At the Philadelphia Health IT Summit, leaders from HealthShare Exchange (HSX), the Delaware Valley region's health information exchange (HIE), outlined new organization strategies that include how its Market Street technology initiative is opening new avenues for innovation.
Martin Lupinetti, president of HealthShare Exchange, opened the presentation at the Philadelphia Health IT Summit, presented by Healthcare Informatics, speaking about HSX 3.0, the next phase for the organization that will concentrate on expanding the HIE, as well as increasing the amount of data and coverage it has in the Delaware Valley. Lupinetti said that will involve looking more at population health, analytics and reporting, with an increased focus on R&D and innovation activities for the first time. “Data acquisition, and making data accessible when and where it’s needed, is key for us,” he said.
Currently, HSX has more than 7 million individual patients in its master patient index, despite being created less than six years ago. The HIE also has more than 10,500 providers in its directory, and over 300,000 messages have been exchanged via the HIE through April 2018. And, 94 percent of those messages that are being sent are inter-health system.
The scope of HSX’s collaboration includes competitors, across all organizations, that during the HIE’s leadership meetings, are continuously contributing ways to better use data. “We are not owned by any single entity; our board is made up of five health systems, five health plans, and then seven at-large seats. We are the independent non-profit in the middle,” he said.
Lupinetti said he believes HSX has created a diverse membership, inclusive of: health plans contributing data, ACOs (accountable care organizations); behavioral health entities; specialty practices; independent practices; and owned practices. “We have a very stable financial plan in place, and we are grant independent," he emphasized, while noting that many HIEs run with the grant cycle, and even though HSX does aggressively go after grants, right now they are grant independent.
Lupinetti further noted that the HIE is now using a new reporting tool with heat maps that shows where patients are coming from and where they are going to seek care. Via the tool, every U.S. state is represented, in addition to some other countries. The tool “dials-in per zip code,” he said, enabling the HIE’s members to get concrete information on their patients that they didn’t have previously.
Similarly, HSX is partnering with community health centers in Philadelphia, and the Health Federation of Philadelphia, an organization which has a patient population that is 35 percent uninsured. So, the HIE offers a variety of services to the Federation, including enabling them access to HSX’s clinical data repository. “This gives them the ability to get much more visibility into the patients who they care for,” Lupinetti said. What’s more, HSX has cultivated a relationship with MANNA (the Philadelphia-based Metropolitan Area Neighborhood Nutrition Alliance), an organization that delivers food to chronically ill patients. Lupinetti noted that MANNA was struggling to get viable data on many of those patients, but using the HIE’s services has helped overcome those challenges.
HSX has also formed a family reunion service that aims to people locate their family members in the event of a major disaster or emergency that would send people to hospitals for care. This was launched in time for the Pope’s visit to Philadelphia in September 2015, and remains live and ready today. To this end, the other event that prompted the reunion service was the Amtrak train derailment in May 2015, said Lupinetti. Such a location service would have helped family members find out where their loved ones who were involved in the accident were taken for care.
HSX Market Street Looks to Take Off
Supplementing the HIT Summit this week in Philadelphia, HSX and Healthcare Informatics are presenting the Consumer Health-Data-Exchange Hackathon in which participants are challenged to utilize exposed APIs (application program interfaces) to develop a solution that enhances patient care through the exchange of the patient's clinical data, officials noted.
Specifically, Hackathon participants are encouraged to be creative with their solutions, and can incorporate integrations with existing patient care platforms. For the Hackathon, HSX Market Street—which officials say is an innovation opportunity for entrepreneurs, providers, and consumers that will drive application development, research, care monitoring, and more—will open its APIs to the hackers as a pathway to innovation. The idea is to get the innovators connected to HSX's newly developed market place.
According to HSX leaders, “This will make available to the hackers an invaluable resource: a vast database of (de-identified) patient data representative of the health status of millions across the greater Philadelphia/Delaware Valley region. Hackathon participants will use this data and the APIs to create tools to increase patient access to their information, and empower consumers to improve their health and care management,” they said.
Rakesh Mathew, innovation and R&D lead at HSX, spoke further about HSX Market Street initiative at the event, noting, “From a technology perspective, these are open APIs layered on top of our HIE. We have custom APIs and some FHIR-based APIs that we are hoping to expose in the coming months. The APIs are built on AWS [Amazon Web Services], and that’s scalable since we have a multitude of applications coming on top of it,” he said.
Mathew said that HSX has also developed a sandbox with test data, with the hope being that vendors will eventually be able to get access to real patient data in the HIE’s clinical data repository. Mathew noted that usually when vendors implement a new solution on top of an EHR (electronic health record) for a health system, the process takes between six and 18 months. But via Market Street, HSX is offering a platform in which vendors can skip those implementation hurdles, and a one-time setup gets these solution providers access to multiple health systems, Mathew said. Indeed, he added, the goal was to “create a platform that would allow different companies to work together without having to do multiple implementations and integrations separately.”
Mathew explained that Market Street has connected with Philadelphia-based Jefferson Health’s “JeffDocs” app—which allows providers to refer their patients to Jefferson Health providers. The app was initially focused on creating a provider directory for all of the health system’s locations, but then, the Jefferson Health team tapped into the APIs of Market Street to enhance the app to enable referrals, too.
What’s more, HSX is also working with Apple and its HealthKit app, where patients can download their health data right to their iPhones. Penn Medicine and Jefferson Health are part of this initiative, said Mathew, who explained that patients often use a variety of health systems and independent providers to get their care. As such, HSX is working with Apple with the goal to enable as many patient health data connections as possible with health systems that are on Epic’s EHR. And then when there is a gap—when those connections are not possible—HSX Market Street can be leveraged. “This will allow these patients to access their data from [all health systems],” Mathew said, adding that HSX is hoping that Google comes up with something similar to HealthKit.