Most of the setup process and instructions you can find Third-Party App Setup and Support Guide on Galaxy. This document serves as a supplement - it adds details specific to Way to Health, and points you to specific sections of the Galaxy document as not all portions of that document are necessary.

Overview

Way to Health is a platform used to power a range of programs in the realms of connected health, remote patient monitoring, and patient engagement. Most of our clinical programs use text messaging, but we also use surveys, connected devices, and other data sources.

Different programs, different integration needs

Different Way to Health programs will have different workflows and integration needs. For example, Heart Safe Motherhood (a postpartum BP monitoring program) requires a way to enroll patients, start them in the program post-discharge, and send BPs received from the patient back to the medical record. Coloprep (a text program to improve colonoscopy prep) does not require manual enrollment, but instead uses an HL7 scheduling feed to enroll patients and trigger the text messages at the right time.

Your Way to Health implementation lead will guide your clinical, operational, and IT teams in deciding which features are needed for the specific program(s) you are implementing.

Setup once, use for multiple programs

Way to Health’s Epic integration requires a one-time setup before it can be used for any number of programs. For example, once the embed is available, health systems can begin enrolling and monitoring patients in as many W2H programs as they’d like with no additional IT setup. Similarly, once an outbound ADT feed is established, this can be used by any number of programs to start the intervention after discharge. This applies to all of the features described below except for flowsheets and InBasket messaging, which are typically configured for a specific program or care team and therefore require program-specific customization.

Use Cases, Features, and Required Setup

Our app listings specify the broadest set of APIs and interfaces we use, but each connected health program will only use a subset. In this document we’ll try to specify which features, which setup, and which apps are required for specific types of connected health programs.

Information to send to Way to Health

(reference: Send Specific Information to Your App Vendor)

Implementation process

Program changes and shutdown

All program changes (including shutdown requests) should be submitted through our help desk located at http://support.waytohealth.org

Epic embed

Desktop Integration

The Galaxy document Create Integration Records for Active Guidelines describes how to create the embedded view. Here are the details you’ll need to supply as you complete that setup:

Recommended method, using SMART launch

reference: Configure the Integration Record for SMART on FHIR

Legacy launch, using AES encryption

reference: Configure the Integration Record for HTTP GET

Flowsheet

We currently only support writing to Clinical Documentation Flowsheets - Patient Entered Flowsheets include workflow constraints that are not feasible for how our programs operate. (Either they require a MyChart account limiting patient access/equity, or they require an order to be placed by the provider to create the flowsheet.) We recommend creating new flowsheet rows and naming them to make clear to any users that the data is patient-entered.

We can send flowsheet data using any of the following three mechanisms:

HL7

More information on setting up HL7v2 over HTTPS can be found in the Galaxy document Incoming HL7v2 Over HTTP or HTTPS Using Interconnect.

Setup required:

• New interface setup:

  • Interface Kind: Incoming Clinical Documentation Flowsheet Data [97]

  • No custom setting or custom executable codes used.  All standard settings.

We have found success with having Bridges create a new encounter for each new data point received. That can be done by setting Bridges Profile variable  VISIT_MATCH_USE_DATE_RANGE [80604] to 0 - Use visit ID only (default 1 - Use visit ID, then search by date range).

Sample message:

MSH|^~\&|WAYTOHEALTH|WAYTOHEALTH|YOUR_HOSPITAL|EPIC|20230614112200||ORU^R01^ORU_R01|12234|T|2.6
PID|1||0123456^^^^MR|876876^^^^WAYTOHEALTH|Doe^Jane||19600101
PV1|1||DEPT_A|
OBR|1||148745|29274-8^VITAL SIGNS MEASUREMENTS^LN|||20230614112132||||||||||||||||||F
OBX|1|NM|SYSTOLIC^INTRAVASCULAR SYSTOLIC^||126|^mmHg|||||F|||20230614112132
OBX|2|NM|DIASTOLIC^INTRAVASCULAR DIASTOLIC^||71|^mmHg|||||F|||20230614112132

Identifiers

• The identifiers in OBX-3-1 (SYSTOLIC an DIASTOLIC in the sample message above) can be modified if needed to match other flowsheet rows in your system.

• The dept ID (DEPT_A in the sample message) is used by Bridges to determine which dept to create an encounter in

• We send MRN, First Name, Last Name, and Date of Birth in the PID segment. These are used for identity verification by Bridges. PID 4 contains the patient’s Way to Health ID, which isn’t used by Bridges but can be helpful for troubleshooting.

Observation.Create

Flowsheet identifiers

We can use two types of identifiers for flowsheet rows - either the FHIR ID or the FLO .1 ID coupled with an OID specific to your health system. FHIR flowsheet IDs can be generated in the Interface Programmer Menu in Text. (d ^AI -> Support Utilities -> Web Service Utilities -> Generate Encoded Flowsheet IDs. If you don’t know the health-system specific OID for flowsheet rows, your Epic TS can help. Reference SLG 4392308.

Inbasket

Base requirements:

• Webservices access (see “User and Security Setup” above)

• Requires installing backend app

Project setup

• We need Pool ID (HIP.1)

• We typically send messages as Staff Message (message id type = 1). Sending messages into other folders requires more complex setup - consult your Epic TS for details on which message types can receive messages via API.

Other optional setup

Some of our health system customers use Smart Forms to drive some of the enrollment or tracking process. Some programs have set up Smart Phrases to pull flowsheet data sent from Way to Health into clinical notes. If you’re interested in using these tools, we can connect you with the IT staff or physician builders who set these up.