Historically, I’ve been pretty skeptical about the benefits that HIEs offer, not because the concept was flawed, but that the execution was uncertain. Toss in the fact that few have figured out how to be self-supporting financially, and you have a very shaky business model on your hands. But maybe, at long last, we’re discovering better uses for the vast amount of data HIEs have been trading.
New research by one exchange suggests that some of the key value they offer is aggregating patient data from multiple providers into a longitudinal view of patients. The research, completed by the Kansas Health Information Network and Diameter Health suggests that the Qualified Clinical Data Registries promoted by MACRA/QPP could be a winning approach.
To conduct the research, the partners extracted data from the KHIN exchange on primary care practices in which more than 50,000 patients visited toward 214 care sites in 2016 and 2017. This is certainly interesting, as most of the multi-site studies I’ve seen on this scale are done within a single provider’s network. It’s also notable that the data is relatively fresh, rather than relying on, say, Medicare data which is often several years older.
According to KHIN, using interoperable interfaces to providers and collecting near real-time clinical data makes prompt quality measure calculation possible. According to KHIN executive director Laura McCrary, Ed.D., this marks a significant change from current methods. “This [approach is in stark contrast to the current model which computes quality measures from only the data in the provider’s EHR,” she notes.
FWIW, the two research partners will be delivering a presentation on the research study at the HIMSS18 conference on Friday, March 9, from 12 to 1 PM. I’m betting it will offer some interesting insights.
But even if you can’t make it to this presentation, it’s still worth noting that it emphasizes the increasing importance of the longitudinal patient record. Eventually, under value-based care, it will become critical to have access not only to a single provider’s EHR data, but rather a fuller data set which also includes connected health/wearables data, data from payer claims, overarching population health data and more. And obviously, HIEs play a major role in making this happen.
Like other pundits, I’d go so far to say that without developing this kind of robust longitudinal patient record, which includes virtually every source of relevant patient data, health systems and providers won’t be able to manage patients well enough to meet their individual patient or population health goals.
If HIEs can help us get there, more power to them.