Interoperability – The Challenge for 2014

sgruber2013Third Annual NY eHealth Collaborative Digital Health Conference

By Sarianne Gruber, MPH, MS
SG Healthcare Analytics LLC

Thanks to an invitation from HITECH Answers, I attended the Third Annual New York eHealth Collaborative Digital Health Conference on November 14 and 15 in New York City. The event was attended by 1,200 healthcare decision makers and professionals including physicians, nurses, administrators, technology innovators, media and thought leaders.  All came together to hear about new technology, programs and ideas to help the lives of patients and better our communities. The New York eHealth Collaborative (NYeC), a not-for profit organization, focuses on improving healthcare in the state of New York via health information technology.  NYeC is a resource for healthcare providers adopting electronic health records as well as the creator of the Statewide Health Information Network of New York (SHIN-NY).

Keynote speaker, George C. Halvorson, entering his fourteenth year as Chairman of Kaiser Permanente, impressed upon the audience that developing functioning systems is only one phase of the process. He recalled when Kaiser Permanente first designed its own home grown internal EMRs and it did not work. The only recourse was to seek outside IT support, and picked EPIC as the core system with EPIC “pluses”.  He mentioned that they are now bringing in the best apps from vendors. Kaiser Permanente, head quartered in Oakland, California, to date is the largest non-profit health plan and hospital system with over 9 million members. This model hospital provides real-time data to patients and physicians.  Halvorson cited several success stories of mastering “interoperability”, an IT challenge still faced   by other healthcare organizations.  (A comprehensive definition of interoperability can be found at www.himss.org/library/interoperability-standards/what-is). He proudly shared how Kaiser’s care improvement programs have reduced rates of sepsis, HIV and improved heart-disease survival.  He noted how tracking sepsis care and getting scripts ordered quickly and medications to the patient simply saves lives. Halvorson voiced to the audience to seek continuous improvement specific to the place you deliver care and use the incentives in ehealth to improve health outcomes.

New York has 19 million patients and 280 hospitals, and may not have the infrastructure like Kaiser Permanente, yet NYeC is making significant strides to meet interoperability challenges statewide.  A top priority for New Yorkers is the ability to access their healthcare records via a patient portal. In August, Mana Health, a New York City-based Health IT start-up was awarded the contract.  The portal is expected to be available to the public in 2014. To help make New York State a hub for health IT, the NY Digital Health Accelerator program, developed by NYeC and the Partnership Fund for New York City last year, has launched 17 pilots and 2 of which have been acquired. For more information check www.digitalhealthaccelerator.com

A dynamic project is the Statewide Health Information Network of New York (SHIN-NY). NYeC‘s Executive Director David Whitlinger spoke candidly to a small audience of media about the challenges of building the SHIN-NY platform. The network is expected to connect information among private practices, hospitals, clinics and nursing homes. And having increased interoperability with HIEs, EFT, FTP and plug and play interfaces to follow-up on medication reconciliation, post discharge care plans and continuity of care. Whitlinger referenced Kaiser Permanente as a best use case scenario with 9 million patients on one EHR. With data coming from different providers with various EHRs and HIEs, vendors must become interoperable. The question arises of how do you get 600 EHR vendors to connect/exchange to each other? Whitlinger commented that originally in Stage 1 there were about 1200 certified vendors, 50-60 would be the right number for the market size for EHRs. Interoperability also extends into the creation of a patient portal for the SHIN-NY system. Whitlinger also highlighted a new SHIN-NY Application Programming Interface (API) initiative. The API layer will allow SHIN-NY members to get access to data and query patient record information. NYeC is inviting developers to develop software products and apps to leverage clinical data for providers. Interested see details at www.developer.nyehealth.org.

There were so many enlightening panel discussions throughout the conference.  Two innovative presentations that piqued my interest.  A new app from Ginger.io provides behavioral analytics by measuring levels of socialization specific to certain chronic diseases on your mobile device and alerts your provider at www.ginger.io.com.   Data was presented on real-time self-reported and sensor information for monitoring depression. And based on predictive models, certain behaviors such as phone usage and time of calls, can be flagged as alerts to a health care provider.  Another new innovation was the Care Manager platform presented by Caradigm at www.caradigm.com.  Designed for health plans or provider organizations, it manages and monitors patients in the hospital, at home or other care settings. This care plan exchange personifies all the benefits of interoperable care coordination.  Starting with patient status, marking interventions, measuring goals and outcomes as well as noting health conditions, active problems health concerns and risks. The challenge of interoperability may be 2014’s initiative for health technology.  Though the takeaway for me was Mr. Halvorson’s closing comment that the “best initiative to a patient is good health”.

Interested in learning more about NYeC visit www.nyehealth.org.