Very exciting things are happening these days at the Nebraska Health Information Initiative (NeHII), the statewide health information exchange (HIE) for Nebraska. Under the leadership of CEO Deb Bass, NeHII has moved ahead to embed some of NEHII’s capabilities into core, and even mandatory, state healthcare processes in the Cornhusker State.
Since January 1 of this year, all prescriptions for controlled substances in Nebraska have had to be logged into the state government-sponsored Nebraska Prescription Drug Monitoring Program (PDMP) database, which NeHII operates. And, beginning on January 1, 2018, all filled prescriptions will be required to be logged into that statewide PDMP database. Meanwhile, NeHII continues to move forward on numerous other fronts as well, particularly in terms of collaborations with payers and providers in the state.
Healthcare Informatics Editor-in-Chief Mark Hagland was able to sit down with Bass during the SHIEC Annual Conference, sponsored by SHIEC, the Strategic Health Information Exchange Collaborative, while it was being held August 27-30, at the Crowne Plaza Union Station Downtown Indianapolis. Below are excerpts from that interview.
I’m interested to hear about some of the latest developments at NeHII.
Well, we’re very excited. When I last spoke with you, we had just passed LB 471 in Nebraska. The Department of Health and Human Services is partnering with us on this. Beginning this past January 1, all controlled substances prescriptions had to be logged into our PDMP database. Now, beginning, January 1, 2018, all filled medications prescriptions in Nebraska will have to be logged into it. We are going to be able to capture all filled prescriptions in our PDMP—our prescription drug monitoring program.
The vendor we were using to get our medication history, had gaps in their data. So we got this bill passed, and that mandated the reporting of all filled prescriptions to our prescription drug monitoring program across Nebraska, and that has moved us forward very strongly in this area.
Every filled prescription must now go into a database?
Yes, that’s right—into a database set up through DoctorFirst, our vendor, through a partnership set up between the state of Nebraska and NeHII. The state owns it. LB 223 passed in May 2017, and that gives nurses access to the information. It makes possible a query directly from the clinician’s EHR [electronic health record] to the PDMP—they don’t have to go into another system. It’s minimizing the clicks so that the clinician can get to the data. Plus, it’s free to all prescribers and dispensers. So we are giving a free medication reconciliation tool to all prescribers and dispensers in our state. You know how much time it takes to do med rec. We have grants from the CDC [Centers for Disease Control and prevention], and a Harold Rogers grant from the Department of Justice.
The law specifically covers filled prescriptions. Can you explain the significance of that element of it?
Yes, many prescribers write prescriptions that aren’t filled. That’s why this is so important. This will help prescribers know which of their prescriptions are ultimately filled, and which not. Our end goal is to address adverse medical events, including the opioid crisis. Look at the dollars associated with adverse medication events, in terms of extended hospital stays, readmissions, etc.
This speaks to why health information exchange is so important in terms of improving processes in healthcare, correct?
Yes, that’s right; we are that trusted community partner. We are the neutral convener. For the most part, the HIEs in SHIEC are non-profit collaboratives, and the mission for nearly all of us has to do with patient safety, increasing quality, and reducing costs. We’ve seen real-life stories of what’s happening to people, and it just makes us all the more dedicated towards those goals, with regard to improving the quality outcomes, the cost control, and the patient, family, and community experience of healthcare delivery.
Those are all Triple Aim and Quadruple Aim goals, of course.
Yes, they absolutely are.
Meanwhile, this has been the third annual meeting for SHIEC. You must be excited by how things have progressed.
Yes, I’m very excited! Those of us who are the board members of the organization started as a little user group, and formed a trust relationship with each other. We share what we’re doing well; we call each other, we share emails. I’m viewed as something like the group’s PDMP expert, and people consult with me on that subject. And we recognize that when one of us fails, it impacts all of us. And that gives you this beautiful, no-holds-barred, trust relationship. We’re here to help each other.
One topic that might be sensitive right now is the number of HIE organizations that have failed in recent months. What I hear some healthcare IT leaders in patient care organizations expressing, is some hesitation about leading their energies to a phenomenon that seems a bit fragile or unstable right now. Could you share your thoughts on that?