Chesapeake Regional Information System for our Patients

Last updated
Chesapeake Regional Information System for our Patients (CRISP)
Company type Nonprofit corporation
Founded USA (2009)
Headquarters Columbia, Maryland, U.S.
Number of employees
100+ employees
Website www.crisphealth.org

The Chesapeake Regional Information System for our Patients (CRISP) is a nonprofit organization created to function as Maryland's state-designated health information exchange (HIE), by the Maryland Health Care Commission. CRISP currently serves as the HIE for Maryland and the District of Columbia. CRISP is advised by a wide range of stakeholders who are responsible for healthcare throughout the region.

Contents

Health information exchange allows clinical information to move electronically among disparate health information systems. The goal of the HIE is to deliver the right health information to the right place at the right time – providing safer, timelier, efficient, effective, equitable, patient centered care. In doing so, CRISP offers a suite of tools aimed at improving the facilitation of care for their service region's providers. CRISP was created by Johns Hopkins Medicine, MedStar Health, the University of Maryland Medical System and Erickson Retirement Communities, [1] and receives input from a wide range of sources, including clinicians, hospitals, patients, privacy advocates, payers, and regulators and policymakers.

Audacious Inquiry is one of several contracted service providers and developers that works with CRISP to enable and manage exchange services and initially served as the program director for the effort. [2] Initiate Systems (IBM) and Axolotl Corporation (Ingenix) were selected in 2009 to provide software as a service to enable clinical information exchange via CRISP. [3] CRISP replaced Axolotl with Mirth Results (NextGen) in 2011.

History

In 2006, CRISP began at a Spring meeting between John Erickson and the CIOs of Maryland's three largest hospital systems, asking how to make medical records for seniors available when they visited the hospital. By 2008, CRISP had partnered with MHCC to plan an HIE for Maryland, the processed engaged dozens of healthcare stakeholders. CRISP received $10 million in seed funding through an adjustment in the reimbursement rates for participating hospitals. [4] The Office of the National Coordinator awarded Maryland $9.3 million to implement statewide health information exchange through CRISP. [5] In the 2009 legislative session, Governor Martin O’Malley signed into law House Bill 706, which gives the Maryland Health Care Commission (MHCC) the authority to regulate the state's insurance industry to provide incentives for doctors to connect their practices to CRISP's health information exchange. [6] Maryland's Health IT Extension Center became a reality in 2010 with a grant from the department of Health and Human Services for $5.5 million. [7] Today, CRISP has connected with all of the acute care hospitals in Maryland and DC, and has rolled out several new services, and dozens of new features. CRISP has even expanded their connectivity through partnerships with neighboring HIEs.

Governance

At CRISP's inception, an HIE Policy Board was convened by the MHCC. The board has oversight authority for establishing the policies that govern the statewide HIE. For more information about the Policy Board click here. Additionally, CRISP, in coordination with the MHCC, has developed a governance model that includes a Board of Advisors to provide guidance and input to the CRISP Board of Directors on certain key decisions during the development and operations of the HIE. The Board of Advisors is intended to be broad-based to ensure that a breadth of interested organizations have the opportunity to participate and represent their constituencies. There are currently over 30 organizations represented.

The Board of Advisors is organized into five committees:

Clinical Advisory Board
Committee reviews and provides guidance surrounding CRISP’s plan for exchange service implementations. This includes providing a clinical perspective on CRISP activities, and helping to prioritize HIE service deployments. The committee also assists in gathering information and perspectives from the broader stakeholder community pertaining to HIE services, assists in garnering support and use of HIE services, and assists in assessing the value associated with various CRISP service offerings in terms of clinical relevance and service value in various care settings.
Technology Advisory Board
Committee reviewed and commented on the exchange technology request for proposal, participated in the RFP response evaluation and selection process, and provided guidance and expertise on infrastructure and other technology related decisions. Responsibilities also include: providing guidance on network security and data encryption best practices; providing oversight of the performance of technology solutions, once deployed; assessing specific technology solutions surrounding areas such as single sign-on, audit protocols, role-based access, and master patient indexing; and assisting in the development of strategies for integrating end-point.
Finance Advisory Board
Committee reviews and provides guidance on CRISP revenue and pricing models. It is refining and modifying assumptions associated with the CRISP revenue model, evaluating how federal funding requirements impact existing revenue planning, evaluating how federal funding opportunities tie into CRISP financing, and assessing specific HIE services with regards to financial sustainability.
Privacy & Security Advisory Board
The Committee provides guidance on privacy and security issues related to clinical data managed through CRISP and works regularly with the Privacy & Security Officer (PSO) who is responsible for all such matters as they pertain to CRISP’s daily operation. Additionally, the Committee serves as a resource for best practices and recommended policies for HIPAA data security, data use, and data sharing, and provides continual guidance on internal and external HIPAA audits as well as any HIPAA security-related incidents that may occur within CRISP.
Reporting & Analytics Advisory Board
The Committee develops, guides and prioritizes reporting and analytics services designed to support statewide efforts of improving care and reducing costs. Additional Committee responsibilities include assessing the value and relevance of reports for a wide array of users, providing guidance on data tools for report dissemination, such as user guides and other information to enhance understanding of the analysis, and to provide direction and vision in short, mid, and long-term planning of services. CRISP has developed basic reports to support initial hospital needs in monitoring performance on readmission goals.

Related Research Articles

<span class="mw-page-title-main">Health informatics</span> Computational approaches to health care

Health informatics is the study and implementation of computer structures and algorithms to improve communication, understanding, and management of medical information. It can be viewed as a branch of engineering and applied science.

Medical privacy, or health privacy, is the practice of maintaining the security and confidentiality of patient records. It involves both the conversational discretion of health care providers and the security of medical records. The terms can also refer to the physical privacy of patients from other patients and providers while in a medical facility, and to modesty in medical settings. Modern concerns include the degree of disclosure to insurance companies, employers, and other third parties. The advent of electronic medical records (EMR) and patient care management systems (PCMS) have raised new concerns about privacy, balanced with efforts to reduce duplication of services and medical errors.

<span class="mw-page-title-main">Health Insurance Portability and Accountability Act</span> United States federal law concerning health information

The Health Insurance Portability and Accountability Act of 1996 is a United States Act of Congress enacted by the 104th United States Congress and signed into law by President Bill Clinton on August 21, 1996. It aimed to alter the transfer of healthcare information, stipulated the guidelines by which personally identifiable information maintained by the healthcare and healthcare insurance industries should be protected from fraud and theft, and addressed some limitations on healthcare insurance coverage. It generally prohibits healthcare providers and businesses called covered entities from disclosing protected information to anyone other than a patient and the patient's authorized representatives without their consent. The bill does not restrict patients from receiving information about themselves. Furthermore, it does not prohibit patients from voluntarily sharing their health information however they choose, nor does it require confidentiality where a patient discloses medical information to family members, friends or other individuals not employees of a covered entity.

Health technology is defined by the World Health Organization as the "application of organized knowledge and skills in the form of devices, medicines, vaccines, procedures, and systems developed to solve a health problem and improve quality of lives". This includes pharmaceuticals, devices, procedures, and organizational systems used in the healthcare industry, as well as computer-supported information systems. In the United States, these technologies involve standardized physical objects, as well as traditional and designed social means and methods to treat or care for patients.

Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region, community or hospital system. Participants in data exchange are called in the aggregate Health Information Networks (HIN). In practice, the term HIE may also refer to the health information organization (HIO) that facilitates the exchange.

A Regional Health Information Organization, also called a Health Information Exchange Organization, is a multistakeholder organization created to facilitate a health information exchange (HIE) – the transfer of healthcare information electronically across organizations – among stakeholders of that region's healthcare system. The ultimate objective is to improve the safety, quality, and efficiency of healthcare as well as access to healthcare through the efficient application of health information technology. RHIOs are also intended to support secondary use of clinical data for research as well as institution/provider quality assessment and improvement. RHIO stakeholders include smaller clinics, hospitals, medical societies, major employers and payers.

<span class="mw-page-title-main">Canadian Institute for Health Information</span> Canadian not-for-profit organization

The Canadian Institute for Health Information (CIHI) is an independent, not-for-profit organization that provides essential information on Canada's health systems and the health of Canadians. CIHI provides comparable and actionable data and information that are used to accelerate improvements in health care, health system performance and population health across Canada.

Protected health information (PHI) under U.S. law is any information about health status, provision of health care, or payment for health care that is created or collected by a Covered Entity, and can be linked to a specific individual. This is interpreted rather broadly and includes any part of a patient's medical record or payment history.

WEDI, pronounced "wee dee", is a not-for-profit user group in the United States for users of Electronic Data Interchange (EDI) in public and private healthcare. It is sometimes referred to by other names including some or all of the words Workgroup for Electronic Data Interchange.

The Mental Health Commission of Canada (MHCC) is a national non-profit organization created by the Canadian government in 2007 in response to a senate committee tasked to study mental health, mental illness, and addiction. The committee appointed Michael J. L. Kirby as the first chairperson. The MHCC was endorsed by all the provinces and territories with exception to Quebec. The Commission is funded by Health Canada and has a ten-year mandate enforced through a sunset clause. On 21 April 2015, Minister of Finance Joe Oliver announced that the 2015 federal budget calls for the renewal of the MHCC for another ten-year mandate starting in 2017–2018.

The Office of the National Coordinator for Health Information Technology (ONC) is a staff division of the Office of the Secretary, within the U.S. Department of Health and Human Services. ONC leads national health IT efforts. It is charged as the principal federal entity to coordinate nationwide efforts to implement the use of advanced health information technology and the electronic exchange of health information.

The Electronic Healthcare Network Accreditation Commission (EHNAC) is a voluntary, self-governing standards development organization (SDO) in the United States established to develop standard criteria and accredit organizations that electronically exchange healthcare data. These entities include electronic health networks, payers, financial services firms, health information exchanges (HIEs), management service organizations and e-prescribing solution providers.

The Health Information Technology for Economic and Clinical Health Act, abbreviated the HITECH Act, was enacted under Title XIII of the American Recovery and Reinvestment Act of 2009. Under the HITECH Act, the United States Department of Health and Human Services resolved to spend $25.9 billion to promote and expand the adoption of health information technology. The Washington Post reported the inclusion of "as much as $36.5 billion in spending to create a nationwide network of electronic health records." At the time it was enacted, it was considered "the most important piece of health care legislation to be passed in the last 20 to 30 years" and the "foundation for health care reform."

<span class="mw-page-title-main">Medical image sharing</span> Electronic exchange of medical images

Medical image sharing is the electronic exchange of medical images between hospitals, physicians and patients. Rather than using traditional media, such as a CD or DVD, and either shipping it out or having patients carry it with them, technology now allows for the sharing of these images using the cloud. The primary format for images is DICOM. Typically, non-image data such as reports may be attached in standard formats like PDF during the sending process. Additionally, there are standards in the industry, such as IHE Cross Enterprise Document Sharing for Imaging (XDS-I), for managing the sharing of documents between healthcare enterprises. A typical architecture involved in setup is a locally installed server, which sits behind the firewall, allowing secure transmissions with outside facilities. In 2009, the Radiological Society of North America launched the "Image Share" project, with the goal of giving patients control of their imaging histories by allowing them to manage these records as they would online banking or shopping.

Health care analytics is the health care analysis activities that can be undertaken as a result of data collected from four areas within healthcare: (1) claims and cost data, (2) pharmaceutical and research and development (R&D) data, (3) clinical data, and (4) patient behaviors and preferences data. Health care analytics is a growing industry in many countries including the United States, where it is expected to grow to more than $31 billion by 2022. It is also increasingly important to governments and public health agencies to support health policy and meet public expectations for transparency, as accelerated by the Covid-19 pandemic.

Medical data, including patients' identity information, health status, disease diagnosis and treatment, and biogenetic information, not only involve patients' privacy but also have a special sensitivity and important value, which may bring physical and mental distress and property loss to patients and even negatively affect social stability and national security once leaked. However, the development and application of medical AI must rely on a large amount of medical data for algorithm training, and the larger and more diverse the amount of data, the more accurate the results of its analysis and prediction will be. However, the application of big data technologies such as data collection, analysis and processing, cloud storage, and information sharing has increased the risk of data leakage. In the United States, the rate of such breaches has increased over time, with 176 million records breached by the end of 2017. There have been 245 data breaches of 10,000 or more records, 68 breaches of the healthcare data of 100,000 or more individuals, 25 breaches that affected more than half a million individuals, and 10 breaches of the personal and protected health information of more than 1 million individuals.

Health data is any data "related to health conditions, reproductive outcomes, causes of death, and quality of life" for an individual or population. Health data includes clinical metrics along with environmental, socioeconomic, and behavioral information pertinent to health and wellness. A plurality of health data are collected and used when individuals interact with health care systems. This data, collected by health care providers, typically includes a record of services received, conditions of those services, and clinical outcomes or information concerning those services. Historically, most health data has been sourced from this framework. The advent of eHealth and advances in health information technology, however, have expanded the collection and use of health data—but have also engendered new security, privacy, and ethical concerns. The increasing collection and use of health data by patients is a major component of digital health.

Federal and state governments, insurance companies and other large medical institutions are heavily promoting the adoption of electronic health records. The US Congress included a formula of both incentives and penalties for EMR/EHR adoption versus continued use of paper records as part of the Health Information Technology for Economic and Clinical Health (HITECH) Act, enacted as part of the, American Recovery and Reinvestment Act of 2009.

Audacious Inquiry (Ai) is an American company founded in 2004 and with headquarters in Baltimore, Maryland. The company provides health information technology services and cloud-based software.

Hixny is a not-for-profit, health information exchange (HIE) serving the Hudson Valley, Capital, Southern Tier, and North Country regions of New York State. A health information exchange connects fragmented personal health information between different organizations for improved overall healthcare.

References

  1. ↑ Sentementes, Gus G. (2009), Md. takes lead in electronic medical records , retrieved 2009-11-26[ permanent dead link ]
  2. ↑ Howard County Economic Development Authority, Audacious Inquiry Partners with CRISP on State-wide Health Information Exchange, archived from the original on 2010-08-12, retrieved 2010-12-22
  3. ↑ Axolotl PR, archived from the original on 2010-05-09, retrieved 2010-12-22
  4. ↑ Goedert, Joseph (2009), Maryland OKs $10 Million for State HIE, archived from the original on 2009-10-23, retrieved 2009-11-26
  5. ↑ Finney, David (2010), Maryland Receives $9.3 Million in Health Information Exchange Funding, archived from the original on 2011-07-07, retrieved 2010-07-07
  6. ↑ HOUSE BILL 706 , retrieved 2010-03-02
  7. ↑ Horst, Rob (2010), Maryland's Health IT Extension Center Becomes a Reality, archived from the original on 2011-07-07, retrieved 2010-05-25
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