HealthShare Exchange (HSX) is the winner of the SHIEC 2018 Achievement Award for Quality and Quality Data, for its efforts in partnership with Diameter Health, to standardize continuity of care documents (CCDs) provided to its participating healthcare members. In Atlanta, on August 20, 2018, the recognition was bestowed on HSX staff members, with recognition called out to Diameter, at SHIEC18, the annual conference of SHIEC (the Strategic Health Information Exchange Collaborative), the national trade organization of health information exchanges. Diameter Health is a solutions vendor that enables better clinical insights through the normalization, cleansing, de-duplication, and enrichment of medical data.
“We knew from the start of HSX that to create confidence in our services it was imperative that the data we provide to healthcare providers and insurers is consistently formatted and high quality, for usability,” says Daniel Wilt, Senior Director of Information Technology and Chief Information Security Officer at HSX.
For its data quality program, HSX first applied specifications and scoring to its encounter alerts that it sends to participating insurers, healthcare providers, and medical facilities when one of their patients is admitted or discharged in the area’s healthcare system. But its services also include quality controlling, relaying, and storing CCDs, which carry more complex information on a patient’s recent medical history. For this challenge, HSX chose to partner with an experienced national vendor, Diameter Health, taking advantage of Diameter’s Fusion and Analyze products.
Dependable, Tidy Data Opens Door for Volume of Use
Today, with about 7.5 million patients in its Master Patient Index and about 12,000 physicians and other healthcare providers in it Provider Directory, HSX sends CCDs downstream over real-time feeds providing it in a format that Diameter has helped to structure for easy, ready, dependable use by the Delaware Valley’s health system. Sending tens of thousands of CCDs per month, HSX is helping to create a new level of informed care for its region that helps to improve the patient experience and reduce medical costs.
The quality control process allows HSX’s implementation staff to scale its testing down to provide one sample to downstream entities to validate for their system’s ability to receive the information, rather than the team having to evaluate formats from multiple sources individually for this step. The Analyze solution also permits HSX’s onboarding specialists to catch potential issues before HSX begins testing. If a C-CDA format is likely to have potential issues for ingestion into HSX’s Clinical Data Repository, the staff can identify these problems before committing resources to a project.
Resulting consistency of real-time CCDs, within a standardized version, has saved resources for HSX members, who might otherwise have been charged separately for adjustment of each data feed that the HIE brought live (potentially costing in the area of $10,000 per data feed per member). With a single data format now, applied to more than 20 C-CDA data feeds, HSX has an approach embraced by its participants and scalable scaled across the region. Applying the approach to new CCD sources, the HIE saves its members money and staff time.
With this structure in place, HealthShare Exchange members have become confident with significantly expanding their volume of data received from HSX. For example, HealthShare Exchange founding member Independence Blue Cross now consumes CCDs, via HSX, from a growing number of large, competing providers, including:
- Temple Health (Jeanes Hospital data)
- Einstein Healthcare Network (hospital and ambulatory data)
- Jefferson Health System (hospital and ambulatory data)
- Jefferson Health Northeast (hospital data)
- Doylestown Health (hospital data)
Members Attest to Standardization
that Facilitates Clinical Use
By this current year, 2018, Independence is receiving an average of 26,000 CCDs per month. The insurer’s care navigators and analysts are able to approach this volume of information as one dependably uniform flow and repository of data. Likewise, HSX’s member accountable care organizations (ACOs) have found that receiving standardized C-CDA data has optimized their abilities to better manage the various populations that they serve.
“The formatting of these documents has allowed our ACO staff to institute a more streamlined use of the information by integrating it directly into our population health platform, and making our patient management more efficient,” says Katherine Schneider, MD, MPhil, FAAFP, President and CEO of Delaware Valley Accountable Care Organization, one of the largest and most widely recognized ACOs in the country. “When the CCD is available through HSX to supplement our claims data and ADT information, our care coordinators gain real-time clinical insights from problem lists, labs, and medications. This makes more efficient and more fully informed their daily task of determining which patients need care contact or follow-up to ensure a safe transition of care.”
At another health insurance member of HSX — AmeriHealth Caritas — Joe Miller, FHIMSS, Director of Strategy and Innovation, says, “Our health plan has come to depend on the consistency of the information that we receive from HSX, both for our purposes of member interventions and for trend monitoring. With more than 400,000 subscribed individuals who receive care through government-funded programs, our insurance plan needs to promptly evaluate the recent medical record information that we receive daily. The CCDs that our care coordinators receive from HSX have quickly become an indispensable tool to our outreach efforts. Without the steps that HealthShare has put in place to standardize this flow of data to us — including through the tools of its vendor Diameter Health — these documents on patient care would require more decoding, interpretation, and sorting through by our staff of nurses and utilization managers.”
The SHIEC 2018 Achievement Award for Quality and Quality Data, recognizes outstanding achievement in an HIE operation or program that advances or assists in quality measurement, quality reporting, quality data and/or quality improvement.