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LIVE From HIMSS17: HIE Leaders Discuss Sustainability and Emerging Services to Deliver Value

February 21, 2017
by Heather Landi
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Healthcare providers increasingly want and need access to their patients’ data for the purposes of care coordination and care management, and, to meet this need, regional healthcare information exchange (HIE) organizations are pushing into advanced analytics and developing new services to bring actionable data to providers at the point of care.

During a session titled, “Emerging Services among Health Information Exchange Networks: Towards Sustainability,” during a pre-conference sessions at HIMSS17 on Sunday, executive leaders at three HIE organizations were joined by John Rancourt, deputy director, office of care transformation (OCT), from the Office of the National Coordinator for Health IT (ONC), to address the issue of HIE sustainability and to discuss several emerging services that HIE organizations are offering to support individual care delivery as well as population health.

However, before the discussion began, John Kansky, president and CEO, Indiana Health Information Exchange, said he took issue with the idea that HIE sustainability is a challenge.

“It’s hard work. I feel like any business that can generate value and has the opportunity to create new value shouldn’t have any problems sustaining itself as a business. With the healthcare system as fragmented as it is, there is no shortage of things that HIEs can do to add value,” he said.

With that being said, the panelists shared what is driving innovation at their HIE organizations and where they are focusing their investments to deliver more value to providers and payers and support interoperability of health data among providers, payers, and other health care organizations.

Brandon Neiswender, vice president and COO, Chesapeake Regional Information System for our Patients – CRISP, a regional HIE serving Maryland the District of Columbia, said, “One of the new things driving innovation at CRISP and what are we investing in is, we believe a lot of the access to C-CDA (Consolidated-Clinical Document. Architecture) clinical data is going to get easier. We see we’re making progress with large national efforts, such as The Sequoia Project and Carequality, moving data a little bit easier upon query,” he said.

However, Neiswender noted, “Connectivity is not interoperability. We have a lot of connectivity, but interoperability is still a challenge for us. FOR CRISP, our stakeholder community is driving us to build care coordination solutions,” he said.

He said CRISP is investing in delivering actionable data at the point of care, “so want to glean relevant information out of C-CDAs and make them snippets of information available at the point of care and building out the C-CDA so other EHR vendor can ingest that directly into the EHRs.” And, CRISP is focusing on connecting the care team, behavioral health use cases and Big Data concepts applied to claims and clinical data.

“We’re also taking a preliminary look at patient-generated data from value-based payment perspective, with a focus on getting that PGD to providers so they can prevent an acute admission,” he said.

Charles Scaglione, CEO and executive director, Bronx RHIO, described his organization as a regional health information organization servicing greater NYC area, specifically the borough of the Bronx, with a population of 1.4 million people. Stakeholders represent appropriately 100 organization from small specialty community-based organizations to integrated delivery systems. Collectively, these providers deliver more than 95 percent of the borough’s annual hospital discharges, more than 600,000 annual emergency department visits and 4.5 million annual ambulatory care visits. Bronx RHIO participates in the Statewide Health Information Network for New York (SHIN-NY).

Currently, key drivers for Bronx RHIO, Scaglione said, health indicators for the Bronx population. “The Bronx historically is poor performing in health outcomes; it’s ranked lowest in New York State, despite the great work being done. It’s a unique population, it’s young, there’s a lot of poverty and challenging health, social and economic indicators, so it’s challenging.”

Health reform initiatives, such as Medicaid redesign and the Delivery System Reform Incentive Payment Program (DSRIP) had a big impact on the organization, he said. “We were the beneficiary of a CMS  [Centers for Medicare & Medicaid) innovation grant four years ago and we have used that to push into analytics and working to introduce analytics into the point of care,” he said.

Further, Scaglione says the organization is being driven by providers moving into value-based care models, such as accountable care organizations (ACOs) and patient-centered medical homes.

Scaglione said Bronx RHIO is specifically focusing on data quality assessment and improvement initiatives. “About four years ago, we were starting out on analytics and we realized we didn’t know enough about our data. So, we’re really focusing on data knowledge, data intelligence and we have a board-level priority to focus on this and we’re working with our stakeholders on data quality initiatives.”

The organization also is focused on advanced analytics targeting interventions and improved outcomes, data aggregation and routing to improve care transitions and coordination, patient and population health safety as well as education and research partnerships.

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