InterSystems

Health information exchange platforms can be the key to unlocking the potential of the Internet of healthcare things or the Internet of Patients.

Hixny, a regional health information exchange (HIE) and an InterSystems customer since 2009, is improving care coordination and population-health management through its Hixny360 services structure. Key Benefits • Fastest path to software for connected healthcare • Sharing patient data across multiple facilities • Leveraging technology that healthcare organizations already use Serving the Capital District, northern New York, and the Mohawk Valley region, Hixny has also introduced a secure, user-friendly patient portal, Hixny For You, that allows patients to view, download, and transmit their own medical records. Hixny has been leveraging InterSystems HealthShare® as its strategic interoperability platform. HealthShare, a family of connected-care products, includes HealthShare Personal Community, a configurable patient-engagement solution. Branded as Hixny For You, it provides a comprehensive patient record and an alternative to costly portals tethered to electronic health records (EHRs). Hixny’s patient portal is available community-wide across multiple systems and drives adoption in a way that couldn’t otherwise be achieved. A New York Presence Hixny today has 564 connected entities and locations. Its 31 member hospitals represent 100 percent of the hospitals in its region. Also part of the exchange are 2,121 physicians — 73 percent of the region’s primary care physicians and 62 percent of its specialists. The HIE processes the records of more than 2.6 million patients. Hixny’s services to members are comprehensive, with the portal delivering more than 88,000 lab, radiology, and transcribed reports per month. The organization announced in May 2015 that it was sending 20,000 patient-event notifications per month into EHRs, which represented a tenfold increase over the previous year. The event notifications inform primary care physicians about changes in a patient’s condition or care, such as emergency department visits or hospital admissions. In 2014, local pharmacy service providers Price Chopper Supermarkets and Hometown Healthcare joined the exchange, which means that physicians can now ensure that patients have filled their prescriptions there. And the information flow is bidirectional: Providers can retrieve and contribute realtime patient data directly into their native EHRs. Patient Portal Hixny For You gives patients access to their own health records, which they can download to their computers or securely send to providers. Also on the portal is a robust digital library of medical information to help educate patients about their medical conditions. Hixny CEO Mark McKinney says the organization decided to create the portal for three reasons. First, he says, it was far more cost-effective for his exchange to build the portal than for each hospital to do so at a cost of about $100,000 each.                   “Sick people see a lot of doctors. Without a single patient portal, they would have to go to every portal and aggregate data themselves.” Hixny CEO Mark McKinney Second, it’s better for patients, designated caregivers, and providers to access the information via a single online gateway. Patients with chronic conditions may see as many as 14 different providers. “Sick people see a lot of doctors,” McKinney explains. “Without a single patient portal, they would have to go to every portal and aggregate data themselves.” Finally, a patient portal is an added incentive for providers and provider institutions to contribute data to the exchange. McKinney notes a few challenges. First, he says, to meet the Meaningful Use Stage 2 requirements for EHRs, he had to build a new system interface and obtain full buy-in from IT departments across the network. More significant was the patient identification issue. How could he be sure that the right people had access to the right records? The solution was to initially restrict use of the portal to patients recently released from five community hospitals. The limited rollout enabled Hixny to establish a process for verifying patients’ identities before releasing the tool more widely. For the future, Hixny will leverage partnerships with a large credit union and a pharmacy chain to help establish a patient’s unique identity. Path to Triple Aim McKinney sees both Hixny and its Hixny For You as critical links on the way to meeting the famed Triple Aim of improving patient care, improving population health, and reducing the cost of healthcare. The portal will lessen the extensive records-management burden on patients and their families. To illustrate the benefits of the portal, Hixny cites the example of Jay Stearns, caregiver to his 84-year-old father, William. “The portal has been instrumental in helping us to keep track of my father’s records and medications,” Stearns says in a Hixny video, recalling the huge stack of file folders he used to carry to doctor visits. Now he just logs in from his cellphone to access all of his father’s records.

(SPONSORED) When Dave deBronkart learned he had a rare and terminal cancer, he turned to a group of fellow patients online — and found the medical treatment that saved his life.

While patient engagement is grabbing plenty of headlines, leaders need to know what’s really happening on the frontlines. HIMSS Analytics Patient Engagement Insights, a study based on a quantitative survey of leaders from 114 healthcare organizations as well as a qualitative focus group that involved nine of these executives, sheds some light on the issue. The findings: Healthcare leaders have embarked upon patient engagement initiatives, with nearly nine of 10 organizations having a strategy in place. The primary drivers for these patient engagement strategies include fulfilling the organization’s mission to enhance and improve health (77 percent), supporting initiatives to build a loyal brand for patients (77 percent), and meeting Meaningful Use requirements (60 percent). Technology is playing a key role in pursuing these goals. More specifically, organizations that have a patient engagement strategy in place are turning to patient portal technologies from their current EHR vendors (67 percent), or from health information exchange platform vendors (15 percent), or they are developing their own portals in house (8 percent). These organizations are most commonly using such technology for patient record access/summaries (92 percent), lab test result distribution (90 percent), and secure e-mail/tests with providers (74 percent). But that’s not all. Many organizations are looking to go beyond these basic functions – and have identified the following next-generation functions as most important: e-visits or consultations (64 percent), health evaluation and coaching (54 percent) and interoperability across organizations/platforms (54 percent). In fact, leaders expressed a strong commitment to going beyond basic meaningful use criteria with their patient engagement initiatives. To learn more about the study, click here.   

Dave deBronkart beat stage IV kidney cancer in 2007 by taking an active role in his own health. As a result, he realized how powerful and life-saving patient engagement can be. Since then, he has authored the book, Let Patients Help! A Patient Engagement Handbook, and delivered speeches on the topic at conferences around the world. Through this advocacy work, he has become widely known as “e-Patient Dave.” While he has been trumpeting the patient engagement cause for years, the concept has only recently become a hot-button issue in healthcare. In fact, the industry has reached a tipping point and is ready from philosophical, technical and financial standpoints to throw its arms around patient engagement. Indeed, nearly three-quarters of the 330 respondents to the 26th Annual HIMSS Leadership Survey indicated that consumer and patient considerations, such as patient engagement, satisfaction and quality of care, would be the business issue that would most impact their organization over the course of the next two years. Thus, many healthcare organizations are apt to migrate toward creating systems that offer the interoperable data to support such initiatives. As observed by deBronkart, that could lead to the type of patient engagement that transforms the care experience: “When interoperable data becomes accessible to the ultimate stakeholder, that is, the patient, it has the potential to seed new forms of growth oriented around value as defined by the ultimate stakeholder, the one for whom we do healthcare – patients and their families.” Challenges still abound. With patient engagement still in its early stages, organizations are looking to strategically move toward the real, meaningful engagement that will lead to better outcomes, more cost-effective care and a positive patient experience. To gather additional insight into how healthcare organizations can move forward with such initiatives, HIMSS Analytics published Patient Engagement Insights, a study based on a quantitative survey of leaders from 114 healthcare organizations as well as a qualitative focus group that involved nine of these executives. To learn more about the study, click here.

By: Dr. Russell Leftwich, senior clinical advisor, interoperability, InterSystems Interoperability begins at home.  The most fundamental interoperability is the ability to access the data in your own system and use that data for care delivery.  There are two steps: first accessing the data and then viewing it in a way that you can most effectively and efficiently use it. A part of the promise that the HL7 FHIR standard is already delivering on is a new and easier way to access and use the data in your own organization’s EHR system.  FHIR is based on the same technology behind social media, e-commerce, travel sites, and other familiar web services many of us use every day.  It is easy for those familiar with this web development technology to begin building with FHIR. Because like these familiar web services FHIR is very adaptable to mobile devices, there is an early explosion of innovation of FHIR apps on mobile devices in a number of organizations. Most of these innovative apps are built around access to data in one’s own system and use fundamental data like patient demographics, vital signs, medications, and problem lists.  This has given clinicians customized views of their data and customized decision support for clinical care.  Clinicians have long desired these customizations, but such customized functions were prohibitively expensive to develop as add-ons for individual EHR implementations. Notable examples of such apps include a pediatric growth chart app already in use in a number of institutions and an app that displays an individual’s blood pressure over time and that is easily implemented in different EHR systems. There are also simple decision support apps being deployed that are invoked by a medication order (prescription) and can show alternative medications based on cost or formulary restrictions.  Decision support apps under development with expectation that they can be implemented within weeks identify patients at the point of care at risk for conditions like Zika virus and associated complications.  It is already apparent that like the new functions that have appeared with each version of a smart phone, the development cycles of the FHIR standard will bring new capabilities and value to healthcare every few months. We know we didn’t have to wait for smartphone-5 to start seeing innovation, and the same is true of HL7 FHIR.   Register for Dr. Leftwich’s upcoming webinar, "Three Apps Fan the Flames as HL7 FHIR Spreads," at http://www.intersystems.com/who-we-are/events/event/three-apps-fan-flames-hl7-fhir-spreads/

Achieving interoperability across boundaries and connecting providers for collaboration is a long process. Here are a few examples of customers where our interoperability technology is improving care and outcomes.

The standard bodes well for future collaborative care models, even if it’s still in its infancy.

(SPONSORED) Collective Health is a software and services company recreating the health insurance experience for companies and their people.

(SPONSORED) Joe DeSantis, vice president of HealthShare Platforms, is responsible for all aspects of the InterSystems HealthShare informatics platform, including software development, product marketing and business development.