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Improving Care Coordination with Data Exchange: Issues Around Community, Standards, Innovation

August 7, 2014
by Kayt Sukel
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Leveraging health information exchange in order to improve care coordination is an ideal that is being pursued in a variety of different ways in a variety of different communities

In April 2004, President George W. Bush called for every American to have an electronic medical record (EMR) within 10 years.  It was a vital call to action—the first step to creating an information network that would allow important health information to be exchanged between doctors, pharmacists and other key healthcare providers, ultimately improving the quality and coordination of care for all Americans.  Now that we’ve passed requisite 10 year mark, true health information exchange (HIE) remains a challenging goal for many medical communities.  To discuss HIE strategy and innovation, the Institute for Health Technology Transformation (iHT2) has tapped experienced data-sharing technologists for its “Improving Care Coordination with Data Exchange” panel.  Two of those panelists, Mary Dallas, M.D., chief medical information officer at St. Charles Health System, and John Kenagy, Ph.D., Chief Information Officer at Legacy Health System, spoke with Healthcare Informatics about the key points they plan to share at the upcoming Health  IT Summit in Seattle, to be held August 19-20 at the Seattle Marriott Waterfront. The Summit is sponsored by iHT2 (since December 2013, Healthcare Informatics has been in partnership with iHT2 through HCI’s parent company, the Vendome Group, LLC). For further information on the Summit, please click here.

Dallas, who manages an integrated system of over 160 ambulatory providers, understands that everyone wants to get the most out of their data—and says that she understands true HIE is challenging.  “Trying to actively develop a community health information exchange is not an easy thing.  At this point, a lot of providers in the community are on different EMR platforms and having the ability to not only exchange data between facilities but do so in a way that we can make it useful is extremely difficult,” she says.  Dallas argues that even the new levels of standards for data exchange are lacking.  “They don’t align and they don’t match up well yet.  So if you’re a patient in the community, you will still see a lot of old-fashioned faxing and access to other EMR systems so clinicians can look stuff up.  There’s just not a great workflow to take information and send it from one place to another.”

Kenagy, responsible for directing data exchange efforts at Legacy Healthcare, agrees that achieving HIE is challenging.  But he argues that the healthcare industry is in a unique time in history right now—which provides a lot of potential opportunity for healthcare organizations, too.  “We are in a post-meaningful use world.  And what I mean by that is, decades after talking about the benefits of electronic health records, adoption is very high because of meaningful use money.  So now we have data we can exchange and we have data we can analyze for improving care,” he says.  “So while the level of barriers is a lot more intense to making real exchange happen, the possibility for success is a lot greater.”

How can your organization find that possibility for success?  By finding the right vendor partners to help with the technology.  “With the government push for HIE and industry purchaser expectations, vendors are really listening.  They are paying attention,” says Kenagy.  “Standards aren’t rich enough that you can have interoperability from the fourth floor to the fifth floor if you’re on two different EMRs.  But, specifically, with transitions of care and direct messaging, the lowest common denominator is actually pretty good.”

But, before your organization makes any significant technology investments towards HIE, Dallas says that understanding your organization’s true goals for data exchange needs to happen first.  “You need to clearly understand what you are trying to accomplish with your information exchange between groups.  Is it more of a use case that you’re trying to build reports to go to an ACO so you can get paid?  Or are you really trying to impact the point of care and change utilization patterns between facilities when a patient goes from hospital A to provider B?” she says.  “Understanding your goals as an organization is really important.  Because there are very different ways you can use information.  And depending on how you want to use it, there are very different tools you need to develop to get you there.”

These and other topics will make for a lively discussion in Seattle, as Mr. Kung and others discuss key topics around population health management, data analytics, health information exchange, and other subjects. To learn more, please check out the Health IT Summit in Seattle, August 19-20,, sponsored by the Institute for Health TechnologyTransformation.