ISD White Paper — Mirth Connect Interface Use CasesJune 1, 2016MIRTH CONNECTINTERFACE USE CASESWHAT’S POSSIBLE? Mirth Connect is an open source interface engine (i.e. Software to move and translate data from onecomputer system to another).EMR AgnosticCross platformMessage & Data Type flexibilityo Multiple transport protocols supportedo Multiple message formats supportedExtensible via Java and JavaScript programming languagesAllows multiple routes, filters, and transformationsAfter deployment, interfaces can be monitored for quick message statistics, as well as the status of activeconnectionsIf there are errors, messages can easily be corrected and reprocessedAbility to send email alerts, so you know quickly if there is a problem with your interfaceScalable - features can be quickly addedCost effectiveo A basic interface can be quickly implemented on one of your existing serverso No upfront software licensing costo No additional hardware costso Interface development costs will vary based on specific project requirements HOW DOES MIRTH CONNECT WORK?1.Download and install MirthConnect software2.Create a database to store the Mirthconfiguration and message data3.Start building the channel4.Thoroughly test interface using a testenvironment5.Migrate to live production environmentINFORMATION STRATEGY DESIGN1

ISD White Paper — Mirth Connect Interface Use CasesJune 1, 2016USE CASE 1 – TRI-CITY CARDIOLOGY MEDNET BI-DIRECTIONAL INTERFACEBACKGROUND: MedNet is a 3rd-party vendor that processes data from patient worn medical devices – Holter and CardiacEvent monitors.MedNet provides a web-based interface for physicians to view and interpret the monitor data.Additionally, MedNet provides a completed, signed report.CLINICAL NEED: Extract patient data from NextGenCreate an enrollment file to send to MedNetFile the completed reports back into the patient’s chart in NextGenBENEFITS:ENROLLMENT INTERFACE Time savings of re-keying patient information into MedNet’s web interface (i.e. faster enrollment process)Greater accuracy of patient information more accurate reportsREPORT FILING INTERFACE Physicians and staff have access to the reports in NextGen within minutes of physician signing report inMedNet.Reduced labor cost for Medical Records department compared to scanning and manually filing thereports.INFORMATION STRATEGY DESIGN2

ISD White Paper — Mirth Connect Interface Use CasesINFORMATION STRATEGY DESIGNJune 1, 20163

ISD White Paper — Mirth Connect Interface Use CasesJune 1, 2016USE CASE 2 — DESERT WEST OB/GYN REMINDER CALL APPT UPDATEBACKGROUND Patient info is extracted from NextGen database via SQL and exported as a CSV file.WAVE phone system uses the CSV file to make appointment reminder callsThe results of these calls are reported in an XML report fileBUSINESS NEED: Update the NextGen appointments with the results of the remindersBENEFIT: No staff time for manually entering appointment confirmationsINFORMATION STRATEGY DESIGN4

ISD White Paper — Mirth Connect Interface Use CasesJune 1, 2016USE CASE 3 — CCHCI-CMR REFERRALS (BI-DIRECTIONAL)BACKGROUND: Chiricahua Community Health Centers, Inc. (CCHCI) staff uses Crimson Medical Referrals (CMR), a 3rd partyweb-based system for managing referrals.Initially staff had to rekey patient demographics and referral orders into CMR websiteThis was time-consuming and allowed the potential for errorsBUSINESS/CLINICAL NEED: Extract order data directly from NextGen and send an HL-7 message to CMRAdditionally, as the referral is managed, CMR sends HL-7 messages back to CCHCI and the interfaceupdates the NextGen order with the scheduled appointment date and time.BENEFIT: Now when the staff accesses the CMR website, all the patient demographics and order information isalready entered.Faster referral processingMore accurate referralsINFORMATION STRATEGY DESIGN5

ISD White Paper — Mirth Connect Interface Use CasesINFORMATION STRATEGY DESIGNJune 1, 20166

ISD White Paper — Mirth Connect Interface Use CasesJune 1, 2016CASE 4: TRI-CITY CARDIOLOGY NCQA HSRP DATA SUBMISSIONBACKGROUND: The National Committee for Quality Assurance (NCQA) offers a Heart/Stroke Recognition Program (HSRP)to recognize physicians for their delivery of quality care to people with cardiovascular disease or whohave had a strokeTo apply for recognition, the practice must submit specific clinical data for a group of 35 consecutivepatients identified by very specific criteria for each physician.Data can be manually entered via the NCQA website or uploaded in XML file format.Data must be resubmitted every 3 yearsCLINICAL/BUSINESS NEED: Extract the required data from NextGen for patients meeting reporting criteriaFormat the data according to NCQA HSRP XML specificationsBENEFIT: Tri-City Cardiology has 21 physicians, so this would be extremely labor intensive and potentially errorprone if done manually.NCQA Recognition allows higher reimbursement rates with some payers.DESIGN DETAILS:IDENTIFYING ELIGIBLE PATIENTS Must be 18-75 years oldHave been under the physician’s care for more than 12 monthsHave had diagnosis of ischemic vascular disease or stroke for more than 12 months (NCQA provides aspecific list of several hundred ICD-9 and ICD-10 codes that are included)For each applying physician, pick a date and going back in time, identify 35 consecutive patients meetingthese criteria and seen at the same office locationCLINICAL DATA TO BE REPORTED Blood Pressure Controlo 75% patients in sample have BP 140/90o Blood pressure values recorded at last visito Query from Nextgen vitalsUse of Aspirin or another anti-plateleto 80% patients have documented use of aspirin or another anti-plateleto Yes or noo Query from NG medication list and allergy list (for documented contraindication)o Smoking and tobacco use cessation assistanceo 85% documentation of tobacco use status within past 12 months, if tobacco user,documentation of cessation assistanceINFORMATION STRATEGY DESIGN7

ISD White Paper — Mirth Connect Interface Use Cases June 1, 2016Tobacco use statuso Tobacco use documentation dateo Cessation assistance documentation dateo Query from NG Social History data and patient visit PlanBody Mass Index Screeningo BMI recorded at last visit. Query from NG vitalso Pregnant females are excluded. Query from NG OBGYN History.Statin Therapy for Patients with CV diseaseo Determine intensity of statin therapy based on listed medication groups for Men 21-75 andWomen 40-75o Exclusions for pregnant or breast-feeding females, women of child-bearing age who are not usingbirth control, patients with kidney or liver impairment, or documented statin intoleranceINFORMATION STRATEGY DESIGN8

ISD White Paper — Mirth Connect Interface Use CasesJune 1, 2016QUESTIONS TO THINK ABOUT WHEN CONSIDERING A CUSTOM INTERFACE WHO are the other entities you are seeking to share data with?WHO are the key players involved in the interface definition and design?WHAT data will be imported and/or exported?WHAT format is the data in at the source and destination?WHAT are the potential savings for time/money?WHAT are the patient care advantages?WHERE is that data found in your EMR?WHEN or how often is the data imported/exported?CONTACT INFODEBRA HRATKODirector of Application Consulting2515 W. Broadway Road, Suite 103Mesa, AZ 85202Direct: FORMATION STRATEGY DESIGN9