One critical lesson that healthcare stakeholders have learned throughout the COVID-19 pandemic is that quality data capture is a critical component of response efforts. Poor data can lead to gaps in communication between public health departments and healthcare organizations that can make it difficult to track cases and reduce infection rates. So far in the U.S., nationwide totals on COVID-19 metrics have not been difficult to find, but accurate and real-time state-by-state numbers have been more challenging to get clean data on due to differences in reporting standards.
As such, across the U.S., health information exchanges (HIEs) have been ramping up efforts to play a part in helping their members respond to the public health emergency. For example, the Keystone Health Information Exchange (KeyHIE), a network of more than 350 healthcare facilities across Pennsylvania and New Jersey, recently announced that it was leveraging its longstanding partnership with Orion Health, a provider of population health management solutions, to enable real-time automated COVID-19 reporting.
KeyHIE needed a way to share reportable COVID-19 lab results from member organization Allegheny Health Network with providers and public health entities. So the HIE’s leaders turned to Orion Health to provide project management and interface development services. Responding to the urgent need, Orion Health completed the implementation in just five days, according to officials.
Now, Allegheny’s COVID-19 reportable lab results are instantly shared with other providers in the HIE, stored in the KeyHIE clinical data repository powered by Orion Health, and routed to the Commonwealth of Pennsylvania’s electronic disease surveillance system, with the goal to ensure accurate and timely public health reporting. An additional benefit of automatic reporting of patient data is that it alleviates the burden of manual reporting, giving providers more time to focus on higher value activities, including patient care, according to the HIE’s officials.
“When COVID became the issue at hand, we quickly [realized] that it would be the golden opportunity for KeyHIE and Orion to be able to help communicate the pandemic [to show] exactly where patients were coming from and where they were going, [allowing] our member facilities to see the trends and patterns that we were seeing,” says Kim Chaundy, the senior director of operations for KeyHIE.
Chaundy explains that by analyzing lab results, CPT and ICD-10 codes, her team began by identifying patients who were possibly exposed, and those who were positive, and started to create a heat map.
“With that heat map, we were identifying only possible exposure and positive exposures at first. And we were doing that in near real-time, updating the [map] every two hours,” she says.
When the HIE’s members started seeing the heat maps and the geographical areas of where COVID exposures were popping up, they started to immediately ask for additional information, Chaundy recounts. That information—such as age, gender and race—was data that KeyHIE already had, so they were easily able to provide that to its members. A lot of the HIE’s member organizations began using this data to predict where the next hotspots would be in their respective communities From there, providers were able to proactively set up treatment centers to care for potential COVID patients in an isolated manner rather than expose those patients inside an ER,” says Chaundy.
The heat map was also color coordinated to differentiate a possible exposure from a positive one, she notes. “You started to be able to see the pandemic come across the map, and you can then predict where it was coming from—such as from the North or South—and how it’s been progressing across the state.”
Chaundy points out that the Pennsylvania leaders had called on five HIEs in the state to communicate their COVID-specific findings. Three of the five networks—KeyHIE, ClinicalConnect in Western Pennsylvania, and HealthShare Exchange, based in the greater Philadelphia area, agreed to participate by providing a tracking report every other day up to the state government. However, Chaundy says that similar to what the HIE’s provider members were doing, the state also implemented pop-up treatment centers. She says she understands the reasoning behind it, but because the state wasn’t able to share their patient population and positive exposures to the other health information networks, Chaundy contends that too much unknown “white space” exists due to the lack of bi-directional data sharing. “That’s something we all need to work on so that doesn’t happen again if there’s ever another or different pandemic that we’re faced with,” she says.
Ultimately, Chaundy believes that the COVID-19 crisis has put emphasis on the role that HIEs can play when disaster strikes. “This [epidemic] has proven why organizations need to be connected to an HIE if they aren’t already. We need to capture that white space, and while I hope something like this never happens again, if it does, ensuring that you have all the data would really assist in predicting what’s going on and the path that the [virus] is taking.”