In launching its strategic plan for the next three years, Health Current, the health information exchange for the State of Arizona, has identified nine areas of opportunity for growth, ranging from care coordination tools and alerts to registry and analytics services. These priorities and their timelines provide a fascinating view of the value HIEs expect to offer over the next few years and which things stakeholders are asking them to do now.
The Arizona HIE says it is designing its system to search for participant-specified data elements so it can deliver the data when, where, and how it is requested. This will be accomplished through customized queries and alerts, as well as use of FHIR-based APIs.
Speaking Sept. 10 at the annual conference of the Strategic Health Information Exchange Collaborative (SHIEC), Melissa Kotrys, M.P.H., Health Current’s CEO, first noted how much her organization has grown over the past few years. “In 2015 we had only 76 active organizations participating, and in five years we have grown 10-fold,” she said. The HIE is working with the majority of hospitals in the state and now reports on 96 percent of statewide discharges and 98 percent of ED visits. It sends out millions of alerts monthly. It has data available on 12 million individuals, and works with 17 accountable care organizations and clinically integrated networks, 103 behavioral care providers, 26 EMS services and 140 post-acute care providers.
With a vision of “making healthcare transformation a reality,” Health Current held meetings and conducted surveys with stakeholders to inform the strategic pan going forward.
Kotrys broke down the opportunities identified in the plan by how soon the organization is likely to move on them. Using a driving metaphor, the ones ready to go soon are “On the Road,” the projects next in line are “On the Ramp,” and ones that may be a few years out are “In the Parking Lot.” She mentioned, however, that the pandemic reminds us that priorities can shift rapidly, and public health projects that were scheduled to be done a few years from now became high priority this spring, and many of them got done very rapidly. “In the parking lots are ideas that the community is excited about, but we can’t do everything in the next three years,” she said, “so we don’t anticipate them being done in a 3-year time frame. Of course, anything can change these days.”
Here are the nine opportunity categories:
• Additional Data Types
• Alerts
• Care Coordination Tools
• Interoperability & Infrastructure
• Public Health
• Quality Improvement & Research
• Queries, Reports & Analytics
• Registry Services
• Miscellaneous
Under Additional Data Types it can make available, a few of the things that are on the road are ACO Membership, Health Plan Membership, Health Plan Claims, Med Fill History – Participants, Radiology Reports and Social Determinants/Social Risk Factors.
On the ramp are ACO Patient Risk Assignment, Court System, Patient-Provider Attribution Health Plan Risk Assignment, Justice System, Med Fill History – Single Source, Med Fill History – Pharmacies/PBMs. In the parking lot are Health Plan Benefits and Health Plan Eligibility.
Health Current is expanding the types of Alerts it can offer. On the road are Gaps-In-Care, Inpatient Readmission, Psych Inpatient ADT, Super Utilizer and Serious Mental Illness (SMI) Patient. On the ramp are Drug Seeking, ED Diversion, Fall Risk, Inpatient Pre-Discharge, Justice System, Part 2 Program/Data. In the parking lot is Patient Facility Transfer.
She said for many of these functions, such as analytics, stakeholders want their own internal solution but “social determinants of health closed-loop referrals is one area where the community said they wanted a statewide system,” Kotrys said. She added that they had a request for information out right now in collaboration with the state Medicaid agency, which has a whole-person care initiative. The goal is to work with social services agencies and healthcare providers to facilitate referrals throughout the state.
In the area of Queries, Reports and Analytics, the HIE has several things on the road: Gaps-In-Care Reconciliation, HIE Analytics & Dashboards, FHIR-based APIs, and Patient Bulk Data Extracts. On the ramp are Risk Stratification Scoring.
In Registry Services, on the road are Advance Directives and OTP 24-Hour Treatment. On the ramp are Psychiatric Bed Availability, SUD Rehabilitation Treatment Availability, Child Vision and Hearing Screening.
“Internally, we have prioritized all On the Road items and will be slating them for development and implementation in 2020 and beyond,” Kotrys said. “We are finalizing a process to capture other ideas from the community.”
Among the success factors they have recognized is that they have to deliver data in meaningful, valuable ways so it can be used to accomplish effective care coordination, quality improvement, predictive risk modeling and management, population health analysis, and more.
