In its recently published April issue, the Journal of AHIMA includes an article on how Health Information Management is shaping the future of population health through HIEs. The article features several HIE use cases, including one of our own as explained by Drew Richardson, Director of Population Health at IHIE.
“HIM Prepped to Shape the Future of Population Health through HIE” By Cecilia A. Backman, MBA, RHIA, CPHQ, FHIMSS; Melanie A. Meyer, PhD, MHA, RHIT, CCS, CPHQ; Kathy J. Westhafer, RHIA, CHPS; and Lee A. Wise, MS, RHIA, CHCO
Read the full AHIMA interview with Drew Richardson below.
AHIMA: How is health information exchange being used for population health management?
Drew: HIEs are exceptionally positioned to impact the specific care of the populations which they serve. Nearly everyone in healthcare defines Population Health differently, but for our purposes, we include both traditional population health management and public health management, as there is often a grey area between these two areas. The Indiana Health Information Exchange has a tremendously rich data repository that we have positioned to provide clinically relevant and necessary data that works to complete the knowledge gap of a patient record.
We have built a population health solution comprised of several services that build on each level of data exchange. Our ADT alerts, for example, notify care providers when their attributed patients receive acute care anywhere in the state. This allows providers to know where their patients are receiving care and to start a dialogue with the patient. Another service we provide is Care Manager access to our data repository through an easy-to-use web application, which allows Care Managers to view their attributed patents’ records and provide coordinated, comprehensive care across health systems. Finally, we also provide access to the clinical data via our Clinical Values Report. This report is a valuable supplement of data on a specific patient population that assists a client in care management, gaps in care, and quality reporting.
AHIMA: What are the challenges with using HIE for population health?
Drew: Many population health initiatives focus on large populations that cover a wide portion of a state or multi-state areas. But HIEs typically cover smaller areas—they are state- and regionally-focused. The challenge is that patients don’t limit the care they receive within these boundaries. So HIEs must work together and share information across geographic divides to provide a complete picture for care providers. There are some exciting initiatives that the Strategic Health Information Exchange Collaborative (SHIEC) is spearheading to begin to overcome these challenges by tying data exchange together between HIEs in pilot regions. When complete, this will set the stage for more HIE collaboration. Additionally, it is challenging to get all stakeholders together to prioritize population health initiatives and align the priorities with available data and other resources.
AHIMA: How are federal mandates, such as the ACA and value based reimbursement, impacting population health initiatives in relation to HIE?
Drew: As new mandates and payment models evolve, we are seeing more and more opportunities to support population health initiatives. A considerable amount of time is required to collect and analyze data, specifically quality metrics, which support the mandates and payment models. HIEs are in a unique position to provide value by serving as a single collection point for these data elements. Our current services include many of the requested data elements however we are also looking to enhance these reports by specifically aligning the output with nationally recognized quality metrics (HEDIS, MSSP ACO measures, STARS, etc).
The value of the HIE data is being utilized in both clinical and quality applications. Just as we have seen the growth of quality metrics, we are seeing growth and evolution of the new value-based reimbursement models, such as Comprehensive Care for Joint Replacement, Cardiac Bundles, and ER Readmissions. With the shift from fee-for-service to value-based care, there is an increased need for data beyond the walls of individual health facilities. That places HIEs in a great position to support these new models.
AHIMA: Do you have the ability to perform population health data analysis or do you rely on partners for this? Who owns the data that is used?
Drew: This area of population health tends to get complex really quickly because the term analysis is difficult to define in the population health space. By conservative definition, I would say we do limited analysis of the data today, and much of our output is fed to analytics engines purchased by our clients. Many of the large health systems have already made significant investments in these tools, and HIEs are purely data suppliers. Smaller systems, though, will be looking for the limited analytic tools that HIEs will offer.
And in terms of ownership, the data is owned by the participants of the HIE, and the HIE is the steward charged with the use, exchange and management of the data.
AHIMA: Where do you see HIE going in terms of population health? What are your future plans? How do you see this changing the way you conduct business or collect information?
Drew: In addition to the new payment models and federal mandates, I see tremendous opportunities to truly impact the health of of the citizens of Indiana. Specifically since 1993 Indiana has moved from 30th to 41st as one of the unhealthiest states in our country. While many diverse organizations have similar missions to improve the health of our communities, and there are many areas Indiana needs improvement in, there are four areas of particular focus: obesity, smoking cessation, opioid epidemic, and infant mortality. IHIE plans to continue to collaborate with our clients and other agencies to improve and expand the data exchange, and ultimately, to improve community health in these four areas. Together we can have a much greater impact.
AHIMA: What role can health information management (HIM) professionals play with regards to HIE and population health?
Drew: It’s important to understand what happens to the data once it enters the EMR of a health system and how the vast number of practitioners, analysts, partners use this data. HIEs “product” is data, and HIM professionals understand this. They also understand the types of data that data consumers use on a daily basis. That is why I think that HIM Reimagined is a great initiative because HIM professionals have such a valuable understanding of the data that many HIEs, population health vendors, and analytics engines need to be successful.
AHIMA: How is Information Governance supporting population/public health?
Drew: There is an increased desire to gather vast amounts and types of data to support population/public health initiatives. Information Governance is critical to ensure the validity of the data collected. It gives assurance to HIEs that the data they are accessing, analyzing and exchanging meets the needs for quality metrics, clinical interventions, and population/public health initiatives.