Q&A: HIE sustainability may depend on business strategies
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CMIO spoke with Momrow about the specifics of starting and sustaining an HIE.
How many providers and hospitals are now participating?
HIXNY currently has 32 members participating in the health information exchange (HIE) in the Capital Region and Northern New York. The HIXNY membership is comprised of hospitals, physician groups and practices and health insurers, among others.
In addition, approximately 320 physicians have signed agreements through the regional extension center program, for which HIXNY is an agent. Also, 38 small physician practices (typically one to five physicians) in the HIXNY service area totaling 116 providers have signed up to participate in the exchange. We believe the unprecedented level of collaboration among our members is a strong selling point in attracting new members and participants to the exchange.
What is HIXNY doing to differentiate itself in what is becoming a very competitive area for HIEs?
Each RHIO in New York State, including HIXNY, operates under a different business model. In the Greater Capital Region and Northern New York that HIXNY serves, the business model is based on offering a portfolio of services. Among these value-added services that leverage the HIE platform are HealthyScripts (an e-prescribing tool), HealthyView (a community-wide patient data service), HealthyDocs (electronic results and reports delivery) and HealthyTalk (a secure messaging platform for physicians).
What is HIXNY doing to ensure sustainability?
HIXNY believes that a sustainable business model is one in which our members feel they are receiving value from participating in the HIE, including the various products and services HIXNY offers.
The current technology platform used by HIXNY to serve our members is based on cost efficiency. Support for growth and maintenance of the current infrastructure is preformed economically using internal staff with flexibility of using contractors as needed for projects on demand.
While many RHIOs in New York State rely on grants and other funding, HIXNY’s business model is based on usage by our members and enabling of new collaborative care models.
Is this HIE exchanging data with other area HIEs?
The goal in New York State is for HIEs and RHIOs to be able to share and exchange data with other areas in the state through the Statewide Health Information Network (SHIN-NY) as well as HIEs in neighboring states. HIXNY is actively working to connect our HealthyView service with the other New York State RHIOs as well as to connect our HealthyDocs and HealthyTalk services to other regions and states using the Direct Project standards as the Direct Health Information Service Provider (HISP) for the region. We expect to have interstate exchange up and running by the end of this year.
How does HIXNY handle interoperability issues?
There are essentially five components of interoperability: patient identification, data interchange standards, core data sets, semantic interoperability and data quality. HIXNY uses the HealthShare technology platform from InterSystems as the foundation for our HIE technical offerings. It offers us the flexibility to assess our interoperability at any point in time to guide the investments being made by our members. With higher levels of interoperability it will be possible to feed data into decision support engines to produce informed population and patient level analytics.
What types of data are being exchanged now? What about in the future?
Currently, the types of data being exchanged between HIXNY and its members include demographics, allergies, medications, procedures, immunizations, diagnoses, notes and department reports, hospital discharge summaries, image reports and lab results.
HIXNY is exploring connecting to the Universal Public Health Node, a statewide immunization registry that captures data from medical devices incorporating social and functional data found in nursing homes and home healthcare and connections to elder care services.
The goal in this exchange of data is to improve the efficiency and quality of care provided to the residents of the Capital Region and Northern New York.