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In The Big Apple, eHealth is Making Waves

November 19, 2013
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Back in February, when I attended a conference at the New York Institute of Technology in Manhattan, Mayor Michael Bloomberg discussed how the use of technology in disadvantaged areas of the city has led to improvements in detecting certain preventable health problems, including high blood pressure, tobacco use, high cholesterol, and diabetes.

Between 2008-2011, with the help of electronic health records (EHRs), 81,000 patients improved their management of diabetes, 96,000 New Yorkers got help controlling their high blood pressure, and 58,000 smokers got help kicking the habit, Bloomberg announced at the conference.

Now, a little less than a year later, even more strides are being made in New York City when it comes to health IT. Last week, healthcare providers, IT innovators, health leadership, start-ups, hospital officials, group practice managers, investors, and entrepreneurs gathered in the New York Hilton to hear insights, ideas, and analysis from leaders in the health IT community at the New York eHealth Collaborative's (NYeC) annual Digital Health Conference.

At the conference, the first example of health IT expansion in the state that I saw was the growth of the Statewide Health Information Network of New York (SHIN-NY). David Whitlinger, executive director of the NYeC, compared this network to electricity, in that it connects the healthcare ecosystem through a common infrastructure. “No one really wants electricity,” Whitlinger said. “They want what electricity could accomplish for them.”

Just this year, the SHIN-NY has made significant progress—beyond the fact that 72 percent of New York State hospitals are connected to the state health information exchange (HIE). In February, NYeC and Healthcare Information Xchange of New York (HIXNY) announced that SHIN-NY would now offer the ability of direct messaging between clinicians. And this summer, the N.Y.-based start-up  Mana Health was selected to develop the patient portal for the SHIN-NY. The portal will be available in the first quarter of 2014, with the hope that 1 million people will use it in the first year to access their health records, keep track of medical appointments, and manage their prescriptions and lab results.

And in the coming months, the NYeC will be launching an API (application programming interface) for the SHIN-NY, which will allow access to the data within the network and will serve as the gateway enabling developers to build new healthcare technology applications on top of it. Through the API, innovators and health IT companies can access the clinical information required to develop products that meet healthcare providers’ needs, with the appropriate policies in place.

The API platform will help create an ecosystem of collaboration among patients, providers, public health officials, and innovators in response to shifting health technology needs, NYeC officials believe. Whitlinger  sees the SHIN-NY as a huge economic opportunity for New York. “No single entity can deliver all of these tools, but it will instead take an ecosystem working together to create transformational results,” he said. With all this in mind, I believe the SHIN-NY has potential to be a game-changer for population health.  

I also sat in on a session from the New York City-based Mount Sinai Medical Center, which recently opened its Geriatric Emergency Department,  funded by a $12.7 million Centers for Medicare & Medicaid Services (CMS) Innovations Award. GEDI WISE is an HIE-empowered care coordination program for older adults. The program will provide clinical, workforce, and informatics enhancements to geriatric emergency care that are projected to produce a cost savings to Medicare and Mount Sinai of over $40 million over the next three years.

Mount Sinai officials discussed a paradigm shift away from the current model of emergency care to one based on the specific needs of older adults. Emergency care, they said, is not designed for rapid turnaround and evaluation of patients. Quick turnover and squeezing patients into rooms is not where “you want to send your grandma,” they said. Now, Healthix, a N.Y.-based RHIO, and NYeC are collaborating with Mount Sinai to create an advanced notification system to help empower GEDI WISE care coordinators to better care for their patients following ED visits.

Concerning the growth of eHealth, George Halvorson, chairman of Kaiser Permanente, said it best during his keynote on the conference’s opening day when discussing the clinical success at KP. "Electronic data lets us uncover all kinds of linkages and causalities in healthcare,” he said. “Without the data, we couldn't have even begun the research. As a result of eHealth systems, our outcomes our twice as good as any in the country."

Kaiser Permanente has set the right example, and the NYeC is applying many of those same principles to help providers throughout the state shift more easily to electronic data—one of the biggest and most fundamental steps towards transformational change.