Meeting Notes on CIE Integration with Cerner

CIE Integration Discussion

Introduction and Team Updates

  • Kathryn Johnson (Director of Community Information Exchange - CIE):
    • Phoenix: Technical product manager.
    • Bianca Barron: Junior project manager.
    • Satyam (Slalom consultant): Middleware.
    • Kyo (Slalom consultant): EMPI.
  • Deanna Handel (Director for complex care coordination):
    • Oversees CalAIM implementation efforts.
    • Doctor Carroll (CMIO): Supported building requirements for transmitting Cerner data to CIE.
    • Ren & Kim: Consultants for IT updates related to CalAIM and PATH grant.
    • Mahender: SQL database manager, developing the flat file report.

CIE Overview and Participation

  • CIE went live on April 28 with 19 organizations.
  • Securing middleware and EMPI solution (decision in the next couple of weeks).
  • Participation agreement required for all organizations, outlining policies, procedures, privacy, and security.
  • Client authorization form ensures clients consent to data sharing.
  • County Council reviewing the participation agreement (readability at the sixth-grade level).

Consent and Referrals

  • Two levels of consent:
    • Consent for the referral itself: Does the client know a referral is being made on their behalf?
    • Consent for creating a client record in the system: Requires client authorization.
  • Suggestion to crosswalk existing client authorization forms with CIE requirements.
  • Consider building an opt-in/opt-out flag for data sharing, similar to Manifest Medix and Commonwealth HIE.
  • Concerns raised about patients not actually receiving/reviewing HIE documents.
  • Discussion of adding CIE information to the annual joint notice of privacy practices.
  • Building a filter to prevent data sharing for patients who have opted out.
  • Implementing an alert when ordering a referral for a patient who has opted out.
  • Policy decision needed regarding adding CIE to the notice of privacy practices and managing opt-in/opt-out.

Referral Mechanism

  • Starting point: utilizing CIE solely as a referral mechanism.
  • Clients will not have client records created; only referrals will be sent.
  • Service providers can obtain consent for creating client records.
  • Affirmatively capturing data on client awareness of the referral on the referral order.

File Requirements and Data Elements

  • Initial list of data elements submitted with the original ticket (columns).
  • The CIE intends to receive referrals directly from Cerner users via an order form.
  • Referrals would follow the typical CIE operational process.
  • Status updates would be sent back to Cerner.
  • Power form with referral orders (six different orders identified).
  • Orders include Medically supported foods, respite care, personal homemaker services, home modification (EAA), asthma remediation and Housing services.
  • Some referrals integrated with WPC.

Data Storage and Automation

  • Plan to extract data from Snowflake (data warehouse).
  • Goal to retire everything from the SQL server and onboard to Snowflake.
  • Automate running the report daily and securely placing it on an SFTP server.
  • Ability to drop the file and archive it after some time.
  • SFTP: secure file transfer protocol.
  • Essential data (name, address, DOB, preferred language, Medi-Cal ID, referral organization, facility address) obtained from registration and demographics.
  • Consider sending two phone numbers: registration and point of contact.

Sample File and Timeline

  • Need a sample file for mapping.
  • The sample file expected in two weeks (by the twentieth).
  • The sample file will contain real data from Snowflake, a data use agreement is required.
  • Consider using test patients from the cert domain (test domain without real patient data).
  • Explanation text for each order (qualifications) available.
  • Access data through C441 versus p441.

Tracking Referral Status and Future Phases

  • Initial discussions focused on a Fire app that plugs into the EHR.
  • HL7HL7 message format to track a referral.
  • HL7 message could complete an order.
  • The closed-loop referral is tracked by the plan, not necessarily the original provider.
  • Decision needed on auto-completing orders versus leaving them in an ordered status for loopback.
  • Initial go-live: orders should auto-complete.
  • Closed-loop status sent to Gold Coast via SFTP.

Action Items and Next Steps

  • Team will follow up on the sample file, containing test (cert domain) or masked data, in two weeks.
  • Begin mapping together after receiving the sample file.
  • Review the fields that needs to be added.
  • Mahender and Phoenix to work directly together.
  • Send out orientation deck and high-level notes about next steps.