2023-07 TrueHealth Running Meeting Notes

NACHC Informatics

TrueHealth

HealthFlow

Integration

Data

Implementation Process

NACHC Informatics

TrueHealth

HealthFlow

Integration

Data

Implementation Process

NACHC Informatics

TrueHealth

HealthFlow

Integration

Data

Implementation Process

NACHC Informatics

TrueHealth

HealthFlow

Integration

Data

Implementation Process

NACHC Informatics

TrueHealth

HealthFlow

Integration

Data

Implementation Process

NACHC Informatics

TrueHealth

HealthFlow

Integration

Data

Implementation Process

NACHC Informatics

TrueHealth

HealthFlow

Integration

[Yesterday 4:24 PM] Julia Skapik NACHC

Notes from the TrueHealth call: all 9 sites for deployment share the same EHR instance and would deploy simultaneously but the Healthflow team agreed to filter out sites since TrueHealth would prefer to start with a few. TrueHealth will provide those ASAP to Healthflow. Training is currently potentially delaying the go-live right now because sites have not done it yet-- Healthflow asked to expedite the training now so they can schedule go live. The go live is not yet scheduled but the estimate is 2 weeks from finalizing the "pipeline" this week. 

Data

Implementation Process

NACHC Informatics

TrueHealth

HealthFlow

Integration status and next steps

athena’s expected level of effort and proposed schedule for them to support the requested flow that athena approved - from Ben, who should have the data by the time of the meeting.

Rosanna, Ken and Ben - have been working on the integration process, they are in contact.

Ken & Ben are in touch to determine architecture of the API, what the script is looking for

What is needed for the API to fire.

Consulting with Dr. Senors - on how to see… athena cannot do a popup to signal provider to approve the order. So now looking for a way to do…

Best place: In the reason for the visit, encounters.

Information will appear there on the intake side - the MAs will see it, will signal to providers that the patient has not been screened for HIV. To prompt a conversation. The provider would then add the order or counsel patients if declined at that point.

The location really matters - must be at the beginning of the clinical flow.

Questions:

If the CDS fires and it shows up in reason for the visit - if an action is not taken, will it fire again another time until an action is taken or denied.

• if the order is placed by provider and the patient refused, there is a way to document that refusal, and make sure it does not fire again.

Ben has summarized progress, Ken’s team is testing.

• How long will HealthFlow need to test? They just access this afternoon 11/13/2023.

TrueHealth will test as well and looking at training of clinical staff and providers, not to be a burden, just to be a reminder but don’t want providers to dismiss it too quickly. Rosanna will be creating a training guide for staff.

Ken to get back to Rosanna with his timeframe for testing.

What can NACHC do to help?

Is there feedback from NACHC’s data team on the data quality?

Data

Pedro confirmed that the data is all set.

TrueHealth will run numbers just prior to go-live, and periodically after to tweak if necessary.

Brings up the question for athena - to consider other measures that might benefit from a pop-up.

NACHC Informatics

TrueHealth

HealthFlow

Integration status and next steps

Establish where we left off - athena did not reach out after the first technical call.

Julia was going to reach out to contacts to see what was going on and ask them to contact Rosanna/Dr. Senors.

Rosanna put in a ticket for the athena team - can athena reach out to facilitate to make sure there is no disconnect between the two athena teams; athena has many teams and the effort needs to be made, based on experience to approach and make sure one of the teams has been tasked with contacting athena.

Julia will contact the fellow who was the head of the technical team from the last tech meeting with athena, cc’ing Rosana and Dr. Senors.

Data

Sarah can give a report on the baseline data pulls.

All the data pull for all tables have been pulled - needs deduping.

Goal is to upload by the end of this week by Rosanna.

Will try to upload via Confluence, if not SFTP site.

SOW

NACHC

NACHC Informatics

TrueHealth

HealthFlow

Integration

No news.

There was 1 group that was supposed to supply the customer service rep with info to give to TrueHealth. Ken recalls that it was to come back to NACHC - to formalize between NACHC and athena.

Ken recalled that athena proposed that this would be done in the same way that they do any sort of customer customizations, but just for TrueHealth at the moment. If the relationship can be between NACHC and athena, it will help drive the wider implementation.

Julia will contact - athena

Regina Haynes - Manager - not TrueHealth customer service.

Dr. Nele Jessel - overall advisory

Doug - was this the team lead on the special team?

BJ Bloom

Data

Data Pull - any questions?

TrueHealth has started working on the reports.

Dx table - does not see in athena where to put in dx start date. There is encounter date, not start date.

• Looking for the dx given at the encounter

• They had the historical one to find out if they had already been dxed with HIV or have hep B because they have considerations if they go to PrEP.

  • It is ok to have it be encounter date.

File size - Use Confluence upload page TrueHealth HIV File Upload Page

If any questions, contact Pedro pcarneiro@nachc.com

Implementation Process

Admin

• Contract

Rosanna Jayson

Sarah Raymonde

Karenna Senors

Data Pull - Data Dictionary and Data Request

1. Data Request

1. Insurance we have duplication as people change in the middle of the calendar year, should we de-duplicate? Best to have “most recent” latest date.

2. Baseline -

   1. How far back do we go? If you can go to 2021, that would be great.

      1. Athena was in use as of January 2021 -that’s ok. No need to go back to legacy system.

      2. What should be final day of the pull - most recent completed month. So June 30, 2023.

3. CDS column in labs - if there are CDS hooks for another CDS system.

4. DX table - is all the Diagnoses within the time frame, not just the dx related to the encounters that had STI-related codes.

5. The scripts

   1. that the provider sent to the pharmacy -

   2. and if you can validate that the script was filled. Refills. That’s usually really difficult.

6. Encounter data

   1. office or telehealth encounters

2. Data Dictionary (and terminology - to map local codes to terminology standards)

Dictionary is a set of value sets that represent different parts of the data NACHC wants.

Do you send NDC codes of RX Norm codes or no codes?

Federal law requires that vendors provide NDC or RX Norm codes.

If you only get the full term descriptors for the drug, Ray can normalize the terms so they can be put with the data from other partners on the project.

The terminology has to be done before you pull the data that Jayson described.

the lab companies have their own proprietary codes, but they are required by law to also report LOINC codes.

Desired Outcomes

1. We have a clear idea of expectations for deliverables by July 31

2. TrueHealth has the tools and information needed to start on the deliverables

3. We all know the status of the contract and the Data Use Agreement

4. We have recorded questions to be resolved, documents to be exchanged, and next steps with deadlines.

athena integration

Would True Health investigated - Athena will need funds. Regina is setting up a demo with the athena tech team and HealthFlow for July 18 so they can tell us what level of effort. If it is within scope for NACHC, NACHC would provide the funding through an addendum to TrueHealth’s award to pay for the integration.

Set up regular meetings

Meeting Date

Person

Topic

Notes

Action Items

Introductions

Dr. Karenna Senors, MD, CMO for Truehealth

Kristin Chesnutt - Grant manager

Aleia Roberts - Dir of Government and Community Engagement

Rosanna Cabello - Director of EHR

Christina Iliff, Director of Risk and Compliance

Julia Skapik, CMIO - Project Lead

Pedro Carneior - Subject Matter Expert

Andrea Price - Project Manager

Ken Allgood - HealthFlow building/connecting software of the HIV Clinical Decision Support CDS tool - also working on a phone application on HIV prevention and care.

Contract to be signed by Dr. Senors

NACHC has funds for $40K but it was limited because of concerns from CFO about spending by July 31, 2023. NACHC will do contract amendment to add funds to go up to the $40,000 reserved for this purpose.

Burning Questions from Truehealth

• Next steps

• What is needed to move forward

Initiating Athena integration

Regular Monthly Meeting time (every 2 weeks just to get going?). Next meeting is Wed. Jul 12, 2023 1pm

• July 12 meeting includes the athena team

• Technical Meetings - start weekly with these for the immediate future.

  • Who needs to be involved on the technical side from TrueHealth?

• 2nd Friday of the month at 11:00am EDT

TrueHealth will send 2-3 potential times for weekly meetings for technical. We can add others as needed (data, training) or set up separate meeting times to which we can invite each of the Turehealth teams as needed.

Introduction to Confluence 

NACHC posts it resources on collaboration software called Confluence. It works like a Wikipedia in that anyone can edit and it serves as our knowledge base, with links to files, resources, the Scope of Work, and meeting notes. Usually, 1-5 team members from the partner side will want access - project lead, data staff, project management, technical person.

TrueHealth will send names of those who will want access - Andrea will find email addresses and ask for the ones she does not have.

Rosanna Cabello rosanna.cabello@mytruehealth.org

Jason Commissiong

Coretta Moore

Vicki Santos

Sarah Pelletier
Andrea sent these to Julia for approval and Efe to add to Confluence.

Overall Goal -

Does adding a CDS tool increase the number of ppl getting HIV tests?

Does adding a CDS tool reduce the amount of time/friction for ordering HIV tests

Data Request process

There are two data pulls:

1. At baseline prior to implementation of CDS tool - initial data request is 6 months prior to implementation.

2. Six months after implementation.

It is one report, separated into tables.

Version 2022-12-872 Data Request

Schedule a meeting with data team and Pedro Carneiro

Next steps

Agenda for July 12 1pm EDT

High-Level overview of the project - Purpose, desired outcome

athena integration

Technical

• Jason

Data

• Sarah

Training support

• Vicki

• Coretta

IT

• Mike

• Justin

2-Pager describing the project