Google Health beta launches May 19, 2008 -- Supports CCR standard

The long anticipated public launch of Google Health beta happened after a news conference in Mountain View, CA on Monday, May 19, 2008.   By end of day  Friday, May  24, there were tens of thousands of news items and blog entries about the new healthURL or PHR from Google, most of them comparing Google Health to Microsoft HealthVault.  Of interest to many developers is the use of the CCR standard by Google Health for receipt of incoming messages from an impressive group of health care providers, including the Cleveland Clinic and Beth Israel Hospital, and several major pharmacies, PBMS, and MinuteClinic nurse practitioner clinics, among others.   Google Health beta also supports a subset of the CCR standard, the Google CCR Profile, for outbound messages that users can send to an array of personal health services that assist users in a variety of ways, including a meds calendar and get email reminders (ePillBox), setting up preferences for health and medical news searches (MyDailyApple), or suggesting alternative medications to the ones you now take (SafeMed).

For developers who are interested in learning more about how to interact and participate with Google Health's platform, here are some suggestions:

• The Google Health Developers' Home Page explains how the Google Health API allows client applications to view and send Health content in the form of Google Data API feeds.
• The Google CCR profile reference guide contains detailed information on the subset of the CCR standard content supported, with examples of xml tagging, and a table for the recommended/supported coding systems used.
• Jerry Lin of Google has just posted  "How to Integrate with Google Health" which provides instructions for developers and programmers....very helpful.

 

AAFP/SureScripts/MinuteClinic/SOAPware Provider-to-Provider Clinical Messaging Demo'd at TEPR 

The future of provider-to-provider clinical data exchange?  One of the most exciting demo's that took place at the recent TEPR conference in Ft. Lauderdale showed how clinical messages between providers can be transmitted over the SureScripts network just as easily as e-prescriptions and requests for refills can go between providers and pharmacies. 

The SureScripts hub and network is a national, secure, certified system for routing prescription information between EMRs in pharmacies and EMRs in medical practices.  Adding the capability to route Retail Summary CCR xml files between any of the more than 500 CVS/MinuteClinics to any SureScripts-certified EMR in a medical practice required only minimal adjustments, according to Cris Ross, CIO at MinuteClinic, Dave Yakimischak, VP at SureScripts, and Randall Oates, MD, CEO and founder of SOAPware.  

This particular demo was limited to CCR xml messages from MinuteClinics to Medical Homes, in fulfillment of  AAFP principles regarding the retail clinic leader's continuity of care pledge, and the reciprocal Medical Home obligation to read and review care summaries on patients treated outside of regular office hours.   Doing this electronically over the SureScripts network with the CCR saves time, money, and prevents errors in communication.  It is a superb example of how HIT does not have to "re-invent the wheel" but can instead utilize existing networks and components, and expansion can take place in an incremental fashion.

 Look for a press release and other announcements from SureScripts in the near future.  In the meantime, address any questions you may have to Dave Yakimischak at David.Yakimischak@surescripts.com  

 

Northern Berkshire Health Information Exchange uses CCR standard

One of the most interesting talks at TEPR this year was given by Dave Delano, CIO of Northern Berskhire Health System, in northern Massachusetts.   Dave spoke on Wednesday, May 21, at the Ft. Lauderdale meeting about the NBH information exchange that is built around the CCR standard and which permits any provider in the community to access health summary data in CCR xml format and the familiar AAFP web design.    According to Dave, 14 medical practices in the community, all using eCW as their EMR vendor, are regularly submitting CCR xml files to the exchange, which then synchronizes the data from one or more physicians, ER visits, etc., and issues a new CCR xml file with combined data and information.  Dave is currently hoping to expand the HIE to other communities nearby where other EMR vendors' products are used.  "As long as they can export an xml file in CCR format, we can accommodate their information and put it to good use in our exchange to improve quality, safety, and efficiency," Dave says.   Contact Dave for further information a ddelano@nbh.org .

 

CCR standard used for cell phone system from AllOneMobile

"Could the cell phone succeed where grand plans for regional health information organizations (RHIOs) so far have failed? Could it be the format that convinces millions of consumers to adopt and maintain personal health records (PHRs) after smart cards, USB drives, and Web sites have elicited a profound yawn from the public?"   Thus writes Neil Versel in a recent blog about the recently unveiled AllOneMobile project to make cell phones the locus of one's summary health data storage, transmission, and management.  The AllOneMobile solution utilizes the CCR standard to store and transmit a subset of summary health data, including problems, medications, allergies, immunizations, and, of course, emergency contact information.  Currently AllOneMobile is available from several of the largest communications providers, e.g. Sprint, and works on all modern cell phones with data services.   AllOneMobile has plans to link to individuals' PHR information at Google Health beta and Microsoft's HealthVault in the near future.

For more information, contact Frank Avignone at AllOneMobile, email favignone@mac.com ,

 

Omedix Uses CCR Standard for Health Information Exchange and Patient Portal

Omedix offers a suite of web-based services exclusively for healthcare practices that combine a public website with patient education, search engine marketing, interactive forms, and a patient portal to help their clients increase patient volume, lower costs, enhance operating efficiency, and boost patient satisfaction.  Omedix counts over 400 clients throughout the USA.

The Omedix Patient Portal was built from the ground up to incorporate the CCR standard.  As a result, it displays CCR data to the end user in a straightforward and intuitive format.  The Omedix Patient Portal also allows easy importing and exporting of CCRs. 

FOR MORE INFORMATION
Please contact

Josh Padnick, President
(877) 866-3349 x901
josh.padnick@omedix.com

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Community Health Information Exchange, HIE, in Arizona & Mexico Uses CCR Standard 

CAPAZ-MEX (Community Access Program of Arizona and Mexico ) is a low-cost program providing primary care and subsidized specialist visits to low-income families and individuals in Yuma County, Arizona and San Luis, Mexico. It primarily services seasonal farm workers. Because users of this program are highly itinerant, continuity of care is challenging and the ability to share medical information is highly desirable. To address this need, a CCR-based electronic community health records system is currently being implemented to allow the latest and historical CCR's to be viewed and edited from a web-based application. Interfaces allowing CCR's to be created and stored automatically from existing electronic information are utilized, thus minimizing impact on existing workflow. The web application and all data storage are hosted at a data center, minimizing the technology footprint required at participating clinics.
 
The program is scheduled to begin as a small scale pilot in Feb/2008 and will be expanded throughout the year.
 
CAPAZ-MEX Contact
Amanda Aguirre , M.A., R.D.
CEO/President
Regional Center for Border Health, Inc.
214  W. Main St.
Somerton AZ 85350
Phone: (928) 627-9222
E-mail: amanda@rcfbh.org
 
Technical Contact
Ken Miller
Solventus LLC
625 Oaks Dr. Suite 305
Pompano Beach, FL 33069
Phone: (866) 891 0537 x703
E-mail: ken.miller@solventus.com 

submitted 1/29/08

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Singapore General Hospital using CCR standard for continuity in care transfers

The Family Medicine & Continuing Care Department (FMCC) in Singapore General Hospital (SGH) is piloting the use of the CCR in transfers of care.  Some degree of electronic health information exchange is currently possible
between tertiary institutions in Singapore, but most family medicine practices are still dependant on paper referrals
or faxed documents for health information exchange.  In part, this has been because of the heterogeniety in ambulatory EMRs and  clinic management systems and the large number of independant small and
medium sized practices.  

The objective is to use the CCR to facilitate informational continuity during hospital to primary care transfers.
Problem list and active medication list data captured in FMCC's ambulatory EMR is used to populate a CCR document at the point of referral.  This document may then be saved on portable media (eg USB thumbdrive) or
sent to the intended recipient via secure email.

To faciliate use of the CCR by the patient, a HTML version of the document is generated concurrently - which may be viewed in a normal internet browser.

Another interesting aspect of the pilot is that medications, laboratory results are associated with the relevant problem via the "internal CCR link" tag, - creating a "problem-oriented" CCR. The idea is to allow recipients to
scan through the problem list and then selectively drill down into the relevant details of each problem.

Currently, CCRs are being generated on an on-going basis in SGH. Next steps include : enhancing adoption within SGH, short-listing family medicine  practices for live exchange of CCRs.
 

This report was submitted 1/14/2008 by the following physicians, and inquiries can be made to them directly. 

Dr Lee Kheng Hock
Head, Dept. of Family Medicine & Continuing Care
Singapore General Hospital
Email : lee.kheng.hock@sgh.com.sg

Dr Patrick Chia
Senior Principal Medical Informatics Specialist
Singapore General Hospital
Email : patrick.chia.c.m@singhealth.com.sg

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MinuteClinic uses the CCR standard to create patient summaries, assure continuity

CVS/MinuteClinic is the leading retail clinic operation in the US, with over 400 in-store clinics in over 25 states as of the end of November, 2007, and a goal of opening over 1,000 nurse practitioner run clinics in CVS pharmacies by the end of 2008.  Known for their convenience, low cost, and friendly attitude, the MinuteClinic brand is helping to change the face of primary care in this country, and has been recognized by Forbes Magazine as one of the "top ten disruptive innovations" of the decade, right alongside Google and the iPhone.   MinuteClinics use a centralized electronic health record, EHR, from their base of operations in Minneapolis, and utilize the CCR standard to create an xml patient summary for over 10,000 customers a day.  These CCR-based patient summaries can be transformed to web pages, pdf document format, and faxed or sent electronically to the customer/patient's primary physician or "medical home" practice.  Other companies in the retail or convenience clinic industry, e.g. RediClinic and TakeCare, have committed to use the CCR standard for interoperable health data exchange in support of quailty and continuity of care.  For more information about MinuteClinic's use of the CCR standard, contact Cris Ross, CIO of MinuteClinic, email cris.ross@minuteclinic.com .

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QED Clinical runs its clinical Protocol Engine using the CCR standard 

QED Clinical, located in Dallas, Texas, provides Point-of-Care clinical reports and evidence-based guidance to hundreds of physicians in medical practices of many different sizes, using the CCR standard in the process of mapping data from various sources and running these through its protocol engine to determine preventive services and schedules for testing in chronic illness management.  For more information on QED Clinical contact Jim May jmay@cina-us.com.

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Fox Prarie Medical Group, PC creates CCRs from NextGen EMR for referrals

Stasia Kahn, MD is one of the real pioneers in using IT to provide her patients and referral physicians with a comprehensive health summary in CCR standard format.  She utilizes the NextGen EMR in her practice, and is able to create a CCR xml document at the push of a button!   Dr. Kahn is also the founder of the Northern Illinois Physicians for Connectivity, a group that is planning a regional health information organizaiton, or RHIO, which will distribute patient health summaries on demand using the CCR standard.   For more information, contact Dr. Kahn at skahn@niphysiciansforconnectivity.org .

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eClinicalWorks and e-MDs among long list of EMR and EHR vendors using CCR standard

eClinicalWorks (Westborough, MA) and e-MDs (Austin, TX) are among a large and growing number of electronic medical records companies serving the ambulatory care medical practice market that have integrated the CCR standard into their basic product offerings to enhance quality, safety, and efficiency of their customers' care.   Both companies are award winning, and have been active members of the CCR Acceleration Task Force and have made significant progress in both import and export functionality during 2007.   To see a more complete list of EMR and EHR vendors who have implemented and deployed the CCR standard in their products, see the list at http://www.centerforhit.org/x2022.xml .

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Tools for creating, testing, and managing CCR files

The CEND-PHR application will allow you to create, display, edit, store, and securely transfer a minimal data set CCR xml file that conforms both to the CCR standard and the AHIC Consumer Empowerment use-case.  It includes options for multiple web services based on the CCR content, e.g. Google Health Search and Co-op, as well as PDF Healthcare features. 

The CCR Validator, an important resource to test/validate a CCR instance, is a now available  Not only does it validate the CCR against the XSD but also the constraints of the implementation guide.  The tool can be accessed here:  http://chit.dyndns.org/CCRValidation 

YourTimeMatters.com allows you to securely create, update, and save a CCR-compliant Personal Health Record(PHR).  The PHR is saved to your local disk as an updateable PDF file, with a choice of printable formats including forms used in actual Patient Registration and Emergency Medicine settings.  Whichever printable format you choose, your CCR is stored as an attachment to the PDF in its original, extractable, and updateable XML format.  Site does not require account and does not provide online storage for your PHR file.