Health Information Exchanges (HIEs) are improving the quality of their data to further increase their value. Higher quality data means they can help healthcare organizations understand their region more clearly, allowing them to allocate their resources in the areas that need it. Key to achieving this is translating the data from the various standards used by HIE participants.
Quality Data Aligns with HIE Goals
When the State HIE program was created as part of the American Reinvestment and Recovery Act (ARRA), the goal was to enable the timely sharing of health information to improve care quality, efficiency and safety. The data collected by HIEs was meant to enable more effective public health programs, power clinical research, and give providers more comprehensive clinical information for use in treating patients.
“What we do is aggregate clinical data from hospitals, behavioral health organizations, nursing homes, federally qualified health centers, and even community-based organizations,” explained Todd Rogow, President and CEO at Healthix – one of the largest public HIE in the US, serving New York City and Long Island – who sat down with Healthcare IT Today. “It is a diverse set of data sources that we have grown over the years.”
An HIE cannot fulfil its mandate if participating organizations do not trust the data that the HIE provides. Having good quality data, therefore, is paramount to an HIE’s success. It is not surprising therefore, that HIEs like Healthix are investing in tools, talent, and processes that improve the quality of the data in their repositories.
“There is a real focus by HIEs across the country to get the right data to the right clinician or care manager at the right time,” said Rogow. “That requires both quantity and quality data.”
Lack of Shared Meaning
It is no secret that data quality in healthcare is less than ideal. There are few data standards, lots of siloed systems, and too many other priorities that supersede interoperability initiatives. It is a minor miracle that HIEs like Healthix managed to collect so much data from so many organizations.
To make the challenge even tougher, the data collected by HIEs needs to be normalized and translated before it can be most useful. Data from a lab test from Hospital A, for example, may be structured the same way as the same lab test from Hospital B, but the two hospitals may use different codes and descriptions for the test. The data, while structurally similar, lacks semantic interoperability.
Put simply, semantic interoperability is the ability to exchange data (that’s the interoperability part) with an unambiguous and shared meaning (that’s the semantic part). Only when the data has shared meaning can it be combined seamlessly with data from other sources. Luckily there are companies that provide solutions for this exact challenge.
“The HIEs we speak with tell us that between 45-55% of the data received is so localized that it is almost unusable,” stated Tami Jones, Director of Account Management and Strategic Partnerships at CareCom who Healthcare IT Today also interviewed. “It has to be mapped to a standard first. Our mission is to help HIEs utilize the data they receive, turn it into quality data that is understandable, rich, and relevant so that they can improve patient safety and outcomes.”
“We collect a lot of data today, like lab results and test data,” continued Rogow. “We wanted to focus on improving that data. So, we partnered with J2 Interactive and CareCom. They are really helping us to bring everything together.”
With the solution from J2 Interactive and CareCom in place, a lab test from one hospital can be made equivalent to one from a different hospital. The result is that when a clinician goes to the Healthix system, they can see clearly and definitively that the patient has gotten the same test across multiple hospitals already.
Strong Partnership
Healthix collects data from more than 8,000 healthcare organizations, has over 20 million patient records, and processes over 250 million clinical messages each month. With this volume of data, they needed strong partners.
“J2 Interactive has been helping HIEs like Healthix for over 15 years,” said Steve McGlothlin, Product Manager at J2 Interactive. “While working with numerous HIEs, we noticed that a lot of their projects involved clinical terminology. Different standard and local codes were being sent from facilities across the HIE making it difficult to truly unleash the value of the data.”
J2 Interactive set out to find a strategic partner who could meet the needs of Healthix and found CareCom.
“Normally, terminology solutions cost a lot and take an army of people to run,” continued McGlothlin. “When we discovered CareCom, we found that wasn’t the case with their solution. We partnered with them to create J2 Managed Terminology, which reduces the cost and effort normally associated with terminology services.”
“There is no single solution out there that can tackle everything,” said Tami Jones, Director of Account Management and Strategic Partnerships at CareCom. “We don’t do what J2 does and vice versa. We need the best of both. We need to play nicely together in the sandbox with everyone else out there.”
“We put J2 and CareCom through the wringer,” said Rogow, half-jokingly.
Big Focus on Small Data = Big Impact
The upside of the effort put in by Healthix, J2 Interactive and CareCom is that healthcare leaders in New York City and Long Island can see the healthcare situation in their region much more clearly. That in turn, means that they can better allocate resources to the right areas.
This capability is especially important during the pandemic when it was critical to understand patient histories so that appropriate care could be given quickly. Being able to look up patients to quickly determine what tests had already been done means less duplication at a time when resources were scarce.
“I think the pandemic has really brought what we do to the forefront in a very positive way,” said Rogow. “We’ve helped our community share data through this crisis.”
Rogow called their approach “big focus on small data”. Rather than try to be the biggest repository of different types of data, they have chosen to focus on making the data they have, high quality so that it can be used to help patients and clinicians. We need more of this!
Watch the full interview with Rogow, McGlothlin and Jones to learn:
- The exciting social determinants of health projects Healthix is working on now
- How the phrase “teach the robot to do it” is applicable to semantic interoperability
- Why list management is important to normalizing data and reducing the effort required to maintain data
- More about the strong partnership between Healthix, J2 Interactive and CareCom
To learn more about Healthix, J2 Interactive and CareCom, check out their websites:
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This post raises a fundamental question: Where should we direct our primary effort and limited resources today — to managing data as you describe here, or to ensuring any physician, anywhere, can instantly access his or her patient’s complete medical record at the point of care?
Clearly, they’re both important. But I believe we’ll be far better off, have a healthier population and actually reduce the cost of care if we initially concentrate on doctors instantly having the information they need, when and where they need it, to deliver better, coordinated care!