomes and lower costs for health and care. Cerner is evolving the programmable capabilities of HealtheIntent therefor we decided to explore the potential for Cerner systems to support the eHMP activity management workflows both to inform our direction and collaborations such as the Health Services Platform Consortium (HSPC).
Using the process flow diagrams for the lab order follow-up workflow that were presented by Dr. Shane Mcnamee (https://www.osehra.org/post/recording-osehra-awg-presentation-ehmp-activity-management-shane-mcnamee-vha and https://prezi.com/x7mqtefddqk2/testing/ ) as the content we were able to able to incorporate all aspects of the workflow into Cerner’s platform. The state transition diagram below that represents the lab order follow-up workflow was generated from Cerner’s HEP adaptability tool which incorporates SOA, complex event processing and process orchestration capabilities. We were pleased that we were able to support the entirety of the workflow.
Analysis of consult activity management workflow identified that it requires a functionality that the VA has referred to as triage which we have not yet identified the need for in our client base but which could well become more broadly needed as value based care models evolve. Specifically, the triage function supports clinical resource management in which a user determines the best clinical resource to utilize to provide a clinical consultation service. For example, the triage process might determine that a Veteran’s needs can best be met by scheduling care at a clinic at the local VA facility or it might determine that in order to meet the clinical needs in terms timeliness that care should be arranged in a community resource or through an eConsult which might avoid the need for the Veteran to travel or take time away from their other pursuits. Triage is a wonderful example of capabilities that can be informed by collaborations such as HSPC to identify approaches that are effective across many care providers and vendors. The remainder of the consult management activity management workflow. Cerner platforms can support all other components of the workflow including the consultation pre-requisites which map nicely to the Discern Advisor capability in Cerner Millennium.
We are looking forward to the opportunity to build on this exploration to confirm that we can directly import and execute the information artifacts created to support eHMP and to continue to learn from thought leaders like the VA and expand the industrywide collaborations that we need in order to more rapidly improve the care of patients, including the population of U.S. Veterans that we are so thankful for, across the world.