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Tuesday, December 18, 2018
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CRISP Services

Last Updated: December 5, 2018

CHEASPEAKE REGIONAL INFORMATION SERVICES FOR OUR PATIENTS (CRISP)

CRISP is Maryland’s Statewide Health Information Exchange (HIE).  An HIE is the technology that supports the flow of health information among physician practices, hospital labs, radiology centers, and other health care institutions.  HIE allows delivery of the right health information to the right place at the right time, providing safer, more timely, efficient, patient-centered care.

CRISP offers many services to physicians including the following:

  • Encounter Notification System (ENS) – Keeping You Connected to Your Patients - CRISP is now offering a service which enables physicians to receive real-time alerts when a patient is hospitalized.  The service is offered in partnership with all Maryland hospitals at no cost to ambulatory providers.
  • Connect to the CRISP Portal - Connect.  Share.  Improve Patient Care.
  • CRISP Direct Messaging - CRISP DIRECT Messaging is a secure and encrypted email service that supports electronic communication between physicians, nurse practitioners, physician assistants, and other healthcare providers.
  • Prescription Drug Monitoring Program (PDMP) – The PDMP monitors the prescribing and dispensing of drugs that contain controlled dangerous substances (CDS).

Please contact Colleen George from the Center for the Private Practice of Medicine at 800-492-1056 ext. 3360 for assistance with signing up for any of the FREE CRISP Services for Physicians.


Medicare CCLF Data Available Through CRISP

In support of state-wide Care Redesign initiatives, CRISP is making available the Medicare Claim and Claim Line Feed (CCLF) data to Maryland hospitals. CCLF data contain Medicare fee-for-service beneficiary claims for Maryland residents with a hospitalization within the past three years. The data contains Parts A, B and D claims including demographics, diagnoses, services received and payments. Hospitals that signed up for the first performance period of the HCIP and CCIP Care Redesign Programs will be able to see both summary and patient identifiable data. Those hospitals that did not sign up for the first performance period will still be able to see summary level data, but not identifiable data. 

Accessing the CRISP Medicare CCLF Data

Beginning on September 27th, you may access the CRISP Medicare CCLF data through the CRS Portal at https://reports.crisphealth.org. After logging in, you will see a new card named 'Medicare CCLF Data.' Click on this card to open the suite of Medicare CCLF Reports.

CRISP will also be making available a comprehensive Medicare CCLF User Guide. If you have other questions or feedback, do not hesitate to reach out to CRISP at support@crisphealth.org.


November Release Summary 

  • Medication Statement – Medication History information given by a patient or practitioner at time of visit.  Extracted from CCD are stored in FHIR service.
  • CRISP InContext – InContext App has ability to launch with only providing Username.
  • CCDA Service – Remove Overdose alerts from CRISP OnDemand CCD and include requesting organization OID in App Insights logging.
  • PDMP – Implemented a fix to improve response time.
  • Alert Service – A new alert service has been released.  The alert service links to all available alerts for a patient.  Each alert type will be hosted within its own microservice which will allow for flexibility among alerts and improved reporting capabilities.
  • FHIR Services – Continued improvements to best fit the FHIR spec and handle querying, POSTing, and logging. 

November Release Details

Medication Statement FHIR v1.0.0  November 1st, 2018

  • Version 1.0.0 will support HTTP Methods PUT/DELETE
  • PUT  supports creating a new MedicationStatement resource in respective database. Method also supports updating existing resource (Delete existing resource > Add updated resource as new)
  • DELETE supports deleting MedicationStatement resource from its respective database
  • Available over API Gateway FHIR endpoint
  • FHIR compliant resource, which closely follows FHIR MedicationStatement resource spec and overall guidelines, with regards to endpoint structure, supported query parameters, error handling, and request/response modeling
  • MedicationStatement Specification: https://www.hl7.org/fhir/medicationstatement.html
  • Basic App Insights logging 
  • Requests logged for requests made to MedicationStatement Microservice
  • Dependencies logged for outbound queries made by Observation Microservice (primarily database interactions)
  • MedicationStatement database resource will be populated with appropriate MedicationStatement data, using PUT requests parsed by Mirth Connect channels. Saurabh Kumar will be responsible for pushing the initial data to MedicationStatement's database, once live in PROD.

CRISP InContext v1.7.2 November 20th, 2018

  • To receive access to PDMP data, CRISP requires user license (CDS, NPI, or DEA) verification for PDMP authorization. If only a username is sent and the user license verification is unavailable, all patient data will still display minus PDMP data.
  • Previously no data was available instead of just PDMP
  • InContext App launches with username only
  • Fixed bug where InContext App would sometimes fail to launch when client only passes username, without any additional provider license codes (DEA/CDS/NPI)
  • PDMP Data is not visible if unable to authorize in Salesforce.

CCDA Service v1.8.1 November 20th, 2018

  • Remove Overdose Alerts from Alert Registry CCD
  • When Alert CCD documents are requested via ITI-43 / ITI-39 ,alerts of type "OD" will be no longer be returned in the Alert CCD. 
  • Controlled by app setting in the event we would like to remove any other alert types from the Alert CCD, in the future
  • Log Requesting OID for document list and document queries
  • Implemented for the purpose of tracking queries made to CCDA Federator via CareQuality, as we are unable to identify the requesting organization otherwise. 
  • The OID will come from the <MessageID> element in the ITI query. 
  • RequestingOID will be logged to request.customDimensions.RequestingOID
  • Endpoints impacted: /list, /listbysmrn, /document

PDMP v2.5.2 November 20th, 2018

  • A large amount of threads were found pointing to the same area of code. Each one of threads affected by the slowdown all shared the characteristics. It turns out that area of code was referencing a dictionary and a lock missing around a dictionary. This is a concurrency issue where multiple threads are interacting with a resource that is not threadsafe. The offending dictionary (which is not threadsafe) will be removed and replaced with a ConditionalWeakTable which is threadsafe.

Alert Service v1.1.2  November 29th, 2018

  • Ability to query Alerts Registry and package data into exact same JSON response currently returned by Alerts Registry. 
  • Supports same query parameters as Alerts Registry (source, excludeSource, type, startDate, fromDate, category etc.). 
  • Supports querying for more than 1 alert type
  • Supports GET (byEID) HTTP Method
  • Will leverage the existing Endpoint for Alerts Registry ([https://api.crisphealth.org/alert/byEID/[eid])]
  • No change necessary for existing integrations
  • InContext App will be using the app service on the backend, but response on the front end will not change
  • Upholds Consent check
  • Each request to Alerts Aggregator undergoes logic to check for consent before handing any data back to the user. 
  • App Insights Logging
  • Alerts Aggregator will log the exact same request as the current Alerts Registry. There should be no change on the reporting side. This logging will replace the existing Alerts Registry logging. 
  • Database for storing configurations and app service connections
  • Supports functionality to search data provider by SMRN (not currently in use, but added to existing code base to setup for future microservices, such as Overdose, which will be queried through the Alerts Aggregator). 
  • Additional bug fixes in place handling bugs 

FHIR Services

DiagnosticReport v1.3.2 November 29th, 2018

  • This micro release of DiagnosticReport contains minor bug fixes, one of which ensures we are following the FHIR spec accordingly for DiagnosticReport resource queries. The additional bug fixes pertain to correcting the request name in the logs, and altering logic to ensure the service can capture the database schema, as well as continue handling the first request properly before closing it's SQL Connection. 

Observation v1.3.2 November 29th, 2018

  • This micro release of Observation contains minor bug fixes, one of which corrects the JSON response model being returned, as it will no longer return a default value for "valueBoolean".  Also, additional bug fix in place to ensure the service can capture the database schema, as well as continue handling the first request properly before closing it's SQL Connection. 

 

If you have any questions about these updates, please contact us at support@crisphealth.org or call us at 1-877-952-7477. Thank you.

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