Success with Healthix HIE for Brooklyn Health Home and Oscar Health Insurance

Sarianne Gruber By Sarianne Gruber, Senior Consultant, Encore Health Resources
Twitter: @subtleimpact

Without interoperability of health technologies, a comprehensive exchange of health data does not exist. Yet, at the New York State Health Department meeting on December 11, 2014, state government officials, clinicians, executives and media gathered at NYU Langone Medical Center for a news breaking session on the achievements of Healthix, a health information exchange for New York City and Long Island ( Presenters from the Brooklyn Health Home, a new service for Medicaid recipients led by Maimonides Medical Center (, and Oscar, an innovative health insurance startup, with a mission to put people first, ( shared their success stories using Healthix’ patient real-time alert system called Clinical Event Notifications.

A Commitment to Build a Network ….On March 31, 2014, The New York State Legislature approved $55 million in funding for the Statewide Health Information Network for New York (SHIN-NY) as part of its Fiscal Year 2014-15 budget. The continued expansion of SHIN-NY is coordinated by the New York eHealth Collaborative (NYeC). Nine Regional Health Information Organizations (RHIOs) or Qualified Entities compose the SHIN-NY. Each RHIO adopts standards, collects health record data from providers in their area and with patient consent, allow this information to be shared securely with other providers in the region. As private practices, nursing homes, clinics, and hospitals move to digitized records, they have the choice to connect to information hubs (or RHIOs/QEs) in their region of the state. The SHIN-NY connects these regional hubs to create a private and secure network spanning the entire state of New York. Check the NYeC website at for additional information and updates.

Foster Collaboration… a timely exchange of patient information among involved providers drives measurable improvements in patient engagements and outcomes. Dr. Karen Nelson, Executive Director of the Brooklyn Health Home and Senior Vice President of Integrated Delivery Systems at Maimonides Medical Center, lauded health IT innovation for breaking silos. The Brooklyn Health Home (BHH) provides behavioral, medical and social services for over 8,000 high-risk patients with multiple chronic conditions, serious mental illness and/or HIV. Healthix’s real-time alerts and clinical event notifications via web-based communication and dashboards have empowered the BHH care team to react quickly to member emergency room visits and hospital admissions, as well as, design better clinical and patient care protocols. By third quarter 2014, BBH Care Managers received over 1,300 clinical event notifications and the number of alerts received increased 10% from 118 in February to 437 in September. Many BHH members battle multiple co-morbidities coupled with psychiatric conditions, and their care management includes clinical, behavioral health and social service providers. Healthix provides secure access to current patient information making it available whenever it’s needed across all care transitions. A member’s consent is required for any data to be shared. When a member arrives at the emergency room (ER) and is admitted to the hospital, a Care Manager is immediately alerted. At the hospital, the Care Manager learns the member is having difficulties at home and has been unable to see a therapist. The Care Manager knowing the member’s history recommends a specific respite/crisis program and the member’s preference for a female therapist. Bringing this information at the time of discharge, and communicating with the patient’s providers such as social workers and the behavioral health team in the community be the BHH member’s best chance to avoid repeat ER visits and hospital readmissions.

An Insurance company with a new agenda for alerts….. Founded in 2012, Oscar is an innovative health insurance company that sets out to put people first through a high-tech data-driven approach, an easy to understand language, plus a unique set of benefits. Mario Schlosser, Oscar’s Co- CEO and Co-Founder, advocates technology, design and data as a means to humanize and simplify health insurance ( Upon enrollment, the tag line reads “Get smarter, faster care. We can better coordinate your care by sharing information and notifications with your doctors”. Members open an e-account, are provided information about RHIOs and are given option to consent. With 17,000 members in New York, Oscar has been using Healthix’s Clinical Event Notifications for over six months. Its medical team has engaged 80% of their members who generated a Healthix’s Clinical Notification on a variety of urgent healthcare issues. Schlosser knows that members have big care events with unplanned ER visits and emergent hospital admissions and believes his insurance company should take a hands on approach. Healthix alerts is just that missing piece. So far the alert system improved both the velocity and effectiveness of case management and care coordination. Healthix’s system notified Oscar’s medical team of 66 emergency visits and hospital admissions within a six week period starting last month. Oscar’s collaborative patient care program has a Nurse Practitioner to support a patient at every stage including health education and counseling, access to finding primary care providers and specialists, solving claims and benefit issues and how to use the doctor on call benefit program. Oscar’s team of doctors and nurses, with the integration of Healthix technology for coordinating care and services, foresee decreasing costs, increasing quality cafe and improving member experience.

Key facilitator of health information exchange and a partner in the SHIN-NY….Healthix, Inc. Committed to developing, deploying and leading innovation, this Qualified Entity uses interoperable health information technology and analytics to facilitate patient-centric care for New Yorkers. Healthix, recently formed through mergers between NYCLIX, LIPIX and BHIX, is expert at delivering health information exchange services, facilitating access to clinical data and providing tools to support care coordination for over 10 million patients in New York City and Long Island ( Healthix is the largest Regional Health Organization (RHIO) in New York State, and now has over 1 million of those patients consented to allow medical providers and care managers access to their data. Over 148 participants and 548 facilities are in the HIE network with over 12,000 doctors and nurses registered with patient consent. Healthix’s patient alert system, the Clinical Event Notifications triggers over 5,000 real-time updates. Increase of 172% growth in the number of participating organizations over the past 24 months. This very robust behavior appeared to be facilitated by state funding under pinning the SHIN-NY.

About Healthix and Its Vision for Interoperability…To create a connected and interoperable, patient focused, healthcare infrastructure which will interconnect clinicians, allow patient health records to be easily transmitted from one point of care to another, and enable the advanced utilization of knowledge derived from patient information. Tom Check, CEO of Healthix, highlighted the functionality and benefits for health care providers:

  • Access to real time data from 100s of Healthix participating facilities
  • Single sign-on access to Healthix via EHR
  • HIPAA compliant secure messaging – i.e. eReferrals
  • Meets Meaningful Use requirements – i.e.  Direct messaging
  • Access Lab and Radiology reports – i.e.  Reduce duplication
  • Monitor and manage complex patients with real time event notification

Data in Healthix to facilitate patient care includes:

  • Allergies – i.e. adverse events for scripts to prevent allergies to meds
  • Consent
  • Diagnosis/Problem List – i.e. Documents prior diagnosis
  • Demographics
  • Encounters
  • Insurance
  • Lab Results
  • Medications
  • Plans of Care
  • Radiology Reports
  • Summary Documents
  • Discharge Summaries

Exchanging Patient Information to transform Patient Care to Get Better Outcomes
Having the ability to generate, real-time automated Clinical Event Notifications such as ER admissions, hospital discharges, Consent Management for patients to share data, EHR integration with a single sign-on on via a web ports, technology integration to optimize workflow such as emails on smartphone to access to the Clinical Message Center, and reporting and analytics is the core of interoperability. HIEs such as Healthix bridge gaps in care by cultivating cross-continuum partnerships such as the Brooklyn Health Home and Oscar Health, and foster a wide range of services to support and enhance patient care and coordination for better care and outcomes. Thanks SHIN-NY, New York eHealth Collaborative and Healthix, Inc.