Managing expectations, physician relationships with health IT, HIEs

Buy-in to state-sponsored health IT initiatives and health information exchanges requires developing in-person, on-the-ground connections with Medicaid providers.

“When our health information exchange [HIE] came out, it was sort of bad timing,” said Dan Roach, III, MD, acting director of the Center for Strategic Health Innovation at the University of South Alabama, speaking at the 2014 State Healthcare IT Connect Summit.

In his previous role as state health IT coordinator, Roach worked to connect hospitals and other providers to the state HIE, but they still were handling their own technology challenges.

“We had to change focus and work on the areas where we were more technically and emotionally ready,” he said.

The state launched a pilot to connect more technically advanced and motivated physicians to the HIE. In this effort, the state met with physicians in their own offices to handle technology issues head-on.

“Don’t underestimate the value of being with people in person. It’s important to find ways to connect them with regional extension centers. They create real relationships with people to help them through the pain and suffering,” he said.

Medicaid providers may understand the value of HIEs, but they “are challenged implementing EHRs in practices at this point. Adding layers to their workflows to address HIEs effectively is a challenge,” said Matt McGeorge, health IT coordinator at the Pennsylvania Office of Medical Assistance Programs.

McGeorge said his team ultimately is looking at collecting patient-level quality measures to share with managed care plans to enhance the care management process. “They are interested in getting that information in a more real-time basis.” Also, the state is working to engage behavioral health members to share more data with physical care providers.

“We did a pilot project where we had behaviorial health entities utilizing Direct messaging. We weren’t able to get too far with it, but it did illustrate that they did have the capability to share information in ways they haven’t before,” he said.

Jim Maikranz, vice president of healthcare solutions government at MedeAnalytics said that part of the company’s strategy is allocating teams to offer “individual love” by scheduling in-person meetings with Medicaid providers. “The adoption process is very slow. They may be willing, but reticent and reluctant to change.”

The visits allow an opportunity to prioritize meaningful technology improvements up front, like putting in real-time eligibility at the point of treatment, putting in links to state-recommended drugs and pharmacies, and putting in metrics showing how they are performing in comparison to their peers in terms of length of state and outcomes.

“When we started doing things that affected their practice and outcomes, they started to pay attention,” Maikranz said.