With an Eye on Value-Based Care, N.C. HIE Presents Health Data Utility Roadmap

The North Carolina Health Information Exchange Authority (NC HIEA) has unveiled a strategic document outlining how it plans to broaden exchange capabilities and support value-based care. One goal is to leverage the NC HealthConnex health information exchange infrastructure more broadly to support social services and community-based organizations.

NC HIEA said it would work to establish, together with partners, a formalized state Health Data Utility model and provide requested statewide health data services. It will develop service-specific cost recovery models for state agencies, health plans and other users who do not submit data, but for whom receipt of clinical data for approved uses cases is of high value.

Another goal is to implement a quality measurement and reporting service to support providers and health plans.

In his letter introducing the roadmap document, Sam Thompson, executive director of NC HIEA, said his enthusiasm for the NC HealthConnex platform grew during his tenure at NC Medicaid as he saw “the degree to which North Carolina’s vision for improving healthcare—integrated care, value-based payment, improving quality and health outcomes, addressing social determinants of health and advancing health equity—is predicated on exchanging complete, accurate, timely health data.”

Over the last several years, the report notes, NC HIEA has focused on expanding its network of connections and supporting a growing number of use cases with partner agencies and stakeholder organizations, while also supporting NC Medicaid’s operational, care management and continuous quality improvement efforts. With integrated, value-based care models rapidly unfolding across North Carolina and an amplified need for modernized public health and safety infrastructure, the demand for timely access to high-quality clinical data is more pronounced than ever, NC HIEA said. 

As of 2024, the state-designated HIE network, NC HealthConnex, connects all acute care and most specialty hospitals statewide, more than 10,000 ambulatory facilities and 54 inter/intra-state HIEs, including the Veterans Administration and Department of Defense via national networks. 

Among its objectives are to enable state laboratory electronic test orders and results (ETOR). An ETOR service replaces manual, paper-based processes with an electronic, closed-loop process and improves clinical decision support workflows, analytics and notifications. Implementing this service with local health departments and other facilities will reduce administrative burdens on both ends and expedite lab result delivery.

The NC HIE will also seek to expand bidirectional exchange and single sign-on (SSO) capability. NC HIEA notes that some NC HealthConnex participants access the consolidated, statewide patient health record within their practice EHR through bidirectional integration or SSO technology. This integrated access increases utilization of the statewide health record and patient data from nationwide networks. One goal is to build SSO capability with additional EHR vendors and participating organizations. Another is to increase bidirectional exchange via new FHIR query offerings.

A key goal is to improve statewide health data liquidity—the ability for data entered once into a system to be securely stored and also easily accessible to others involved with the care of a patient—by enabling FHIR retrieval across NC HealthConnex services.

This involves establishing governance rules for FHIR and TEFCA data access. The organization plans to onboard to a Qualified Health Information Network (QHIN) within TEFCA, and address emerging FHIR use cases, including Medicaid, public health and other state agency FHIR queries and bulk FHIR exchange to support patient access, surveillance efforts, and other HIPAA- covered use cases. It will also leverage API services to share data with NCDHHS for relevant use cases.

The organization also plans to investigate integration with North Carolina Department of Health and Human Services’ NCCARE360, a statewide coordinated care network, to enable sharing of health-related social needs screening and referral data and easy access for users across systems. At the direction of NCDHHS, it will seek to provide SSO from NCTracks, NC Medicaid’s claims and eligibility system, to NC HealthConnex, enabling Medicaid providers’ easy navigation from a patient’s eligibility and enrollment status to their statewide patient health record.