Deriving Value from a Health Information Exchange HIMSS17 DA-CH Community Conference Healthix I New York I February 20, 2017
About Healthix
About Healthix Hundreds of healthcare organizations at more than 1,500 facilities across New York City and Long Island participate in Healthix. Healthix is the largest public Healthix Information Monthly Statistics Exchange (HIE) in the United States 50 Million inbound clinical Supplies messagesecure data to improve 510,000 real-time healthcare clinical quality, efficiency alerts and effectiveness Provides 97,000 Patient a range Summary of clinical information Documents Shared (CCDs) in real-time Facilitates care coordination
Healthix and the SHIN-NY State Health Information Network New York The SHIN-NY is composed of 8 HIEs or Qualified Entities. The NYS DOH establishes common services, privacy and security policies, and technical standards for interoperability. When a user queries for patient data, Healthix automatically returns data from both Healthix and the SHIN-NY
Data Available in Healthix Allergies Diagnoses/Problem List Demographics Encounters Insurance Lab Results Medications Care Plans Radiology Reports Summary Reports
Sources of Data Hospitals Independent Physician Practices of All sizes Long-term Care, Nursing Facilities Behavioral Health Facilities Federally Qualified Health Centers (FQHCs) Community Based Organizations Home Care 60 180 68 52 34 21 19 Health Plans PPS Leads In development Medicaid Health Homes Independent Pharmacies Independent Labs & Radiology Centers NYC Correctional Health Services All Other Public HIEs in New York State 11 9 2 7 2 1 7 EMS Medicaid Claims Veterans Administration
Healthix Participating Organizations Hospitals ( 6% ) Ambulatory ( 69% ) Physician Practices ( 5% ) More than 1,500 facilities across New York City and Long Island FQHC ( 7% ) LTC ( 4% ) Behavioral Health ( 3% ) NYS & NYC Public Health ( 1% ) Home Care ( 1% ) Community BO ( 1% ) Health Plans ( 1% ) Other (.3% )
Healthix Services
Providing Solutions, Adding Value 1 2 3 Coordinated Care: Complete View of Patient Real-time Intervention at the Point of Care Determine Risk and Provide Actionable Data BETTER OUTCOMES COST EFFICIENCY HIGHER SATISFACTION
Providing Solutions, Adding Value 1 2 3 Coordinated Care: Complete View of Patient Real-time Intervention at the Point of Care Determine Risk and Provide Actionable Data BETTER OUTCOMES COST EFFICIENCY HIGHER SATISFACTION
Clinical Event Notification Workflow
Clinical Event Notifications: NOW Current Functionality Method of Subscription Subscription file All patients Rule-based Trigger Method of Notification IP admission/discharge ED admission/discharge SNF admission/discharge Incarceration/release from NYC jail Patient expiration (death) Frequent ED notifications at time of encounter Healthix Clinical Message Center (Portal) HL7 v2 MDM interface
Clinical Event Notifications: FUTURE Method of Subscription Future Functionality Subscription file All patients Rule-based Trigger Complex CEN, change in patient condition Real-time notification of readmission (configurable) Frequent ED Visits Detect at time of encounter Detect receipt of clinical notes and notify PCP Detect duplicate CT scans real-time Detect when prescription is filled or not Method of Notification Augment information in notification: diagnosis, recent encounters CEN digests summary Detect receipt of clinical notes and notify PCP
Providing Solutions, Adding Value 1 2 3 Coordinated Care: Complete View of Patient Real-time Intervention at the Point of Care Determine Risk and Provide Actionable Data BETTER OUTCOMES COST EFFICIENCY HIGHER SATISFACTION
Predictive Risk Scores Modeled on Client Specific Data/Populations 1000s of Patient Features Age Gender Geography Income Education Race Diagnoses Procedures Chronic conditions Visit and admission history Outpatient medications Vital signs Lab orders and results Radiology orders Social characteristics Behavioral characteristics Patient History Risk Model Development Multivariate Statistical Modeling Decision Tree Analysis Machine Learning Patient Risk of Event or Outcome Available Risk Models Population Risk Models (predicts future 12 months) Predicted future cost Risk of inpatient admission Risk of emergency department (ED) visit Risk of acute myocardial infarction (AMI) Risk of asthma Risk of cerebrovascular accident (CVA) Risk of congestive heart failure (CHF) Risk of COPD Risk of diabetes Risk of hypertension Risk of mortality Event Based Risk Models (predicts future 30 days) Risk of 30 day readmission Risk of 30 day ED re-visit
Case Study: Population Management - ED Utilization Population Utilization Risk Landing Page: Latest risk profile for patients in NYS Can drill down based on demographics (gender, age, county, city, risk factors, disease) Allows for better allocation of care management resources to at risk patients.
Case Study: Population Management - ED Utilization View Patients with High Risk of ED visit: User filters and criteria to get information on those at highest risk.
Case Study: Population Management - ED Utilization Select a Patient from the Patient List: View the risk and visit history of that patient. Here the patient s ED risk (red line) has risen significantly in 3 months. 16
Readmission & Return Risk 20
Disease Prevalence & Risk
Consent Models Explained
Patient Consent New York State Consent Model: Patient consent is not needed for participant organizations to provide patient data to HIE Patient consent is needed for participant to access data Patient grants or denies consent to allow a Participant to access data and receive Clinical Event Notifications Emergency providers can access data without consent in some circumstances New Developments: Healthix now has Community Consent Healthix has implemented electronic Oneto-One exchange.
Evolution of Health Information Exchange Understanding the Journey is a Community Effort Build & Maintain the Foundation Data Collection and Standardization Unique Patient & Provider Index Reaching Critical Mass Governance Integration & Adoption Workflow Integration Data Integration System Integration Real Time Notifications / Alerts Standard of Care One Patient Record Population Health Predictive Analytics Patient Involvement Public Health Reporting Biosurveillance Community Care Plans Utilization & Performance Management
Lessons Learned & Success Requirements Best Practices: 1. Focus on services to realize short term value for clinicians and patients 2. Make an investment to ensure data collection interfaces are capturing required data and is standardized across key areas to facilitate a robust clinical exchange 3. Build key security requirements into the service Success Requirements: 1. Make healthcare incentives supportive of clinical exchange across organizations 2. Target specific clinical workflow integration features to make the technology work for clinicians 3. Foster a community of trust through development of a governance structure
Questions & Answers 25 Healthix Website: www.healthix.org Learn more about our services See list of connected facilities Better understand how clinical data exchange is improving patient care and supporting our healthcare participants Thank you! Todd Rogow SVP & CIO
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