Across a county in a mid-western state, healthcare organizations with seven disparate EHR systems, or none at all, use a Direct-driven event notification service. Admission, discharge and transfer notifications from two local hospitals are processed and automatically delivered via Direct to organizations providing care for their patients. Members of a person’s care team are notified simultaneously, and better care coordination begins in real-time. Direct enables secure bi-directional communication among all participants. Care Managers get the information they need to reach out more quickly to their patients, Indian Health Services gains better insight into the care needs of their community, and communication gets easier between primary and tertiary care providers. Hospitals aiming to reduce readmissions benefit by improved patient care coordination throughout the area.

A hospital-based lab for a large regional hospital system wanted an easy way to share lab results with unaffiliated providers. Affiliated providers received results through the hospital’s existing data hub, but they faxed results to unaffiliated providers, which was a time-consuming task and disruptive to the lab workflow. MaxMD’s solution interfaced directly with the hospital’s lab information system and results for non-affiliated providers were transformed through MaxIntegration™ into a format that could be exchanged via the Direct Protocol. The unaffiliated providers had differing technical capabilities, so MaxIntegration™ formatted the lab results differently for each receiving provider. Some practices received PDF versions of the lab results in their Hosted Direct mdEmail® Version 3.0 accounts. Other practices were able to receive the Lab Report via Direct in the form of a C-CDA for ingestion into their EHRs.

There are two accepted formats for transporting a CCD using the Direct Protocol. The preferred method is between partners utilizing IHE-XDM as recommended in the Applicability Statement for Secure Health Transport. Another acceptable method involves attaching a CCD to an SMTP email; this is referred to as RFC 5322. Many non-hospital entities, such as ambulatory EHRs and some Inpatient EHRs, rely on the SMTP+CCD method. This method of exchange works well when an IHE XDM-hospital sends to a RFC 5322-physician, but does not work well in reverse. A client hospital was having problems ingesting CCDs from an Inpatient EHR using SMTP+ CCD, because the SMTP+CCD method does not include adequate metadata in the structure. Through an inbound channel, MaxIntegration™ reformatted the message to add the expected metadata before it was delivered as a structured data packet to the ambulatory EHR where it was seamlessly consumed.

Meaningful Use is a great motivator for standards-based Health Information Technology, but it doesn’t apply to everyone. Long-term care facilities, nursing homes and home health, for instance, have been left out of MU incentive programs to date. These significant market segments account for over one-third of the hospital discharge dispositions in the United States. MaxIntegration™ is currently being used to provide reformatted Transition of Care data from hospitals to a major long-term care and rehab facility that does not utilize CEHRT in pursuit of MU. By utilizing Direct from end-to-end, the sending hospitals are able to count these transactions as part of their MU measures. When the message arrives to the Direct Address of the Long Term Care facility it is processed by request of the receiving party through the MaxIntegration™ product. MaxIntegration™ makes a copy of the CCD attachment, and reformats it as a customized PDF for facility personnel to view and delivers both versions to the non-CEHRT endpoint. This allows the recipient to view the information as a customized PDF formatted to their needs and also if necessary forward the original CCD on to another healthcare organization for consumption in a CEHRT. In this use case, the patient, the hospital, and the recipient facility all benefit from better coordinated care.

In states that offer a standard interface specification (or Direct address) to receive reportable clinical event notifications, MaxAlerts™ adds intelligent alerts to any outbound channel. These alerts interrogate the message for reportable information, and if any is present, forward a copy of the message in a format that is useful to the public health recipient. This feature ensures 100% of desired events are reported, and takes the burden off the provider to keep track of what is and is not reportable. This can be used for registry population (immunizations, cancer, etc) or for communicable diseases. In addition, ad-hoc situational alerts can be configured to address timely and current public health concerns.

MaxIntegration™ fully supports all aspects of traditional HIE technology, including query, master patient index, and record locator service functions. MaxIntegration™ can be configured to be the core technology for HIE; however, its footprint is light enough to enhance an existing HIE’s bandwidth. MaxIntegration™ has been designed to be a natural feeder to an existing HIE. For example, in cases where an HIE has been built on ADT encounter data, MaxIntegration™ can receive clinically-rich CCD messages from hospitals and deliver them to their destination for Meaningful Use, all while sending a copy of this advanced data to the local HIE. Not only does this give the HIE an opportunity for richer data from existing sources, it also offers them a potential ability to interface with the message recipient to increase their breadth of data capture among provider settings in the market.

MaxAlerts™ is ideally designed to support use cases where multiple notifications need to occur based on a single clinical event. Usually, these instances occur within an Accountable Care Organization or a Patient-Centered Medical Home model. There are few limits to the rules engine embedded within MaxAlerts™, making it a unique solution for prioritized notifications and conditional copying of messages. Care providers or coordinators in these models can also take advantages of the HIPAA- compliant communication that is natively supported through Hosted Direct mdEmail® Version 3.0.
At its core, MaxAlerts™ is a powerful and versatile communication tool. With it, MaxMD’s team of engineers and solution architects work closely with you to overcome the technical obstacles your organization is facing. We tailor our solutions to your needs, with a forward-thinking approach that encompasses your overarching goals – instead of just solving today’s problem. Our expertise at distilling complex data and interoperability issues means the unique solutions we create are often far simpler and more elegant than you might expect.

What if you wanted to easily add a new front-end to your EMR to increase provider satisfaction?  That’s what one HIT innovator is using MaxMD to do. 
Their system allows specialists to work the way they like to work. The specialist dictates a history and physical SOAP note in a way that is fast, easy, and familiar for a Cardiologist or Otolaryngologist. It uses natural language processing and other techniques to gather and transcribe the note gathered on a mobile device.