Unified Data: The Key to HIE Success

The following is a guest article by Todd Broadhurst, Solutions Director, Tamr.

Electronic Health Information Exchanges (HIEs) are exploding globally and in the U.S., with 92% of the U.S. population now served by them. Private companies, states, and even large counties and cities are scrambling to launch their own HIEs.

Why the exponential growth? HIEs are an increasingly important part of the healthcare IT landscape because they allow healthcare providers (doctors, nurses, pharmacists, and others) and patients to access and securely share vital patient medical information electronically, improving the speed, quality, safety, and cost of patient care.

HIEs can improve the completeness of a patient’s records, which can positively affect care, as history, current medications, and other information can be jointly reviewed during visits. Near real-time sharing of vital patient information can better inform decision-making at the point of care and allow providers to avoid readmissions and errors, improve diagnoses, and decrease duplicate testing.

The massive HIE issue: disparate, siloed data

Because of the tremendous upside of HIEs, competition to provide the most information about patients to the largest number of providers is intense. Companies and organizations looking to improve the customer experience with improved speed, security, and reduced cost and trying to become the biggest HIE or create the largest EMPI (Enterprise Master Patient Indexes) on the block will look to merge with other HIEs; but that’s not as easy as it may seem.

When it comes to data, HIEs are highly complex. The needs and requirements for health information exchanges differ from practice to practice, and the solutions and security requirements required differ from state to state.

Adding to the challenge, there are several different types of HIEs: directed exchanges that send and receive secure information between care providers; query-based exchanges that let providers request information on a patient from other providers; and consumer-mediated exchanges that let patients aggregate and control the use of their health information among providers. Changes in insurance coverage, reliance on multiple providers, and increases in specialty care add more potentially relevant, yet disparate, information into already fragmented, non-interoperable silos.

Most HIEs also use different patient information nomenclatures, categories, and partner designations. Data typically comes from various sources with differing formats. People inputting data might make spelling, address, or other errors. Trying to merge all this disparate data will cause massive confusion and potential errors caused by duplicate records, conflicting information, and—worst case—mismatched patient identities.

According to a Black Book Market Research press release, “The average expense of repeated medical care because of duplicate records costs a reported average of $1,950 per patient per inpatient stay and over $800 per ED visit.  Survey respondents estimated 33% of all denied claims result from inaccurate patient identification or information costing the average hospital $1.5 million in 2017 and the US healthcare system over $6 billion dollars annually.”

Realizing the value of HIEs: unified data required

The downsides and risks of not unifying, cleansing, and categorizing HIE data are substantial. Numerous factors underscore the need for changes to this state of isolated, fragmented health information. We are a mobile population that requires access to vital information in different locations. For example, many retired Americans receive treatment in very different locations seasonally, and increasingly prevalent chronic conditions, like diabetes, can only be managed by information-based care management.

Patient safety and quality issues arise in the handoff of patients among providers that fail to share necessary information. Natural disasters displace individuals to locations with unfamiliar providers and can destroy or render inaccessible existing health information repositories. The growing use of pharmaceuticals and associated recalls of drugs from the market may call for immediate identification of affected individuals. Finally, the all-too-familiar likelihood of serious pandemics calls for rapid identification of ill people and accurate immunization histories.

The big question: How can local, state, or government-sponsored networks support HIEs to better improve information flow and patient outcomes state-to-state and hospital-to-hospital? The value of HIEs will never be fully realized until there is a way to standardize the data and ensure its integrity. Once unified, matched and standardized, data can be shared among HIEs. Also, the data transferred can seamlessly integrate into the patients’ Electronic Health Records (EHRs), further improving patient care.

Cloud-native Master Data Management (MDM)

At the scale required, the HIE data problem can only be tackled by connecting and curating internal and external HIE data sources through a combination of machine learning (ML) algorithms and human expertise. Cloud-native data mastering solutions make it easy to connect internal and external data sources quickly to power analytic insights and drive better healthcare and patient outcomes. So easy and quick are our solutions that our customers see as much as: 50% better data quality,  a massive (75%) reduction in manual effort and faster (days compared to months/years) time to insight.  Data from a variety of sources and silos can be mastered at massive scale in the cloud.

With human-guided ML for data mastering, ML does the heavy lifting to consolidate, cleanse, and categorize data, enabling healthcare teams to drive better outcomes faster. This approach can also vastly improve patient analytics allowing for targeted care, geographic trends, and predictive analysis.

A proven approach

This approach is already being used by large healthcare organizations to consolidate disparate data sources—EHRs, CRMs, and credentialing systems—and master their data to streamline operations, improve care coordination, and drive patient engagement strategies. It has also been used by federal agencies such as the U.S. Air Force and Department of Homeland Security for everything from entity resolution to supply chain logistics and planning.

This proven solution will work well for organizations at the local, state, or federal level that need to support HIEs to better improve the patient experience state-to-state and hospital-to-hospital. The end result: reduced confusion about different patient information nomenclatures, categories, and partner designations and improved speed and accessibility of healthcare records for more immediate and accurate patient care. In addition to improving patient experiences and outcomes, unifying HIE data produces solid ROI. A recent Forrester Consulting study affirms that clean data can deliver 643% ROI in just three years.

A final thought

We all envision a future of lower cost and higher quality healthcare – rapidly growing adoption of health information technology is a key lever in achieving that future. Achieving this goal; however, requires strategies and technologies for overcoming the problem of disparate, siloed data faced by HIEs. We have the right technologies and processes to overcome the challenge. By adopting them, we can deliver on the promise HIEs hold to reduce costs and errors and improve patient outcomes.

About Todd Broadhurst

Todd Broadhurst possesses more than 25 years of wide-ranging experience across the US public sector and commercial verticals. Currently, Todd serves as the Solutions Director for Tamr Government.

   

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