Archive for the tag 'HIE'

Healtheway – Not a new diet, but the key to Interoperability

Healtheway, Inc. is a fully incorporated organization that provides management and administration support for two Health Information Exchange (HIE) programs, eHealth Exchange and Carequality.  They host monthly informational calls that are open to the public in which updates on both programs, including general and specific points along their existing project timelines, are discussed.

eHealth Exchange is the federal network that focuses on developing the infrastructure to support the secure and trusted exchange of health information between the federal agencies and healthcare organizations.  Participants in this network are onboarded and must demonstrate success through 35 tests to operate as a bi-directional exchange.  There are currently 51 participants in the eHealth Exchange process and the list can be viewed here.


Carequality is a recent addition to the oversight role of Healtheway and their goal is “to facilitate agreement on a common national-level set of requirements that will enable providers to access patient data from other groups” (Carequality Press Release, 2014).  Their model is similar to the banking industry’s framework during the creation of the ATM network.  Both programs are designed to operate independent of their support organization and have their own by-laws and organizational structure to help them accomplish their goals and achieve their mission.

On their June 6th call, it was evident that the eHealth Exchange model is maturing, and that existing discussions involve expansion of the participants and further defining of specifications to improve confidentiality and security of health information.  An example of the expansion involved a discussion to create a new subset of Responder Only Profile members that would represent intermediaries, such as medical release of information organizations and EHR vendor networks. These members would not initiate requests but only respond to requests over the Exchange network. This represents a shift in how the Exchange had previously been designed, and presents an opportunity to expand both the size and scope of the network.  Further discussions will define criteria for inclusion and sending to the Coordinating Committee for approval.

The updates continued with the Carequality timeline and their creation and approval of the organizational structure, including the Governance Charter, Articles of Incorporation, and By-Laws.  This signifies completion of a critical path in their development, and a shift in focus to establishing additional committees, councils, and work groups to begin defining the common national standard for the transmission of health information.  To facilitate this major undertaking, the organization is actively seeking nominees for individuals to serve as members in any of these roles that have been defined by their By-Laws; interested individuals can apply on their website .

It is evident that progress is being made to build a standardized structure akin to the banking industry’s implementation of online banking for customer access, and eventual banking access across multiple accounts and institutions.  While there are differences in the guiding hand of this progress, the interoperability of healthcare information is key to driving one of the goals of health care reform in reducing costs and improving quality of care.

On July 16th at 2:00 pm, Galen will be presenting a webcast that will provide additional explanation of how this exchange will occur and how real-time access to the patient’s record can substantiate these claims.  You can register to this webcast by clicking here.

HIE is here to stay

Galen Healthcare Solutions announced its strategic partnership with Orion Health in a past January article. Since then, Galen has been heavily involved in the recent boom of Health Information Exchange (HIE). What’s an HIE? In a nutshell, HIE is the “secure health data exchange between two or more authorized and consenting trading partners” (HIE Implications in Meaningful Use Stage 1 Requirements). On one end is the data supplier; on the other end is the data receiver. A third party – in this case, Orion Health – facilitates the data transfer to ensure quality control and necessary HL7 specifications.

I’ve spent the past few months working with two promininent HIE projects: hundreds of hospitals in each state sending demographic information, clinical documents, laboratory results, radiology reports, and immunizations to the state’s data repository. Providers from those hospitals are then able to access a portal that can display a patient’s full medical history from multiple hospitals on one profile.

Engaging in an HIE is one way for a hospital to meet Stage 1 Meaningful Use objectives. HIE engagement will only grow in the future as Stage 2 and Stage 3 Meaningful Use requirements are initiated. At its core, Meaningful Use is using EHR technology to promote patient engagement, care coordination, and health security. A breakdown of the 3 stages are as follows:

An important criteria for Stage 2 is that providers who have met Stage 1 for two or three years will need to meet meaningful use Stage 2 criteria to continue collecting government incentives. As eligible providers move into the next phase of meaningful EHR utilization, we can expect the trend of HIE to continue, with increased attention on advanced clinical procedures.

HIMSS 2014 Re-cap

Galen Healthcare Solutions HIMSS 2014

HIMSS 2014 represented Galen’s first as an exhibitor to the event. The results were simply fantastic. It was great to connect with clients, both new and old. We had conversations regarding ways we could help with initiatives that are top of mind for clients- assessment and optimization of existing application deployment, integration and conversion strategy and needs driven by HCO acquisition and EHR vendor switch, patient engagement enablement through solutions such as Dragonfly, public and private HIE participant on-boarding, and most importantly the roadmap to value-based-care. As an organization, we have evolved from our Allscripts roots, through partnerships and business lines with prominent vendors such as Orion, Meditech, Epic, RelayHealth, Aternity, Merge and Intersystems to name a few. It is clear that our methodology (empowering, nimble, ego free, one-stop shop, personable and collaborative) is well received, resonates with our clients, and really differentiates Galen in the overall client experience. If you have yet to work with us or are new to Galen, we encourage you to get a sample by attending one of our industry-leading free webcasts. The excitement generated from HIMSS is palpable, and we are thrilled to bring our passion, energy and commitment to better the industry.

Responsibility Matters: A Message from a Data Analyst

I recently read an article that raised the question of who owns your health data. By ownership, I am referring to who has the power to either access or give someone access to your medical information. There are many interested parties in knowing all about you for valid reasons:

  • Your PCP wants to know what care you have received so s/he can effectively manage your health
  • Your specialists want to know your medical history so they can rule out contra-indications and assess for conditions that could affect the effectiveness of your treatment plan
  • Your insurance providers want to know the health status of their covered patients so they can effectively calculate the risk of their covered members
  • Your state and federal governments want to know population level data so they can effectively manage public health and policy initiatives

Those are a lot of players interested in what is recorded about you in EHRs around the country. Do each of those players need to know everything about you? When we visit a physician to deal with a problem, we are putting our trust in them to make medical decisions for us. Certainly they may need to know your medical history. Therefore, we could say that every physician we interact with should have the right to access your medical record. I don’t know about you, but as a patient that sounds scary. A dermatologist doesn’t need to know about a patient’s erectile dysfunction to remove a wart!

I am currently working on HIE and ACO integrations and have been grappling with the technical challenges of seamlessly integrating information from Medicare’s Opt-Out program and from the ACO’s opt out program with the care management programs that the PCPs have signed up for. This got me thinking, if I have the right to withhold medical information from my physicians, can I hold them responsible for missing a diagnosis when they did not have a complete medical history or medication list? Providers certainly don’t think so! While we haven’t found it yet, there is a balance between sharing enough information for everyone to do their jobs, and the patient taking responsibility for managing their medical record. At the core of the ACO model is the concept of a PCMH which focuses on the physician-patient relationship as a way for both of them to manage the patient’s health together. If we as patients want to have ownership of our medical identity yet still provide the necessary information for everyone to do their jobs, then it is time for us patients to become more involved with all the members of our health management team and to understand the implications of both sharing and withholding information.  As a data analyst, I know most organizations share healthcare data securely with only those who need it and data is not being abused. As a consumer, I also know that nobody predicted that FICO scores would be used by insurers and employers. We need to know who is using our data for what purposes and voice our concerns to our healthcare providers and lawmakers.There are many benefits to sharing data openly with ER docs, ACOs, state HIEs, etc. that I am sure you can imagine. So if you are choosing to withhold your information, I urge you to review the implications of withholding information and the responsibility it places on you with your PCP.

As a childhood hero of mine was once told: “with great power, comes great responsibility!

Let My Data Go!

I recently had a nice chat with a colleague analyzing HIT industry trends for Kalorama Information. Kalorama does industry research for the medical and life sciences for many of the major news and consulting organizations. I got in touch with her specifically because of Kalorama’s analysis on EHRs in 2012 which was used by Bloomberg Government for their (very expensive) EHR industry analysis for provider and vendors. She found that in 2012 one of the most immediate challenges for providers was implementing EHR systems that meet meaningful use standards. She also found that vendors were having trouble with interoperability and usability.

Fast forward to 2013; a lot has changed. Epic has grown to dominate many markets. Allscripts has a new CEO and a few new toys to play with. eClinicalWorks has become a force to be reckoned with in the small practice space. However, the challenges the providers are facing have changed. My colleague and I talked for a while about various organizations we each have worked with and came to the same conclusion: providers are now having trouble with interoperability and conversions of data.

2013 Priorities

The majority of physician offices have implemented EHRs, but they must now communicate with other entities such as HIEs and ACOs. With the increase in mergers and acquisitions, we are also seeing an increased demand for conversions from one system to another. These problems involve a thorough understanding of the underlying data structure as well as a solid foundation in interoperability standards such as LOINC, HL7, SNOMED, and CDA. The vendors have the expertise to work on the problems for their products, but they are not enthusiastic about helping clients switch off their platform. Selling the EHR has been the primary goal for vendors in the past, not technical support that moves a client away from their product. Vendors are under the assumption that if they make switching off their product difficult, then clients will be less likely to undertake the conversion or integration with a product that is not part of the vendor’s family of products. While this is definitely true for disgruntled clients, it only makes it frustrating for clients who do not have a choice in the products they work with. This reality has led to some very important questions.

Where is an organization to go when their own vendor is not supporting their efforts? How do organizations extract meaningful data from such complicated or cloud based databases? How can we become self-sufficient in managing our data? How does an organization meet new institutional and government requirements? Galen can help clients with these challenges, but vendors need to help by making products that play nice with others.

At the end of our conversation my colleague and I simultaneously came to the same conclusion: “Organizations feel like their data is being held hostage!

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