US Department of Health and Human Services Health Resources and Services Administration HIVAIDS Bureau Rockville MD CAREWare Overview Part A Training July 31 2013 Presentation Goals Provide brief history and context for development of CAREWare ID: 931583
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Slide1
John MilbergDivision of Policy and Data
U.S. Department of Health and Human ServicesHealth Resources and Services AdministrationHIV/AIDS BureauRockville, MD
CAREWare Overview
Part A Training
July 31, 2013
Slide2Presentation GoalsProvide brief history and context for development of CAREWare
Describe main features and software development modelDescribe usersDiscuss the role and future of CAREWare in a rapidly changing health information technology (HIT) world
Slide3Why CAREWare Was Developed
Concern over data quality reported to Bureau (1999-2000)Need for a standardized tool to report on services delivered, demographics, basic clinical informationLimited resources and time to build and/or purchase their own systemEnsure that aggregate data reports were derived directly from client-level data, resulting in more reliable data
Slide4What It Is – What It Does
An electronic health and services information system developed by the HIV/AIDS Bureau made available for free to our grantees and providers First released in 2000 in MS-Access; rebuilt in 2005 in VB .NET with SQL Server databaseAllows providers to produce all reports required by HAB and track client demographics, services, clinical information, referrals, etc.Contains comprehensive customizable reporting functionality, including a performance measures module to track the quality of care
Can be configured to run as a standalone or under a comprehensive wide area network administered by a state, city, or group of clinics/providers
Slide5What It Is Not!CAREWare is NOT a
certified EMR/EHR It is not mandated by the HIV/AIDS Bureau. HAB only mandates what data are reported to us, not how you collect and report that data
Slide6FeaturesCollects
: DemographicsLongitudinal data on services, medications, lab, screenings, diagnoses, immunizationsAppointment schedulerExtensive custom fieldsReferrals
Reports
:
HAB required outputs (client-level export, ADAP); HOPWA
Custom reports module
Performance Measures module, including pre-built HAB performance measure
Clinical encounter reports for managing HIV care
Slide7Features and Security
Imports: Data from EMRs/EHRsLabs (HL7-formatted data from LabCorp and Quest)Provides security
:
Standard password protection, rule-based access rights
Uses native .NET encryption
Network configurations typically use a VPN, Citrix, or other private security tools
Accommodates HIPAA security guidelines
Slide8Main Demographic Screen
Slide9Performance Measures Module
Slide10Performance Measures Module
Slide11Who Uses It?
51 percent of all Ryan White Program-funded grantees and providers to submit their required client-level data (958 of 1870 providers in 2010) 56 percent of outpatient ambulatory care providers Providers in 48 states, Puerto Rico, Guam, and the U.S. Virgin IslandsIn 17 states (and PR, VI, and Guam), it was used by 100 percent of providers to submit their data
Slide12Who Uses It/How Configured?
Configured as a centralized network in 21 States: Arizona, Connecticut, Florida, Georgia, Idaho, Iowa, Kentucky, Louisiana, Maine, Minnesota, Mississippi, North Carolina, New Jersey (in process), New Mexico, Nevada, Ohio (in process), Oregon, Pennsylvania (in process), Puerto Rico, Tennessee, and Washington Cities
:
Denver, CO; New Haven, CT; Oakland, CA; Philadelphia, PA
17 state grantees to manage their AIDS Drug Assistance Programs
International clinics funded by PEPFAR in Barbados, Nigeria, Uganda, and Vietnam
Slide13Percent of all Ryan White Program Providers/Grantees (N=1870) that used CAREWare to submit year-end data report: 2010
P.R.
Slide14Number of (duplicated) clients (N=800,580) reported by Ryan White Program Grantees/Providers using CAREWare: 2010
Slide15How Much Client Data?
360,756 duplicated * client records were submitted from 958 CARE Act-funded providers using CAREWare in 2010That represents 45 percent of all client records submitted *A client can visit multiple providers and, therefore, will have a record submitted from each, hence his or her record will be “duplicated”
Slide16How CAREWare Fits into the Larger HIT Environment
Many agencies import data into CAREWare from other applications, primarily EMRsElectronic download of laboratory test results from LabCorp and Quest, using data in HL7 format, active in over 20 sitesPerformance measures module provides functionality to produce outcome rates with formal numerators and denominators
Slide17A Typical Ryan White Program Network Configuration
Central Administrator (Grantee at state/city/clinic)
Mental Health Provider
Primary care
Primary care
Substance abuse counselor
Primary care
Labs
Slide18Future Issues and Developments: Internal and External Factors
Interoperability-Primary concern expressed on the CAREWare item on the ListservPatient-centered health information. Giving clients access electronically to their recordICD-10 requirements and “cross-walking” with ICD-9
Coordinate with Federal HIT
initiatives and
principles
Slide19Contact InformationJohn Milberg- HRSA, HIV/AIDS Bureau, Division of Science and Policy
Email: jmilberg@hrsa.govCAREWare Website: http://hab.hrsa.gov/manageyourgrant/careware.html