Lifespan of Greater Rochester, a New York-based nonprofit agency serving 30,000 older adults and caregivers annually, is taking advantage of a partnership with the Rochester RHIO (Regional Health Information Organization) to integrate healthcare and social data.
In a video, part of a series emphasizing how regional partners across the state are improving healthcare delivery by using the Statewide Health Information Network for New York (SHIN-NY), Lifespan leaders talk about the impact access to real-time data has had on their work.
Lifespan, founded in 1971, offers more than 30 services, including assistance for caregivers of people with dementia/Alzheimer’s, assisting with Medicare, health and wellness classes and workshops, and elder abuse intervention and prevention programs.
“When we connected to the Rochester RHIO, at first it was very simple. We got alerts when our clients went into the hospital or the emergency room,” said AnnMarie Cook, president and CEO of Lifespan of Greater Rochester. “Now it's so much more. We're able with client consent to go into the portal to look for lab results that would help them. Our nurses can do that. We also — and this is critical for us — utilize the RHIO in a lot of our evaluation methods.”
On the evaluation front, Annie Wells, division leader for healthcare initiatives, said the Community Care Connections program has been able to do some data matching of their client records. “We send an extract to the RHIO and they match ED visits, hospitalizations and encounter data to our records. They identify it and then they send it to our evaluator, New York Academy of Medicine, who then can analyze the data to show pre- and post changes in ED visits and hospitalizations. And it's been very significantly helpful to us because we've been able to prove the value of our intervention in connecting people to the services that they need.”
Jodi Owen, R.N., co-director for Community Care Connections, supervises a team of L.P.N. healthcare coordinators. “We know our client is discharged from the hospital, and we're able to then schedule a home visit, talk to the client to make sure they understand the discharge instructions to prevent that rehospitalization. That's our goal. When we're working on a case, and we can get information in real time about alerts if somebody's hit the hospital or ED, that makes our work so much easier. We immediately contact discharge planning and social work in any of the area hospitals to say Lifespan’s involved. Were connected to this client. Let's work together on an appropriate discharge. And we can make sure there are plans in place before that older adult leaves the hospital and makes a huge difference in the lives of older adults. It makes the transition easier and it makes our work easier.”
“The partnership between Rochester RHIO and Lifespan of Greater Rochester demonstrates the value of health information exchange, which Rochester RHIO and the SHIN-NY network work so hard to enable. Lifespan of Greater Rochester serves tens of thousands of older New Yorkers in the Finger Lakes region, and by being part of this network they are better able to ensure their clients receive the services they need,” said David Horrocks, CEO, New York eHealth Collaborative, which administers the SHIN-NY, in a statement.