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At iHT2 New York, NYU Medical Center Shares How Private HIE Improves Care Coordination

October 1, 2015
by Heather Landi
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For NYU Langone Medical Center, a private health information exchange (HIE) is helping to improve patient care and care coordination by enabling more efficient clinical information sharing across New York City, according to Frat Iqbal, senior information manager at NYU Langone Medical Center, who spoke Wednesday during the iHT2 (a sister organization to Healthcare Informatics) New York Health IT Summit.

During a case study presentation, Iqbal outlined the challenges, operations, strategy and analytics of it’s HIE. Iqbal said NYU Medical Center’s private HIE is focused on a specific region and community and is funded by private organizations with less reliance on state and federal grants, and this enables the HIE to have independent strategies sand goals.

“As a private HIE, we are more agile, more focused, we can align the HIE with our goals and we are local to New York,” he said.

“When thinking about why we needed an HIE, there saw that there were 7,397 registered group practices and we saw the reality, which was inefficient clinical information sharing,” Iqbal said. “Our vision is electronic clinical information sharing to provide 360-degree care, so a patient’s information is readily available right there and then. We wanted to improve patient care and coordination in our community.”

The HIE started in 2011 and the goal was to connect 375 private practices with a target of integrating 3,500 clinicians with more than 42 electronic medical records (EMRs). Today, there are 210 private practices connecting and sharing data on the private HIE, with about 1,900 clinicians accessing data and 26 EMRs connected, Iqbal said.

Through the HIE, clinicians can access clinical information such as lab results, dermatology, pathology, EKG and CCD.

“We do a lot of clinical information. We don’t let go of any opportunity to collect data and we go above and beyond. Epic is our in-house EMR, so we collect data from them and outside clinicians can look at that data,” Iqbal said.

NYU Medical Center built the HIE one group practice at a time with a strategy that focused on picking the right technology, setting the right expectations, building the right team and standardizing the processes and technical requirements, Iqbal said.

And, Iqbal admitted that the process was often “painful,” as it entailed interfacing with 42-plus EMRs as well as PHI management, “which itself is a nightmare,” he said. Other challenges included resources, scheduling and expectations, project prioritization and technical incompetency.

The result, he said, is that there are now 200-plus physicians sharing data, which means that “if a patient goes to any of these practices, our HIE covers that data and now we can improve the coordination of care.”

The HIE enables immediate access and sharing of clinical data, efficient transition of care, reduction of needless visits and lower cost of care.

“Patients’ clinical information comes with them wherever they go and that is something we need to tackle today, the urgency is today,” he said.

Looking ahead, Iqbal said HIE data will be a useful tool to address the high cost of the top 5 percent of patients as well as focusing on predictive analytics.

“Analytical innovation will get us there,” he said, noting that the combination of HIE data, Epic data and payer data allows for what he referred to as “clinical 3D analytics.”

Iqbal said the HIE platform – NYU Langone Medical Center is currently migrating to a new Optum HIE 2.0 platform – collects clinical and lab information, such as new patients with evidence of diabetes or patients’ chronic diseases, and transfers that information into cost and risk data.

“Now we can understand, how much is this actually costing us,” Iqbal said. “A PMPM (per member per month) takes us three minutes. That is the power of analytics that we are seeing at NYU Medical Center.”