Health Information Exchange (HIE)

LAS VEGAS - The Staten Island Performing Provider System is running into all of the challenges inherent in implementing a value-based model for Medicaid payment reform in New York State. The Delivery System Reform Incentive Payment Program has as its goal to reduce avoidable hospital use by 25 percent over the next five years, according to Staten Island’s Executive Director Joseph Conte, speaking at HIMSS16 in Las Vegas. Asked how the program was going, Conte said, “In 11 months that’s the expectation to achieve. We’re not there yet. Looking at information we have from two hospitals, it’s a positive trend.” [Also: See photos from Day 2 of HIMSS16] Staten Island Performing Provider System is a corporation formed by Richmond University Medical Center and Staten Island University Hospital. Over 60 healthcare agencies and community-based organizations have joined Staten Island in the effort to reduce costs while increasing the quality of health for a very diverse population including 130,000 Medicaid recipients and 50,000 uninsured residents.  The big challenge, Conte said, is that timely data is not available from the state.  “It’s at least a six to nine month retrospective,” he said. “Everyone’s in a different place as far as electronic health records.” As of October 2015, an IT assessment showed that of the 26 healthcare systems partnering with Staten Island, 92 percent had an EHR platform or were in the process of getting one and 14 of them had different EHR vendors, Conte said. The overarching mission is to align IT strategy and execution, said Raj Lakhanpal, MD, CEO of SpectraMedix, and member of HIMSS Clinical and Business Intelligence Committee. To this end, Staten Island will be collecting data from providers and data feeds, and integrating it to create longitudinal records. They will apply population risk assessment models to predict high-risk patients and to flag those who should be included in disease registries and to identify gaps in care. [Also: See photos from Day 3 of HIMSS16] Conte said, “Data needs to be turned into business intelligence. Everyone needs prompt, accurate performance feedback.” The partners will need to make some IT investments to connect to state, Staten Island and other health IT platforms, he said. They’re starting to realize the value of receiving real-time measures of population health, he said. “Data six and nine months old is of zero interest to them,” Conte said. “What’s of interest to a doctor, (he or she) never knows that their patient is in the emergency room, or has been hospitalized.” Twitter: @SusanJMorse This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

CIOX Health launched Tuesday at the HIMSS16 Conference and Exhibition with the vision of advancing the way health information is managed. The company, created by the 2015 merger of HealthPort, IOD Inc., Care Communications Inc. and ECS, offers a variety of services in release of information, record retrieval and health information management, and serves more than 18,000 provider sites, 100 health plans and 1 million unique requesters of patient information, the company said. [Also: See photos from Day 1 of HIMSS16] “CIOX Health is the single largest nexus for meaningful health information in the country,” contended Vishal Agrawal, chief growth officer and president of health plan solutions at CIOX Health. “As a technology-enabled services company, we are uniquely positioned to bring consent-driven access to all those who need it—regardless of location, EHR or health system affiliation.” CIOX Health offers products and services that assist in the management and exchange of health information with the aim of increasing efficiency, speed, quality and security, and positively impacting the bottom line. The company delivers expertise in information exchange, workflow, coding, and audit management technology and services. “We’ve unveiled a new name and brand because we’re the combination of four best-in-class companies, and we are driving a transformation in the way health information is managed,” said Matthew Bennett, CIOX Health CEO. CIOX Health is demonstrating its technology in booth #6021 at the HIMSS16 Conference & Exhibition. Twitter: @SiwickiHealthIT This story is part of our ongoing coverage of the HIMSS16 conference. Follow our live blog for real-time updates, and visit Destination HIMSS16 for a full rundown of our reporting from the show. For a selection of some of the best social media posts of the show, visit our Trending at #HIMSS16 hub.

The Patient-Centered Outcomes Research Institute announced a plan to make it easy for individuals to access data in their electronic health records and share it for research that could improve care for their conditions.

A new agreement with FHA will allow DirectTrust's federal partners to operate their Direct implementations within its Security and Trust Framework.

Collaboration with Greater Flint Health Coalition hopes to improve health IT infrastructure, analytics, long-term care coordination goals in the area.

After facing an unacceptable 70 percent patient matching rate, the San Diego Health Connect health information exchange said it has turned its performance around using identity validation technology to better match patients and in the process clean up its master patient index. Its current patient matching rate is 98 percent. "To a certain degree, we caused the problem ourselves," said Dan Chavez, executive director of San Diego Health Connect. "We use very strict matching criteria. Not every HIE uses the strict matching criteria we do. We require a 100 percent match on six variables to automatically match patients. Other HIEs make the governance decision not to match on such strict criteria. If you loosen the rules in probabilistic and deterministic matching, you can have a higher rate. We want the machine to do as much as possible, but we don’t make it easy because we want the faith and trust that what comes out of the HIE is 100 percent correct." [Also: 'New value propositions' emerge for HIE.] At the 70 percent matching level, San Diego Health Connect had a backlog of requests that had to be manually reviewed. For example, Dan Chavez and Daniel Chavez and Daniel J. Chavez could all be the same person, with different records at different facilities in the San Diego area. Further, when consumers get married or divorced and change names, multiple different records may exist. "There are more than a few Chavez's in San Diego, as you might expect, so my name might go into the exception queue — and I’ve received care at Sharp and Scripps, and maybe my records do not match," he said. "Prior to using Verato, someone from the Sharp medical records department and someone from the Scripps medical records department would have to get together through an e-mail or phone call. If I had additionally been to UCSD, or if someone fat-fingered my Social Security number, the exception would pop up yet again for me, and UCSD would have to get online with Sharps and Scripps. So you see the magnitude of the problem." The exceptions queue grew so large and the backlog so long that medical records departments in the community said this HIE thing was killing them. [Also: New HIE, vendor members for CommonWell.] Verato's Carbon is a cloud-based identity data management system, what the company claims to be the most complete and accurate database of U.S. identities. "We source billions of records including credit agency and telecommunications provider data, along with government and legal data; and we use proprietary technology to produce our view of individual identities," said Joaquim Neto, senior solutions architect at Verato. San Diego Health Connect, for instance, automatically ran its exception queue against the Carbon database and quickly matched 80 percent of the exceptions to their correct records, Chavez said. "Then, with a little bit of examination, we could much more easily deal with the additional 20 percent — associating pediatric patients with parent addresses," Chavez cited as an example. "One of the challenges of patient ID in pediatrics is naming conventions. With the interactions with Carbon, we then could go back to the community and say, 'We all are doing some things incorrectly.' It gave us some guidelines in community-wide naming conventions, so we could go back to participants in the HIE and say, 'If it’s a hyphenated last name, let's place the second name in this field and the first name in that field.'" Improving the patient matching rate earned San Diego Health Connect a higher degree of confidence in the information coming out of the health information exchange among healthcare organizations in San Diego and Imperial County, Chavez said. "People know if the HIE is delivering information for Dan Chavez that there is a 98 percent-plus chance that we in fact have the right Dan Chavez," he said. "That confidence was not there before." [Like Healthcare IT News on Facebook] The HIE declined to share the cost of using the Carbon system from Verato, but the vendor said the ticket could be between $250,000 to $500,000 a year for an organization the size of San Diego Health Connect. "The soft return on investment is the confidence in the HIE as we deal with the medical records in the entire community of 3.2 million people; these providers know when they get patient information from SDHC, it is correct," Chavez said. "The hard ROI comes in no need for medical records departments to call up anyone to check exceptions. They do not have to challenge the data or make 3-5 phone calls to reconcile. Those phone calls at a minimum of 5 minutes a head are expensive." Twitter: @SiwickiHealthIT

Physician adoption of electronic health records rose steadily between 2013 and 2014, with nearly 75 percent of doctors going digital, according to the Centers for Disease Control and Prevention’s National Electronic Health Records Survey. The CDC’s four key findings based on the survey: In 2014, 74.1 percent of office-based physicians had a certified electronic health record system, up from 67.5 percent in 2013. The percentage of physicians who had a certified EHR system ranged from 58.8 percent in Alaska to 88.6 percent in Minnesota. In 2014, 32.5 percent of office-based physicians with a certified EHR system were electronically sharing patient health information with external providers. The percentage of physicians with a certified EHR system electronically sharing patient health information with external providers ranged from 17.7 percent in New Jersey to 58.8 percent in North Dakota. Access the full CDC report here.

Indianapolis-based Indiana Health Information Exchange and Cincinnati-based Health Bridge, two of the biggest and longest-standing health information exchanges in the United States, are now sharing data bidirectionally across state lines.

The path of destruction in the Gulf Coast states wrought more than a decade ago by Hurricane Katrina also resulted in unforeseen benefits for healthcare providers in the region.

Not many health information exchanges can say they handled a papal visit, but that's exactly what HealthShare Exchange of Southeastern Pennsylvania did.