Integrating the Power of WISHIN Pulse within Your EHR

By Jean Doeringsfeld, Chief Operating Officer

If you've been watching our WISHIN Pulse Dashboard numbers each month you know that the amount of data being shared in WISHIN Pulse continues to grow. It's really pretty impressive. With data on more than 3 million unique patients and more than 82 million encounters, from more than 1,100 sites of care across the state - it's clear that WISHIN Pulse has reached the point where just about every provider in the state could use the system and find important health information to treat their patients.

It makes sense then that the WISHIN team has been receiving a lot of questions from participants (and non-participants!) asking how they can start using the system.  You might be surprised to learn that WISHIN Pulse portal (as useful as it is) isn't the only option.  Here are a few options for you to think about:

1. SSO (single sign-on) Launch:  In this option, the WISHIN Pulse portal application is launched from within the EHR so the user/provider never has to leave the EHR to access the system.  The user's logon information, along with the patient context, are passed behind the scenes from the EHR to WISHIN Pulse so that the user doesn't have to log in again or re-search for the patient. 

Advantages

• The user never leaves the EHR.
• The user doesn't have to login separately to WISHIN Pulse.
• The user doesn't need to search for the patient in WISHIN Pulse.
• The user has access to all the data available in WISHIN Pulse and can use the launched portal to query the eHealth Exchange.
• Fits most provider workflows because it does not require them to leave the EHR.

Limitations

• IT staff (or EHR vendor staff) will need to create a link or button in the EHR in order to launch WISHIN Pulse.
• IT staff (or EHR vendor staff) will need to implement an Application Programming Interface (API) in order to pass the user's credentials (login, password) and patient context to WISHIN Pulse.
• In contrast to query-response below, the user cannot automatically bring data from WISHIN Pulse into the EHR without the added steps of downloading the data from WISHIN Pulse and uploading the data into the EHR (assuming that the EHR supports an upload).

Options

• Organizations with a large number of users may choose to implement SSO in a way that does not require them to manage user accounts and passwords in both the EHR and WISHIN Pulse.  This can be done by establishing "trust" between the EHR and WISHIN Pulse.  While user name and role information is still needed in order to ensure proper security, access and logging, management of user credentials remains primarily within the EHR, where it is today.

2. Query-Response: In this option, the EHR is set up to use standard query and response transactions (primarily XCA/XCPD) to obtain care summaries from WISHIN Pulse (and, by extension, the eHealth Exchange) and display them within the EHR. This functionality operates completely behind the scenes in the EHR and, in most cases, the user doesn't even know that it's happening. In many EHRs users can then determine if they want to incorporate care summaries  into  patient records (you'll need to check with your EHR vendor to determine if they support this functionality).  WISHIN Pulse provides the care summary in the CCDA format, which can be ingested by any EHR that meets 2014 CEHRT standards.

Advantages

• The user never leaves the EHR.
• The user doesn't have to login separately to WISHIN Pulse.
• The user doesn't need to search for the patient in WISHIN Pulse.
• Fits most provider workflows because it does not require them to leave the EHR.
• The user has access to care summaries available in WISHIN Pulse and from configured eHealth Exchange participants.
• Query-response functionality has been proposed as a requirement for Stage 3 of Meaningful Use.

Limitations

• IT staff (or EHR vendor staff) will need to build and test the query-response functionality.
• Users will not have access to all data in WISHIN Pulse - they will only have access to care summaries.

3. WISHIN Pulse Portal:  In this option users open the WISHIN Pulse portal, log in, and are able to access the data in WISHIN Pulse (within the limits of  their roles and security settings, of course).  We know:  accessing a portal is outside the normal workflow for many providers.  But there are some providers who have determined that  this type of access makes sense.  For example, some independent providers, clinics, and nursing homes don't have EHRs - and if they do, they may not have the IT resources needed to complete a technical integration.  For them, accessing a portal is an obvious option.

Advantages

• The user has access to all the data available in WISHIN Pulse and can use the portal to query the eHealth Exchange.
• No IT resources are required.

Limitations

• The user must logon each time they use the system.
• Users must separately search for each patient they are treating.
• If the WISHIN Pulse participating organization is not contributing Admit-Discharge-Transfer (ADT) data to WISHIN Pulse, the users for that organization will need to break the glass the first time they access a patient's information in order to establish a treatment relationship.
• Will likely require an addition or change to the provider workflows because requires the use of a new system as part of process for treating a patient

As you can see by these options, WISHIN Pulse supports a number of ways in which providers can access the data in WISHIN Pulse when treating their patients. If your organization would like to learn more - or if you have questions about the option noted here, please be sure to contact us!