CRISP DC is a Health Data Utility
The CRISP DC portal is a free tool available to healthcare providers and delegated staff. As clinical and social needs information is created and shared with CRISP, it is made accessible in real time to participating care providers through the CRISP portal. The portal gives providers the ability to securely look up patient information through the internet and view data from multiple organizations consolidated into one platform.
The HIE Supports the Coordination of Care
Patient History and Clinical Information
Healthcare providers will share information about you through CRISP that they believe is important for your other healthcare providers to know about. CRISP may have access to Health Records from your doctors, hospitals, and pharmacies that you have visited. Among other things, providers may share your test results, radiology images, or notes about your care.
Reconciling patient history
A provider is seeing a patient in the Emergency Department, and is trying to understand the patient’s complex medical history and recent tests and procedures.
Care Coordination During Inpatient or Sub-Acute Encounter
Practice staff wants to help coordinate care while their patient is hospitalized or at a sub-acute treatment facility. This could include providing support or information to hospital/facility staff, and potentially avoiding hospital admission or reducing length of stay.
Transitional care management (post-discharge)
Practice staff can identify patients who have been discharged from hospital-based care. The physician can support her patients’ safe transitions from inpatient hospital settings.
Addressing potential gaps in patient care
A provider is responsible for ensuring that a patient completes preventive health screenings, and may need documentation of these screenings for quality measurements. They need to distinguish between patients who are out of compliance and those who may have completed screenings for which the provider has not received results.
Test Follow Up
A provider has ordered a test or procedure and would like to follow up on its results.
Vaccine Tracker
The vaccine tracker is a powerful tool that provides visibility on a patient’s vaccine status. It is a CRISP Reporting Services (CRS) tool that has the ability to sort by age, race, ethnicity, medical conditions to facilitate process and equitable outreach. The tool uses Medicare attribution and the vaccination data is updated daily from ImmuNet (IIS). It allows for user-editable status to track outreach results. The tracker also provides summary reports so practices can track patient vaccination status over time and compare by demographic fields.
Pre-visit planning
In an outpatient setting, a staff member or clinician is preparing for a patient encounter and trying to understand the patient’s complex medical history and recent tests and procedures.
Care Coordination During Inpatient or Sub-Acute Encounter
Practice staff wants to help coordinate care while their patient is hospitalized or at a sub-acute treatment facility. This could include providing support or information to hospital/facility staff, and potentially avoiding hospital admission or reducing length of stay.
Transitional care management (post-discharge)
Practice staff can identify patients who have been discharged from hospital-based care. The physician can support her patients’ safe transitions from inpatient hospital settings.
If available, a payor can submit a risk score to CRISP. It will display in the portal with an explanation of the score and the name of the submitting organization.
Demonstrating value of intervention
Access to DC CRS Pay for Performance (P4P) reports, generated by our partner vendor hMetrix using Medicaid Claim data, for the organizations Medicaid-attributed patients through CRISP ULP.
Identifying high and rising risk patients
A practice administrator would like to identify high and rising risk patients, and provide patients with adequate support, education, appointments, and services to prevent a decline in health.
Care Coordination During Inpatient or Sub-Acute Encounter
Practice staff wants to help coordinate care while their patient is hospitalized or at a sub-acute treatment facility. This could include providing support or information to hospital/facility staff, and potentially avoiding hospital admission or reducing length of stay.
Transitional care management (post-discharge)
Practice staff can identify patients who have been discharged from hospital-based care. The physician can support her patients’ safe transitions from inpatient hospital settings.
Addressing potential gaps in patient care
A provider is responsible for ensuring that a patient completes preventive health screenings, and may need documentation of these screenings for quality measurements. They need to distinguish between patients who are out of compliance and those who may have completed screenings for which the provider has not received results.
Test Follow Up
A provider has ordered a test or procedure and would like to follow up on its results
Pre-visit planning
In an outpatient setting, a staff member or clinician is preparing for a patient encounter, and trying to understand the patient’s complex medical history and recent tests and procedures.
Users alerts for ambulance-based encounters
ENS alerts are available in real-time as a patient is treated by EMS. Lately, this collaboration also helped providing alerts to Fire and EMS on patients who tested positive for COVID-19 prior and post the ambulance encounter. The result of the EMS encounter is available in both Health Records and ENS, in the “Disposition” field and reports can be found under the label of “DC Ambulance Encounter”. Key details include medications administered, procedures, exams, primary & secondary impressions, patient disposition and patient care narrative.
Hospital Use Cases & Best Practices
An ED Nurse had a patient who was pregnant with complications. She indicated that she was at another hospital a couple of days ago and had some blood work done. We were able to use CRISP to see the labs and quantitative data as well as a past diagnosis.
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As a physician in the ED, when I have access to a patient’s imaging and CT scans from other hospitals, it drastically reduces that patient’s exposure to radiation, saves time as we no longer have to go through the procedure, and it lowers health care costs while improving patient experience.
As an ED physician I used CRISP to review patient data to quickly get a more complete view of the patient’s medical history. While speaking with a patient in the ED I found that the patient recently went to another hospital and received tests for their abdominal pain; but was not able to share anything about the visit. Using CRISP, I was able to review the previous visit, which prevented a repeat CT scan conducted three days earlier. CRISP also identified medications that were prescribed. Together, these prevented costly duplication of services, improved patient care, and provided a better patient experience.
I am an ER nurse at a local hospital. A new patient comes into the ER and needs to be triaged. The patient is unable to recount their medical or family history, so I utilize the CRISP button within my EHR to find the patient. I can view a comprehensive history of the patient and triage more effectively.
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I have a pre-op patient that needs to be prepped for surgery but is a new patient to the hospital. I utilize the CRISP button in my EHR and relay any relevant lab and imaging data into my EHR for consumption by other providers.
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When reviewing patient data in CRISP, I review the discharge summary to see what was done with the patient. Even seeing what wasn’t done via the discharge summary can be helpful in treating my patients.
In our hospital, Internists are expected to get information from our patients, but our second- and third- year residents are expected to look at external sources to inform patient care and CRISP is built into our expectation for patient care.
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As an ED nurse, I had a situation where a patient had an abnormal lab value. We did not have any other labs available to compare and determine if the patient is stable. Reviewing lab notes in CRISP allowed us to know that the patient was stable even though the range was not typical.
I am a nurse working in the maternity ward in a local hospital. A new patient, already in the early stages of labor, is transferred from another facility. I click the CRISP button in my EHR and apply the Maternal Health filter in Health Records. I can view pregnancy-related labs and tests, informing our team of any pre-conditions the patient may have.
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I am an ER nurse preparing to discharge a patient who has frequent admissions to the ER. I utilize the Care Coordination section in CRISP InContext and see the section is blank, indicating that no providers are receiving alerts when the patient is admitted. I launch the CRISP Portal and click on the Directory tab to find a primary care physician close to the patient’s home.
District Initiatives & Partnerships
The PDMP monitors dispensed drugs that contain controlled dangerous substances (CDS). CRISP serves as the access point for clinical providers, including prescribers, pharmacists, and other licensed healthcare practitioners for viewing filled CDS prescriptions. This helps physicians and pharmacists provide a safer experience to patients when prescribing and filling prescriptions.
In the past, users located in the District of Columbia who had DC-based medical licenses were permitted direct access to the Maryland PDMP data in accordance with Maryland regulatory guidance. Indirectly, access to Maryland PDMP included access to the DC PDMP through the Maryland pathway. Due to regulatory changes in Maryland, the Maryland pathway will be disabled in mid-May. Due to this change, DC-based organizations that would like to continue to view the DC PDMP data (and out of state PDMP data, including from Maryland) through CRISP moving forward, should request integration with the DC PDMP through CRISP or through their internal health records system using the Appriss Gateway integration form.
The Community Resource Information Exchange (CoRIE) grant was awarded to CRISP DC in March 2020 to create accountable and strong clinical-community linkages that address unmet social needs to improve equity, health and well-being. The CoRIE team aims to address the need for sharing social determinants of health data by creating a technical solution for communication between healthcare providers and community-based organizations. In collaboration with DHCF, DCPCA, Socially Determined, and DCHA, the CoRIE technical solution focuses on interoperability in order to accomplish 4 tasks that support patient care for Medicaid beneficiaries: screen for care and social service needs; refer beneficiaries to social services; monitor, track, and file follow-ups after referrals; and analyze population-level data. Key project work that is working towards this goal includes: integrating with existing social determinants of health (SDOH) systems in the district; establishing agreements and technology needed to share and standardize SDOH screening; building a closed loop referral tool for organizations that do not use a referral platform; outreach and piloting with CBOs and healthcare providers; and creating measures for internal and external reporting. The overall objective is to ensure the solution is adapted to local workflows, facilitates transitions of care, and improves outcomes.
For more information, click here.
The vaccine tracker is a powerful tool that provides visibility on a patient’s vaccine status. It is a CRISP Reporting Services (CRS) tool that has the ability to sort by age, race, ethnicity, medical conditions to facilitate process and equitable outreach. The tool uses Medicaid attribution and the vaccination data is updated daily from DC Health. It allows for user-editable status to track outreach results. The tracker also provides summary reports so practices can track patient vaccination status over time and compare by demographic fields.
Through the Chronic Absenteeism Reduction Effort or CARE – parents or guardians can give permission to District of Columbia Public Schools to securely share attendance information with their child’s doctor(s), nurse(s) and medical office staff. This information will help these healthcare professionals to provide special outreach and medical attention to children that might be missing school and their families.
Click here to learn more.
Applications
The Patient Care Snapshot combines critical information relevant to your role in the patient’s care. It displays data from a variety of sources to provide an at-a-glance view of the patient’s clinical history. Information is presented from a compilation of care management data alongside real-time hospital encounter feeds, up-to-date demographic information, patient to care provider attribution, and clinical summaries of care from our real-time interfaces with providers across the region.
Health Records is an application within the CRISP DC Unified Landing Page (ULP) that provides clinical information to treating providers and their staff. For example, if you are a primary care provider and your patient was admitted to a hospital in the HIE service region, you could use the Health Records application to look up his/her radiology report and discharge summary.
For more information, click here.
ENS
CRISP offers a service which enables medical personnel to receive real-time alerts when a patient has a hospital encounter. The service is offered in partnership with participating hospitals at no cost to ambulatory providers. Customizable by practice, the CRISP ENS will send a secure email message to providers for active patients in the practice.
Patient Attribution
Uses ENS data to indicate who is involved (i.e. the organization that receive the patient’s ENS alerts) in the care of the patient.
Prior Admissions
Provides a list of encounters in the last 60 days.
Image Exchange (IX), is an online image sharing service that allows CRISP users to view patient diagnostic images in one central location.
Currently, 4 hospitals in DC are contributing images to the image exchange service. These images are then made available to any CRISP user through our portals to facilitate greater collaboration and efficiency among healthcare providers, ultimately leading higher quality patient care.
The diagnostic images are securely stored on servers located within each connected hospital’s local environment. Images taken within the last 30 days are made available to all authorized CRISP users within seconds of collection while deeper archives of images older than 30 days are available within minutes.
CRISP offers two ways of viewing patient clinical data and images. The first option is to directly log on to the Unified Landing Page, using specific user credentials. The second option is to utilize the CRISP HIE InContext app within EPIC and Cerner EMRs.
CRISP Reporting Services (CRS) provides secure access to health care data and related analytics tools to assist health care organizations in improving patient care throughout the District. CRS links multiple data sources to offer a unique perspective on readmission rates, the total cost of care, and other critical measures to support hospitals, ambulatory providers, and public health organizations.
Care Alert
A short summary of the most pertinent information needed for acute care.
Care Manager Attribution
List of care management programs in which the patient is enrolled, alongside the name of the care manager and their contact information.
Care Plan Availability
Alert that indicates if a care plan is available on the CRISP Health Records portal.
A complete DC Provider Directory, that can be relied upon by DC healthcare organizations to identify external providers, so that clinical information can be safely sent, and digital delivery is maximized. To learn more, click here.
Patient Intake
Accurately record patient’s PCP at intake (supporting new CMS eNotification rule to PCP and Post Acute Care)
Referrals and Care Transitions
Improve digital delivery rates of clinical information using up-to-date contact information including all provider Direct addresses (supporting CMS Promoting Interoperability goals)
Admin and Credentialing
Real time access to provider data including qualifications, specialties, license information.
With the HIE InContext platform, an EMR user can access patient information within their established workflows without ever needing to navigate directly to the ULP. This embedded application delivers relevant information consisting of vaccine schedules, lab results, prescription medications, and more.
Data Sources
- All D.C. acute care hospitals
- All Maryland acute care hospitals
- All Delaware acute care hospitals (in partnership with DHIN)
- 17 Northern Virginia acute care hospitals (in partnership with ConnectVA)
- Most West Virginia acute care hospitals
CRISP DC is receiving clinical data from over 250 ambulatory practices in the District. CRISP DC through its’ shared platform also receives ambulatory data from Maryland and West Virginia sources.
As the designated HIE by the Department of Healthcare Finance, CRISP DC receives all District Medicaid data.
CRISP DC partners with many District Agencies to receive relevant clinical information. Some District partners include:
- DC Health
- Department of Energy and Environment
- Fire and EMS
- DC Public School System
- Department of Behavioral Health
- Child and Family Services
- Department of Corrections
- Office of the Chief Medical Examiner
CRISP is a Regional Health Information Exchange (HIE) serving Maryland, West Virginia, and the District of Columbia. It is the District-Designated HIE in the District of Columbia and the State-Designated HIE in Maryland. Through this shared services model, patient data is accessible to providers with care team relationships for patients who cross state lines. Delaware is a state partner which has an agreement to share data for patients through CRISP.