- The New York eHealth Collaborative (NYeC) and the New York State Department of Health released a health data exchange roadmap outlining the projected evolution for the Statewide Health Information Network for New-York (SHIN-NY) under value-based care.
SHIN-NY connects the state’s eight regional health information exchange (HIE) networks. Using stakeholder feedback, the SHIN-NY 2020 roadmap detailed how the opt-in statewide health data exchange network has progressed over the past ten years and lays out a timeline for future development.
Since its inception, SHIN-NY has so far assisted in reducing hospital readmissions, emergency department visits, and unnecessary lab test and x-ray ordering. The roadmap also highlighted the ways SHIN-NY improves population health management, care coordination, transitions in care, and data reporting.
"A decade in, the SHIN-NY has allowed healthcare providers to coordinate care across different settings and areas, improving patient experiences and outcomes," said NYeC Executive Director Valerie Grey. "Ultimately, the SHIN-NY will create a 360-view of a patient's health, empowering them and their care team to create a treatment plan that addresses not only an illness or injury, but underlying conditions, medical history, and social determinants of health."
The roadmap set forth the following five strategies to achieve new performance-based contracting, policy changes, and advocacy:
- Ensuring a strong health information exchange (HIE) foundation (the basics) across the State for providers, health plans, and public health.
- Aggressively supporting patient-centric, value-based care, and certain tools, supports, and services desired by stakeholders.
- Enabling interoperability and innovations using HIE as a foundation.
- Promoting efficiency and affordability of the SHIN-NY system.
- Advocating collectively for the SHIN-NY and its stakeholders.
As part of SHIN-NY’s efforts to ensure a strong HIE foundation across the state, the network aims to achieve 100 percent hospital participation across New York, with all hospitals contributing full data by 2020. Additionally, SHIN-NY intends to require HITRUST certification for all qualified entities (QEs) and NYeC by the end of 2018.
“The DOH intends to enter into one contract with NYeC for the SHIN-NY enterprise and NYeC will enter into performance-based contracts with each QE,” stated the roadmap. “These performance-based contracts will link a portion of QE payments to the attainment of performance goals.”
To support value-based care, SHIN-NY intends to implement up to three enhanced functionality projects and three additional data and services projects. The network also seeks to develop basic alerts without a written consent option and achieve consent for 95 percent of all adult New York residents, among other goals.
SHIN-NY hopes to enable improved interoperability and foster innovation by developing and implementing a new innovation pool program and funding the best innovation proposals that are consistent with state priorities.
“This program would be a ‘try before you buy’ statewide approach and identify the experiments of highest value before implementing innovations on a large scale,” clarified the organization. “It would also be a pool that could fund some of the value based care tools and services.”
The network will promote efficiency and affordability by implementing new core infrastructure payments and measuring efficiency. Additionally, SHIN-NY plans to implement performance payments based on key metrics, manage and calibrate SHIN-NY based on government funding levels, and implement a “wire once/pay once” strategy.
“The current system sometimes supports duplication and non-standardized approaches (e.g. high-cost EHR interfaces),” stated the roadmap. “Moving forward, a new “wire once”/“pay once” strategy will be employed. Given that the SHIN-NY network allows QEs to provide information statewide, payments will be made only once rather than multiple times for connections to multiple QEs or NYeC.”
Finally, the network will advocate for itself and its stakeholders by continuing to demonstrate the networks value, organizing around EHR vendor issues, and participating in interoperability and standards work, among other efforts.
Authors also expressed an interest in considering additional work on EHR adoption literature review, workflow barriers study, core services review, statewide demand, and other work to fine-tune data exchange.
“The Statewide Health Information Network for New York's 2020 Roadmap is an ambitious plan which will further New York State's efforts to improve care, increase fiscal accountability, and enhance the patient-provider relationship,” said New York State Department of Health Commissioner Howard Zucker, MD.