TIHA Solutions

We offer our members a computing architecture that powers the electronic flow and use of health information across organizations and communities. The technology scales to meet the objectives of provider organizations, ranging from single doctor practices, to long-term care facilities, to hospitals or integrated delivery networks. Members are able to securely exchange patient information with almost any other health information system — no matter what electronic health records (EHRs) are in use.

Members choose from a menu of connectivity services based on what makes the most sense for their organizational needs.

DISCOVER:  TIHA Health Information Exchange

  • Create a longitudinal community record for your patients
  • Access and retrieve clinical data on demand from other health care providers
  • Improve referral management and care coordination between care settings and providers
  • Improve accuracy and security of patient data
  • Increase efficiency and patient cost savings through the elimination of redundant tests and treatments
  • Increase efficiency of staff by minimizing time spent sending information to other providers
  • Enhance communication between providers and patients
  • Strengthen medical community partnerships

COLLABORATE:  Direct Messaging

Need to send or receive PHI (Protected Health Information), in a fast and secure environment? Use Direct Messaging, which operates as a secure form of email between health care providers.  Additionally, Direct Messaging can you help you meet Stage 2 Meaningful Use requirements.

Benefits of Direct Messaging include:

  • Quick, efficient, and private communication with other providers involved in the care of your patient.
  • Reduce administration workload, decreasing lost documents, and wait times.
  • Improve referrals by providing a secure method for external health care providers to refer to your organization.

SEND:  Hub Services

Send orders, results and more beyond the care venue
  • Share lab orders, results, and clinical documents
  • Contribute health information to public entities such as immunization registries, public health reportable labs, syndromic surveillance

iStock_000015415681_72_AllianceConnecting Missouri Makes A Healthier Missouri

The natural first step in moving towards a healthier Missouri is to establish a platform for the transfer and sharing of health related information.
The strength of these connections is the ability to aggregate data that is typically stored in multiple organizations, while maintaining the context and integrity of the information being exchanged.

The TIHA Health Information Exchange will provide access to and retrieval of patient information to authorized users in order to provide safe, efficient, effective, and timely patient care.

Benefits of Partnering With Us

  • Broad Connections: We  believe in partnership for the benefit of the communities we serve. As evidenced by our continued collaboration with  the Lewis and Clark Information Exchange (LACIE).  As a result, our members are part of a network of health care providers that consists of more than 30 hospitals, 500 clinic locations, 5,300 providers, and various other types of providers such as skilled nursing facilities, home health agencies, behavioral health, and emergency medical providers.
  • Improved Patient Care: HIE provides more complete clinical information to your providers when and where they need it, at the point of care. HIE also lays the foundation for population health management.
  • Increased Efficiencies & Financial Performance: HIE reduces time, waste and expense because it is embedded in your workflow. Spend more time doing value-added work and less time on the phone, fax machine and scanner. HIE will also facilitate the transition from fee-for-service to pay-for-performance.
  • Local Governance & Partnerships: As part of the University of Missouri, a health technology pioneer, and locally based in Columbia, we will be responsive to your unique needs. We can help you customize a system that will strengthen your clinical partnerships and allow your care network to operate smoothly.
  • Privacy: HIE is more secure than traditional information sharing methods. We have robust user agreements in place to ensure only HIPAA-permitted utilization. Routine audits are also conducted to ensure compliance.
  • Sustainability: The Tiger Institute is a long term partnership between the University of Missouri and Cerner, two national leaders in health care and information technology.

        Contact us now to get started!

About Tiger Institute Health Alliance (TIHA)

The Tiger Institute Health Alliance, a division of the Tiger Institute for Health Innovation is a coalition of health care organizations dedicated to improving the efficiency and quality of care delivery, while positively impacting the health of their communities and beyond. The major goals of member partnership are to provide access to new health innovations, leverage the most advanced health information technology, and provide opportunities for collaboration with forward-thinking peers who are also working toward a healthier Missouri.

Because each member organization is different and has differing needs, our partnerships deliberately focus on creating an environment in which the members can be successful where they live. We believe that success is created by providing health care organizations with the technology needed to more efficiently coordinate care when and where it is needed, empowering individuals with the tools to engage in and manage their own health, and creating outstanding health care experiences for all.

Click on one of the organization types below to see which solutions might best serve your needs:

Acute Care
Ambulatory Care
Post-Acute Care

Acute Care

As a hospital or hospital system you are charged with providing better care for more and more patients with urgent medical conditions while cutting costs and watching revenue streams evaporate. It’s a constant balancing act. You want to avoid re-admissions, but you also want to avoid doing too many procedures or duplicating tests. You need solutions that will help you provide the right care, at the right time, at the right place, at the right cost with the right outcomes. Below are some of our proven solutions that can help you overcome these challenges. First, see what one of our current members had to say:

 

 

We are using the Tiger Institute Health Alliance HIE to improve communication with our employed physicians and reach out to private practices in Jefferson City. The Tiger Institute Health Alliance HIE puts us at the center of our healthcare community. We are looking for partners to help navigate the many changes on the horizon for health care organizations. The Tiger Institute gives us a vehicle to help plan for these changes while developing stronger relationships with providers across Missouri.

 

– Ed Farnsworth, President—Capital Region Medical Center

 

Connect

Hub Services enable the flow of clinical data from hospitals to physician practice settings, labs, pharmacies, and immunization registries, regardless of the EHR system or systems in use.

This Internet-based service eliminates the need for hospitals to fax or mail information to the physician’s office or referring clinic. Instead, test results, immunizations, medications, lab orders, encrypted messages, discharge instructions, and clinician notes are automatically pushed to the ambulatory EHR at the primary care physician’s or specialist’s office. The service eliminates the need for primary care providers to develop connections between multiple hospital EHR systems, the scanning and faxing of patient records into an EHR system, and the time wasted in trying to track down or re-send lost or misplaced files.

Coordinate Care

Direct Messaging provides an encrypted communication channel for health care providers and patients. This alternative to coordinating care through faxes, papers, and phone calls reduces operational costs, offers read-receipt notifications, and supports many types of attachments. Providers use Direct Messaging for referrals and discharge summaries, to send appointment and health maintenance reminders, new patient registration forms, and other ad-hoc health-related communication. Direct Messaging follows the standards and protocols set forth by the Office of the National Coordinator’s (ONC) Direct Project, ensuring interoperable communication across technical platforms.

To provide the safest, most effective care, health care providers need to see a patient’s entire medical history. The challenge, of course, is that patients have records scattered across various organizations, so there’s no comprehensive summary available. To solve this problem, the Tiger Institute formed a Health Information Organization (Tiger Institute Health Alliance) to electronically compile patient data into a single, longitudinal record.

The Health Information Exchange (HIE) is our technical solution for creating the longitudinal record. It uses open source code that leverages Integrating the Healthcare Enterprise (IHE) standards to connect a wide variety of EHR systems. Through this technology, our Members gain access to aggregated views of care summaries and other health information from across Missouri. When accessed, clinical data flows from hospitals, physician practices, labs, post-acute care providers, and other health care providers and aggregates into one summary record. The data then presents back to the requesting user. Information displays in the user’s EHR, ensuring no disruption to workflow. And if an EHR isn’t in use, the HIE is accessed via web portal.

The Impact of EHR and HIE on Reducing Avoidable Admissions: Controlling Main Differential Diagnoses

table one

table twoBen-Assuli et al. BMC Medical Informatics and Decision Making 2013, 13:49 http://www.biomedcentral.com/1472-6947/13/49

Ambulatory Care

As a clinic-based Primary Care Physician or Specialist you are the “quarterback” in the efforts to coordinate care for your patients. Whether it’s admitting a patient to the hospital, referring them to another provider or sending their records to a Nursing Home, you and your staff are inundated with paper. Your role has increased in importance with the rise of Patient Centered Medical Homes. How do you keep the patient at center and not paper, faxes, phone calls and e-mails? Below are some of our proven solutions that can help you overcome these challenges. First, see what one of our current members had to say:

DR_PT_ExamRm_13

As a physician in the Veterans Affairs Hospital in Iowa City, I had access to a patient’s health records throughout the VA health system. It was a crucial tool to help me understand the context of each patient and provide care based on reliable information. We now have the chance in Missouri to do the same for any health care provider regardless of what EMR they use. This is the right thing to do for our patients and our caregivers.

– Dr. Kevin Dellsperger, Senior Associate Dean for Clinical Outcomes and Professor and Marie L. Vorbeck Chair in Medicine—University of Missouri Health Care

Coordinate Care

Direct Messaging provides an encrypted communication channel for health care providers and patients. This alternative to coordinating care through faxes, papers, and phone calls reduces operational costs, offers read-receipt notifications, and supports many types of attachments. Providers use Direct Messaging for referrals and discharge summaries, to send appointment and health maintenance reminders, new patient registration forms, and other ad-hoc health-related communication. Direct Messaging follows the standards and protocols set forth by the Office of the National Coordinator’s (ONC) Direct Project, ensuring interoperable communication across technical platforms.

To provide the safest, most effective care, health care providers need to see a patient’s entire medical history. The challenge, of course, is that patients have records scattered across various organizations, so there’s no comprehensive summary available. To solve this problem, the Tiger Institute formed a Health Information Organization (Tiger Institute Health Alliance) to electronically compile patient data into a single, longitudinal record.

The Health Information Exchange (HIE) is our technical solution for creating the longitudinal record. It uses open source code that leverages Integrating the Healthcare Enterprise (IHE) standards to connect a wide variety of EHR systems. Through this technology, our Members gain access to aggregated views of care summaries and other health information from across Missouri. When accessed, clinical data flows from hospitals, physician practices, labs, post-acute care providers, and other health care providers and aggregates into one summary record. The data then presents back to the requesting user. Information displays in the user’s EHR, ensuring no disruption to workflow. And if an EHR isn’t in use, the HIE is accessed via web portal.

Post-Acute Care

Admitting and treating a resident in a long-term care facility or other post-acute setting is difficult. You need to gather a lot of information from the hospital or physician to ensure your resources meet the patients’ needs and that you will be properly reimbursed. You also have LTACHs or DMEs requesting information from you. You have to work with incomplete information when treating demented patients or patients whose family caregiver is not present. You don’t want to over-prescribe dangerous medications, cause unnecessary side effects or re-hospitalize the patient. How do you cost-effectively gather and share these documents and fill the clinical information gaps so you provide high quality, efficient care? Below are some of our suggested solutions that can help fulfill these unmet needs.

Coordinate Care

Direct Messaging provides an encrypted communication channel for health care providers and patients. This alternative to coordinating care through faxes, papers, and phone calls reduces operational costs, offers read-receipt notifications, and supports many types of attachments. Providers use Direct Messaging for referrals and discharge summaries, to send appointment and health maintenance reminders, new patient registration forms, and other ad-hoc health-related communication. Direct Messaging follows the standards and protocols set forth by the Office of the National Coordinator’s (ONC) Direct Project, ensuring interoperable communication across technical platforms.

To provide the safest, most effective care, health care providers need to see a patient’s entire medical history. The challenge, of course, is that patients have records scattered across various organizations, so there’s no comprehensive summary available. To solve this problem, the Tiger Institute formed a Health Information Organization (Tiger Institute Health Alliance) to electronically compile patient data into a single, longitudinal record.

The Health Information Exchange (HIE) is our technical solution for creating the longitudinal record. It uses open source code that leverages Integrating the Healthcare Enterprise (IHE) standards to connect a wide variety of EHR systems. Through this technology, our members gain access to aggregated views of care summaries and other health information from across Missouri. When accessed, clinical data flows from hospitals, physician practices, labs, post-acute care providers, and other health care providers and aggregates into one summary record. The data then presents back to the requesting user. Information displays in the user’s EHR, ensuring no disruption to workflow. And if an EHR isn’t in use, the HIE is accessed via web portal.

At The Bluffs, we are using the Tiger Institute Health Alliance HIE and Direct secure messaging in conjunction with our MDS tools and EHR to provide better care for our residents. We are already improving communication with the hospitals and clinics we work with and our ultimate goal is to better capture ADLs and reduce ED visits and hospital readmissions.

– Jeff Robbins | Executive Director | The Bluffs, Columbia, Missouri

Frequently Asked Questions

What is the Tiger Institute Health Alliance?

The Tiger Institute Health Alliance, a division of the Tiger Institute for Health Innovation, is a coalition of health care organizations dedicated to improving the efficiency and quality of care delivery, while positively impacting the health and care of their communities and beyond. The major goals of member partnership are to provide access to new health innovations, leverage the most advanced health information technology, and provide opportunities for collaboration with forward-thinking peers who are also working toward a healthier Missouri.

What is health information exchange?

Health information exchange (HIE) is an electronic, patient-centered approach that assists with the transfer and sharing of health related information between physicians, hospitals, and other health care providers at the time it is needed to help them make clinical decisions. An HIE provides authorized care providers and physicians with quick, reliable, and secure access to patient health records from different EHR systems.

Why should I exchange health information with the Tiger Institute Health Alliance?

When the most up-to-date health information is available at your fingertips, you will be more likely to provide accurate and timely care. Benefits of sharing health information with Tiger Institute Health Alliance members and partner health care organizations include:

• Immediate access to important health information from other Tiger Institute Health Alliance member and partner organizations you would otherwise need to obtain by fax or mail

• Improved communication with your patients, resulting in enhanced coordination of care

• Reduced need for duplication of tests and treatments

• Reduced likelihood of dangerous medication interactions

• Reduced likelihood of lost health information, resulting in improved patient privacy

In addition to the exchange of health information at the point of care, the Tiger Institute Health Alliance aims to leverage its HIE technology to better understand the drivers of health, quality, and cost and collaborate with members to improve the health and care of their communities.

Will the Tiger Institute Health Alliance share information with other organizations?

While most care occurs regionally, the Tiger Institute Health Alliance understands a health care provider’s need to occasionally view health information for a patient that lives outside their region of care. The Tiger Institute Health Alliance HIE will serve as the gateway for your organization to share information across your region and beyond.  We recently finalized data use agreements with two other health information organizations: Lewis & Clark Information Exchange (LACIE) in Kansas & Kansas City as well as Secure Medical Records Transfer Network (SMRTNet) in Oklahoma to better serve border regions of Missouri.

What types of health information are shared among Tiger Institute Health Alliance members and partner health care organizations?

The most common types of health information shared among Tiger Institute Health Alliance members and partner health care organizations are:

  • Demographics
  • Problem List/Conditions
  •  Medications
  •  Allergies
  •  Lab Orders
  •  Immunizations
  •  Microbiology
  •  Anatomic Pathology Results
  •  Procedures
  •  Vital Signs
  •  Radiology/Imaging Reports
  •  History & Physical
  •  Lab Results
  •  Discharge Summaries
  •  Provider Reports
  •  Visits
  •  Other

Members may also choose to provide additional information they consider important for other health care providers to know when treating their patients.

Will patient-sensitive information be available to Tiger Institute Health Alliance members and partner health care organizations?

This type of information is also necessary to provide the best possible care to patients; however, since some patient information is sensitive in nature it will only be available for health care providers to use if patient consent is obtained.

Will health information from medical equipment and devices be shared with Tiger Institute Health Alliance members and partner health care organizations?

Because the Tiger Institute Health Alliance HIE obtains patient health information from your EMR, if information from other equipment and devices is being pushed into your EMR, it can also be contributed to the Tiger Institute Health Alliance HIE. The details of what information is shared are determined by member organizations and partner health care organizations.

Who has access to patient information shared by Tiger Institute Health Alliance members and partner health care organizations?

Only providers at Tiger Institute Health Alliance member and partner organizations who are authorized by HIPAA laws will have access to health information on the Tiger Institute Health Alliance HIE.

How secure is patient health information shared by Tiger Institute Health Alliance members and partner health care organizations?

All Tiger Institute Health Alliance member and partner organizations as well as their health care providers must abide by State and Federal privacy laws, the Health Insurance Portability and Accountability Act (HIPAA) of 1996, the Privacy Act of 1974, and the security provisions for health information in the American Recovery and Reinvestment Act (ARRA). Additionally, all Tiger Institute Health Alliance members and partner organizations use state-of-the-art information technology to keep health information safe and secure. Only participating health care providers who are authorized by HIPPA laws to view patient health records will have privileges to access the Tiger Institute Health Alliance HIE.  Routine audits are also performed to ensure compliance to applicable laws and user agreements.

How do patients share their information with Tiger Institute Health Alliance members and partner health care organizations?

Once notified by your office that you are participating in the health information exchange, nothing is required by patients who wish to participate because they are by default opted-in.  If they do not wish to participate, you will need to have them complete an opt-out form (paper or electronic).  Patients should understand that if they opt-out of the health information exchange they will limit your ability to provide the best possible care.  By opting out of the health information exchange they accept the risks associated with that decision.  Their health information will continue to be shared (without their specific authorization) among your providers and health plans through other means, such as mail, fax, or secure e-mail.  In other words, opting out of the health information exchange will not prevent you from seeing their complete medical record.

How do I talk to my patients about sharing their information with Tiger Institute Health Alliance?

Sharing patient clinical information is not new.  Before HIE, health care providers like you exchanged information directly by hand, fax or telephone.  These methods are more expensive, time consuming and not secure.  In other words, communication was at the center, not your patients.  You are probably already using an electronic health record (EHR), but it is not linked to other providers to whom you might refer patients.  HIE allows you to share information so your EHR can “talk to” their EHR.  Communication is much more efficient this way so you can put your patients at the center.

How will Tiger Institute Health Alliance membership help my organization meet Meaningful Use requirements?

The Tiger Institute Health Alliance may facilitate the attainment of Meaningful Use Stage 2 through the sharing of health information with other health care providers or state agencies. One example of where our solutions can help is the Transfer of Care Summary MUS2 objective.

Who are the current members and partner organizations of the Tiger Institute Health Alliance?

For the most up-to-date list of all Tiger Institute Health Alliance member and partner organizations, please visit here.

What is the cost of a Tiger Institute Health Alliance membership?

Costs are usually comprised of one-time interface fees along with monthly subscription/maintenance fees.  There are several factors, such as your existing technology, the size of your organization and the solutions you need, that determine exactly how much those are.  Please contact Monica Roberts at RobertsMon@health.missouri.edu  to get a quote.