HealtheConnections, a regional health improvement organization in New York state, recently introduced their value-based care analytics tool myData. The application allows healthcare providers to easily access and understand comprehensive data in their patients’ profiles, identify gaps in care and see how they rank in quality measures.
For today’s healthcare professionals, ensuring visibility into their patient panel, measuring patient outcomes and providing proof that they have accurately met quality performance measures are major concerns. Many single electronic medical record (EMR) systems do not contain all of the historical or community medical information necessary to see a complete picture of a patient’s needs.
When a patient sees another doctor or is admitted to the hospital, that visit or event may not be shared with their full care team, which leaves providers with informational gaps that hinder their ability to identify and quickly rectify emerging issues.
MyData combines HIE data and provider data to deliver insights to participants in responsive, user-friendly dashboards and reports. This makes information easier to access, interpret and track.
“Organized, actionable information is paramount, and there is a critical need for analytics and data stratification tools,” Rob Hack, president and CEO of HealtheConnections, said. “We worked with provider partners to develop this application with practicality, efficiency and ease of use at the forefront. Give us your data, and we’ll give it back to you in an organized format with community-wide data you didn’t have before.”
MyData builds upon the aggregated data in HealtheConnections’ HIE, collected from throughout its 26-county service area, New York state databases and national databases. HealtheConnections houses the largest collection of patient data in its supported region, and offers the ability to query across the state.
“We don’t have a problem with data, we have a problem with information,” David Page, MD, of FamilyCare Medical Group said. “This allows me to look at my panel of patients, to identify and take action on a population of patients that have unaddressed needs. I have a visibility I’ve never had before, and that’s the true value of myData.”
HealtheConnections and its provider partners like Page developed the application to use information for population health management, supporting the growing provider, care management and payer needs of value-based payment systems. myData features three tools: community health dashboards, quality measures and data discovery.
MyData’s community health dashboards leverage HealtheConnections’ clinical and data quality knowledge for three primary medical concerns: hypertension, diabetes and high hospital utilization. These registries based upon contributed community data help providers get the most complete picture of their patient panel.
HealtheConnections is a qualified certified data registry (QCDR) by Centers for Medicaid and Medicare Services (CMS). MyData’s quality measurement tool provides certified and/or proxy measures with associated dashboards, based on NCQA-certified electronic clinical quality measures.
Data discovery is a query tool that integrates and organizes provider and community-wide patient data to allow a user to ask questions about their patients’ demographics, medications and more—without needing an inside analytics team, often out of reach for smaller organizations.
“This is moving beyond the core HIE,” Hack says. “We’re maximizing the value a healthcare provider can get out of the data that’s already available. We’re turning it into useful information that helps the provider, the patient and the overall health of our communities.”
HIEs present opportunities to improve care, lower costs and enhance the overall healthcare experience of patients and providers. More than 10,000 providers and almost every hospital in the HealtheConnections service area participate with the HIE, with more than 400 of those organizations contributing data.
MyData is currently available in Central New York, and will be rolled out to other regions throughout the year.
At HealtheConnections, we strive to offer healthcare providers with the connections they need to provide better patient care. By giving clinicians the tools they need in order to have easy access to their patient’s information, HealtheConnections helps bridge the gap between the patient, the healthcare organization, and the entire community.
One organization that fully utilizes the many opportunities HealtheConnections provides is Sullivan County Public Health. We spoke with Epidemiologist Haley Motola, MS to learn more about how Sullivan County Public Health benefits from our services.
Motola explained that the Health Department is comprised of a Certified Home Health Agency, an Epidemiology Department, the Early Intervention Program, Healthy Families of Sullivan, and Public Health Education and that they offer Public Health Nursing-visiting nursing, occupational therapy, physical therapy, childhood immunization clinics, adult immunization clinics, disease education and prevention promotion, rabies reporting, childhood lead poisoning prevention, and many other public services.
“The staff working within all of the Sullivan County Department of Public Health Programs help those who would otherwise have difficulty accessing care and are vital to our community health,” Motola said, adding that the overall goal of her department specifically is to prevent the spread of infectious agents and environmental concerns that harm human health and wellness.
How does HealtheConnections come into play within Motola’s department? “I use HealtheConnections every day to complete infectious disease investigations. I am able to access information such as illness onset, pre-existing conditions, notification of the patient of the diagnosis, symptoms, medication prescribed and provider contact information and more,” she said. She also indicated that HealtheConnections helps her organization locate information that can be difficult to obtain, such as insurance coverage and next-of-kin.
She also said that often, the patients they work with have provided a more thorough view of their disease progression to their provider or their local emergency department. They may not be able to recall all the pertinent details when Motola’s department investigates, which can negatively impact the investigation. “HealtheConnections has reduced the impact that recall bias has on important investigations by providing information from the patient at the time of the illness, instead of relying solely on recollection,” said Motola.
Time is frequently of the essence when it comes to disease investigation, and Motola is pleased that the services offered by HealtheConnections have cut down on that time. “I used to spend a great deal of time trying to find out information from providers on the phone. With HealtheConnections, I am able to spend more time talking to the patient during the investigation, with more lab information and diagnostic transcriptions. Having faster and more timely information has been the absolute most beneficial aspect of HealtheConnections within our department.”
How Sun River Health Uses HealtheConnections
HealtheConnections recently had the opportunity to work with Sun River Health, a Federally Qualified Health Center and one of the nation’s largest community health providers. Sun River Health was awarded a grant centered on creating a dashboard that would, of many things, help lower readmission rates and schedule follow-ups after an ED visit. One of the goals was to implement an alerting system in which secure files would be sent as an alert to their dashboard. HealtheConnections was able to assist by quickly setting up its daily digest alerting function through Sun River Health’s dashboard.
This is just one example of how organizations like yours can use HealtheConnections and the health information exchange to improve care.
Like all of our core HIE services, it is FREE.
If you are interested in learning more about HealtheConnections Alerts, or any other services we offer, email us at email@example.com
For a busy care manager, coordinating medical treatments, including administering assessments, developing care plans, and monitoring medication compliance to advocate for a patient’s health is no easy task.
Care managers serve as the main point of contact between the patient and practice and need to get in touch with various people to coordinate a patient’s care. But getting the right person on the phone or through email can be a challenge.
With HealtheConnections, care managers can view a patient’s medical summary, including provider notes, discharge information, medications, allergies, and more, all in one place.
No faxing. No calling. No waiting.
Care Managers leverage HealtheConnections’ services to:
“HealtheConnections is a huge part of follow-up. If there is a patient who is not in our hospital system, we can log into the myConnections portal, see why the patient was there, view provider notes, and receive discharge information all in one place. That way, we know what steps to take upon their discharge and assist the patient with any needed follow-up.”
-Care Manager Coordinator, St. Joseph’s Health
This is just one example of how your staff can use HealtheConnections and the health information exchange to improve care.
Like all of our core HIE services, it is at no cost.
If you are interested in learning more about HealtheConnections and the services we offer, email us at firstname.lastname@example.org