# Presentation: 027766

## WIRuralRx 

- Jeannie Tichy
- Software Product Analyst
- Marshfield Clinic

**Planning a Rural Prescription Network**

- Copyright 2005 Marshfield Clinic

## WIRuralRx: Vision

- 	The WIRuralRx partnership will develop a plan for implementing a point-of-care tool that will make accessible real-time, accurate patient-level prescription medication data for any patient receiving health care services at any one of the partnering institutions.

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## WIRuralRx: Partnership

- Initial planning was a collaboration between 3 facilities in a rural area
- St. Joseph’s Hospital
- UW Health Wausau Family Practice
- Marshfield Clinic
- Implementation will add a fourth partner
- Ministry Medical Group – Plover Family Practice

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## WIRuralRx

- Partner clinic without EHR: uses software from the Network

- Partner clinic with EHR: send and views data via an electronic interface to the Network

- Partner hospital with EHR: views network data for admissions/ER; at discharge, transfers meds to partner’s outpatient e-prescribing application

- “Read-only subscribers: do not send data to the Network but can view Network information (e.g. a small hospital ER)

**WIRuralRx**
- Merge medication lists into one, non-duplicative list with access to multiple types of Network “subscribers”

- At discharge, med information “cleaned up” (reconciled) by outpatient e-prescribing application and then sent via interface to Network

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## WIRuralRx: Specific Aims

- Aim 1: Creation of Network Infrastructure Components
- Development of an Electronic Master Patient Index
- Development of a Master Medication List
- Development of an Inventory of Allergies and other Adverse Drug Reactions (ADRs)

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## WIRuralRx: Specific Aims

- Aim 2: Establishment of Network Regulatory Elements and Membership
- Network security
- Patient consent
- Provider agreements

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## WIRuralRx: Specific Aims

- Aim 3: Establish Essential Capabilities for Interaction with the Network
- Data Transfer **TO** the Network
- Data Viewing/Transferring **FROM** the Network

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## WIRuralRx: Specific Aims

- Aim 4: Decision Support
- Basic decision support
- Enhanced decision support

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## WIRuralRx: Specific Aims

- Aim 5: Evaluation of Network
- Utilization
- Contribution to Patient Safety
- Effectiveness
- Costs

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## Electronic Master Patient Index (EMPI) at Marshfield Clinic

- Definition:  A system that maintains demographics and unique patient identifiers from different,  independent institutions and maps them to a common identifier.

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## EMPI: History

- Marshfield Clinic developed its EMPI to accommodate for the Regional Early Childhood Immunization Network (RECIN)
- Software processes combined with timely Health Information Management (HIM) assistance constantly search for, sweep, and remove duplicates from the database, thereby storing the patient identifiers, and up-to-date demographics once and once only.

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## EMPI: Components

- Real-time Deduplicator
- Batch Patient Integrator (BPI)
- Batch Examiner
- Medical Record Data Integrator (MRDI)

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## Copyright 2005 Marshfield Clinic

## EMPI and WIRuralRx

- Where are we today?
- Effective system but will need changes to accommodate for the WIRuralRx
- Current system requires a significant amount of manual effort to be effective.
- Current system does not support demographic information exchange between disparate systems through an **interface**.
- We are utilizing available resources to address issues to produce an efficient and effective EMPI for the WIRuralRx

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic

## Questions?Thank You

- Jeannie Tichy
- Marshfield Clinic
- tichy.jean@marshfieldclinic.org
- Ryan Ketterer
- Marshfield Clinic
- ketterer.ryan@marshfieldclinic.org

- Copyright 2005 Marshfield Clinic

- Copyright 2005 Marshfield Clinic