Learning Objectives for this Presentation:
By the end of the presentation participants will be able to apply the approach taken in San Diego in considering regional healthcare interoperability initiatives.

Background:
The national healthcare interoperability effort is an opportunity for Immunization Information Systems (IISs). In San Diego, a pilot interoperability project beginning in November, 2006 leverages the regional IIS to the benefit of both efforts.

Setting:
The San Diego County Medical Society Foundation (SDCMSF), with Blue Shield Foundation, is sponsoring an Emergency Department Medical Home (EDMH) project. The objective of EDMH is to provide patients who are currently using hospital Emergency Departments throughout San Diego County as their source for routine medical care an opportunity to establish a stable medical home with a primary care provider. EDMH will include a connection to the San Diego Regional Immunization Registry (SDIR) and will use some of its features.

Population:
EDMH will include 6 San Diego hospitals and up to 18 community clinics. SDIR connects over 100 providers and maintains demographic and immunization data for over 850,000 unique patients.

Project Description:
This project will:
• Leverage existing IIS features to jump-start a RHIO
• Test new ways to access the IIS from the RHIO portal
• Pilot the use of Integrating the Healthcare Environment (IHE, www.ihe.net) communication protocols in connecting the RHIO to the IIS


Results/Lessons Learned:
Leveraging the progress of IISs helped address these key challenges to getting an interoperability effort off the ground:
• Agreeing on data to exchange that least aggravates privacy and security concerns.
• Building upon existing infrastructure so as to minimize cost.
For EDMH, the key was to make sure that the project would not only improve quality while reducing costs but also improve healthcare access.