Tools, Technology Already Exist for HIEs to Succeed

The following is a guest article by Sonia Chambers, Executive Director at West Virginia Health Information Network.

Infrastructure is available nationally for states to leverage and customize locally for their unique Health Information Exchange needs

Health information exchanges (HIEs) are well-situated to help healthcare organizations achieve three core goals of value-based care: providing better care for individuals, reducing healthcare costs, and improving population health management strategies. But establishing an HIE and finding success can be a tremendous challenge for some states to establish in large measure because they require complex and expensive technical infrastructure.

Fortunately, that infrastructure doesn’t need to be built from scratch for every state. Our experience at the West Virginia Healthcare Information Network (WVHIN) in collaborating with another nonprofit called CRISP Shared Services (CSS), which originated through the Maryland-based HIE CRISP — offered us important insight. Many of the tools and technology already exist for any state to build or enhance an existing HIE quickly, while still leveraging local expertise for individual communities. 

Resources for All States

CRISP was one of the first HIEs in the nation and invested tremendous resources to develop the infrastructure it has, which is now available to other HIEs. Although West Virginia is located close by, states as far away as Connecticut and Alaska are taking advantage of the CRISP infrastructure through CSS, which enables and supports each local jurisdiction to improve patient outcomes by implementing solutions that best serve the needs of their unique communities. 

Some ready-made CSS tools that states will find useful include: 

  • An Established and Reliable Platform. Consolidating and coordinating information between providers, payers and public health departments is particularly tough, not only because there are so many providers, but because of the variability between data platforms and systems. CSS already has the tools in place to deal with these differences including having built secure technical connections to thousands of providers. The platform is designed to manage large data sets and handle difficult healthcare data analytics. Getting started is as simple as establishing an account and logging on. 

During the early days of COVID-19, CSS took a tremendous burden off local health departments that needed to do contract tracing. Those without access to the platform faced sending hundreds of faxes back and forth rather than being able to focus on other critical activities. 

Notably, the platform is modular and provides multiple technology solutions for HIE participants. For example, organizations have the option to interface with a user-friendly graphical interface or an embedded data solution that puts information directly into the workflow. The infrastructure includes notifications which let providers know in real time when patients have just been to the emergency room, advance directives, public health alerts, claims data and other clinical data sets used for treating patients.

  • Agile Technology Tools. CSS has developed a technology stack with an eye toward innovation and flexibility. This allows for responsiveness to different geographies, local priorities and new programs. An experienced staff of software developers who are already deeply familiar with the healthcare platform can quickly build an application or accessory. 

Having ready-built software that’s been thoroughly tested to meet required healthcare data standards and with the easy ability to scale and manage data on huge populations is helpful. Individual states — particularly smaller ones — get to benefit from economies of scale to access cutting-edge software when they might otherwise not be able to afford that sort of technology or expertise. 

Tailoring for Your Community

Regardless how much infrastructure and software are immediately available and already compliant with federal healthcare standards, it will still be true that any state building or growing an HIE will need to design certain processes and types of outreach to uniquely meet the needs of their own local communities. For instance: 

  • Provider types and structures will vary widely. In Maryland, where CRISP is based, for instance, there are many one- to two-person physician practices, and the medical community does a lot of internal communication via provider societies and associations. That’s quite different than West Virginia, where most providers are affiliated with a hospital and there are fewer and smaller associations. That means outreach to providers functions quite differently in each state. 
  • Different communities are challenged by different population health needs. Certain populations might have predominantly older demographics, with many people in their 70s and 80s. Regionally, those populations might be affected by very particular sorts of allergies, disease outbreaks and genetic susceptibilities. All this makes a tremendous difference in what sort of health data you need to track and how you track it.  
  • State legislatures make different laws and work according to different protocols. Politics can significantly affect the enthusiasm or skepticism certain communities have when responding to public health agency data gathering. Beyond politics, individual relationships with specific legislators matter a lot when getting important public healthcare work done, and those relationships are unique to each geography. 

Best of Both Worlds

A well-designed HIE can offer tremendous advantages. In recent years, some states leveraged the power of HIEs to identify COVID-19 hotspots in communities. They traced outbreaks in nursing homes, analyzed data on race and ethnicity, and helped agencies such as public health departments and regional health districts access more extensive patient information during an emergency.

Sharing services is really the best of both worlds. It offers a way for states to access innovative, solid technology that’s already been built at a very affordable price — and leverages the local relationships and community expertise that’s required to make the model work in your own public health and provider community.

About Sonia Chambers

Sonia Chambers has a wide variety of healthcare experience. She began her professional life working for Congressman Bob Wise, serving as Legislative Aid, Legislative Director and Staff to the House Budget Committee. In 1992, Ms. Chambers returned to West Virginia where she served in various state government capacities including Director of Policy for Governor Caperton, Special Assistant for Coordinated Health Purchasing for the West Virginia Public Employees Insurance Agency and Deputy Secretary for the West Virginia Department of Health and Human Resources. In 2001, Sonia was appointed to the West Virginia Health Care Authority (WVHCA). As Chair of WVHCA, she oversaw administration of hospital Rate Review, Certificate of Need, Clinical Data Analysis and Financial Disclosure. 

Since 2015 Sonia has led the West Virginia Health Information Network (WVHIN), the state’s Health Information Exchange. Under her leadership WVHIN transitioned from a state entity to a non-profit, became an affiliate of the Chesapeake Regional Information System for our Patients (CRISP), and has grown into a trusted exchange in West Virginia.

Sonia is a graduate of Davidson College. She loves her family, hiking, yoga, the great outdoors, live music, and good food.

   

Categories