Security, sustainability, accessibility of healthcare information… these are just a few of the items at the top of a HIE’s Executive’s to do list. Every HIE Executive has a unique war story. Galen Healthcare Solutions, an IT technical and professional services and solutions company, interviewed several executives to discuss their experiences. Here are excerpts from a few of those conversations:
Paul Brannan, Alabama Health Information Technology Coordinator, Alabama Medicaid Agency
A champion in the Medicaid arena and now in health information exchange, Paul Brannan, Health Information Technology Coordinator and Director of Alabama’s HIE, One Health Record®, knows how to make quite the connection. His advice to those in the HIE startup/entrepreneurship space is the same he follows himself: create solutions that are easily usable in the provider’s workflow. Brannan’s future initiatives reflect this provider-centric way of thinking: from working to integrate with Public Health so One Health Record® can become a connection hub for their providers, to reestablishing their connection with Georgia’s HIE, One Health Record® has a robust value proposition and it shows.
The key to working in the entrepreneur/startup space is making something that is usable in the provider’s workflow. That’s ultimately where the rubber is going to meet the road. As long as a HIE system is seen as an additional tax on the provider’s time, then it’s going to be difficult to get buy-in, no matter how much value it gives. Most providers are still thinking in a fee for service mindset, where they’re looking at maximizing the volume of patients treated. If what is being provided for them adds time and effort to the treatment of the patient, there’s going to be a resistance. Integrate what you’re doing into the workflow of the provider so that it works somewhat seamlessly or causes minimal disruption to what is already a busy workflow. Most of the resistance we’ve seen comes from providers who say ‘well I see value in that, I just can’t afford to take an extra five minutes per patient. Because of the way my EMR looks at the records you provide, it requires me going to a whole other screen and making so many additional clicks.’ That’s part of the reason we’re willing to integrate into EMR systems for providers who have the wherewithal to support the cost and effort it takes for the EMR to integrate our records into their system.
Unfortunately, one of the drawbacks of being a state entity is that as long as we’re under the state umbrella, we follow state procurement laws, which means we can’t purchase a system that other vendors use on a permanent basis. Instead, we have to periodically go out for bid. Our HIE backend software had to go out for bid last year, and a new vendor won the bid, which meant we had to replace our HIE software. This required us to reestablish our Sequoia certification which was part of the underlying agreement we had with Georgia. Because we are reestablishing that certification, we have had to temporarily cut off the connection with GaHIN.
Charles Christian, VP, Technology & Engagement, Indiana Health Information Exchange
Innovation is high on the mind of Charles Christian, and rightly so. Christian is part of the largest health information exchange in the U.S. and is continually looking for ways to make connecting over 100 healthcare organizations simpler. In this interview, Christian discusses the compelling work his organization is engaged in: From aiding the United Way in their quest to reduce infant mortality rates in particularly lower income areas, to analyzing data to target childhood obesity.
We are a member of the Strategic Health Information Exchange Collaborative (SHIEC), whose members are 50 of the sustainable HIEs in the country. Many of the members have different business models than we do. For instance, some are state entities, like Kentucky Health Information Exchange (KHIE), and others don’t persist data, they just transact, as with the Kansas Health Information Network (KHIN) model. Our first annual meeting was in 2015, where about a dozen of us got together to share ideas and have conversations about how we can work together, ways to share services, and how to lower operational costs. Our country does not have an operational HIE that covers all of the market. SHIEC is the closest we have, and that covers about half of the population.
One of the innovative capabilities we have is a smart search within our repository – likened to a google search. Take one of our ER physicians at Eskenazi, for example. He’s got a search protocol called “chest pain,” which pulls any recent admissions with chest pain as the chief complaint. It also pulls troponin levels, any echocardiograms, or cast studies, and delivers to him instead of the physician having to hunt for them. We are actually working with an EMR vendor to embed this capability within the system of record. In this way, we can embed a search bar and the physician can access saved searches that retrieve information based upon criteria and filters they setup.
Todd Rogow, CHCIO, Senior VP & CIO, Healthix
Todd Rogow, Senior VP & CIO of Healthix, the largest public HIE in the nation, recently led the organization’s move from an outsourced resource model to an insourced technical team, including the implementation of a robust security program and SOC 2 Audit. In this interview, Todd elaborates on the benefits of building a mission-driven internal team to support the HIE, including improved scalability, nimbleness and responsiveness, but also cost effectiveness and innovation.
When I joined Healthix, it was really to redesign the HIE, and begin a program to insource operations. For several years before I joined, the IT department was outsourced. One of the major tasks I was given was to build a team to handle the complexities of this business. We talk about Healthix as the largest public HIE in the nations. We really measure not just for the number of connections or data feeds we have built, but rather the size of the population we serve. At this point, we’re well over 16 million unique identities which contain clinical information. We have a lot of people who come in and out of New York City from all over the state, the country and even the world who may end up in our healthcare system.
Both at HealthInfoNet and Healthix, I’ve heard stories where our staff goes out to visit with sites and they tell us how they are treating complex patients and how our service is being used to push insights out to them. It drives the point about mission home, and even though my staff are focused on keeping the system up and adding new capabilities and functionality to make it a more useful service, they believe, and I believe, that we are really saving lives. Not only saving lives, but also helping to improve healthcare for patients. That’s why we’re here and in this business. To have our staff get exposure to that is impactful when it comes to our mission.
Thank you to Galen Healthcare Solutions for sharing these important interviews with today’s thought leaders in our industry. We will be highlighting them throughout the summer, stay tuned. Read our series.