- While many healthcare stakeholders are dissatisfied with the current state of EHR interoperability and health data exchange, a number of health systems are leveraging existing technology to support care coordination and patient data access.
The College of Healthcare Information Management Executives (CHIME) recently recognized a select group of health systems in its 2018 Most Wired list as exemplary organizations embracing new healthcare IT to deliver superior care.
Pennsylvania-based Lehigh Valley Health Network (LVHN) ranked third in the nation for its advanced use of health IT. The health system consistently updates its health IT infrastructure and integrates new technologies and data sources into its health IT ecosystem. These ongoing changes support patients throughout their healthcare journey, no matter where they receive care.
LVHN Senior Vice President and CIO Michael Minear recently spoke with EHRIntelligence.com about the importance of EHR integration and the current state of interoperability in healthcare. For Minear, the picture of health data exchange in the industry is not as bleak as some might say.
“One of my frustrations is that in Washington and the media, I still read how healthcare doesn't share data,” said Minear. “We actually do share a lot of data.”
At LVNH, the volume of data points exchanged per day numbers in the millions. Currently, the health system integrates information from more than a thousand different sources into its EHR system.
“In the hospital, we take about 1,400 devices and use them to upload about 54 million data points every day,” Minear explained. “We’re starting to put devices in patient homes and collecting data on blood pressure, temperature, and weight. And we’re on the verge of loading that information into Epic.”
“We want the data to follow the patient,” said Minear. “If they come to us from somewhere else on a referral, we want that data from their prior encounters.”
To date, LVHN has leveraged Epic to share 6.1 million patient health records with 630 other healthcare providers.
“We use Epic Care Everywhere if it’s another Epic customer,” said Minear.
LVHN has reached out to other industry alliances and interoperability services providers to enable connectivity with external stakeholders in the public and private sector.
“We’ve joined Sequoia and Carequality,” Minear explained. “By joining Sequoia, we can now share data with VA hospitals, the Social Security Administration, and Indian Health Services. Many public health organizations are members of Sequoia, so we can connect with them.”
To share patient health records with hospitals, clinics, and health systems with different IT platforms, LVNH employs a variety of health data exchange solutions built into its Epic EHR.
“We use Surescripts for Direct secure messages,” said Minear. “Smaller clinics typically use Surescripts or somebody else to manage the address books and we share thousands of messages through that.”
Direct secure messaging allows providers to send and receive health information securely over the internet.
The health data exchange standard is a form of document-based exchange based on a set of specifications and protocols called the Direct standard. The standard allows healthcare organizations to seamlessly exchange data with other Direct users regardless of which vendor system they use.
“We turned on anything we can to share data,” said Minear. “That's why we share so much.”
LVHN exchanges nearly 210,000 e-prescriptions a month with community pharmacies through the combined Surescripts-Epic functionality.
Currently, the health system exchanges patient prescription information with 16 emergency medical services (EMS) units in Eastern Pennsylvania and has also established a connection with the Pennsylvania Immunization System to share immunization records.
Enabling connectivity with healthcare organizations across the state is high-priority for Minear in part because he has seen firsthand the inefficiencies of siloed, inaccessible data.
“Some of my passion comes from my own family members who needed clinical care and couldn’t share data,” Minear explained. “It’s really important.”
For healthcare organizations looking to boost their level of interoperability, Minear recommended rallying members of the C-suite around the issue.
“If healthcare leaders don’t make it a priority and lay out a plan, there won’t be progress,” Minear said.
Highlighting interoperability as an organizational priority can help to ensure all internal stakeholders are committed to adopting, implementing, and utilizing health IT solutions that increase levels of complete health data exchange.
“Number two, you need to partner with your EHR vendor,” advised Minear. “We're lucky in that we have Epic. They've been focused on this for some time. We didn't have to write an interface to accommodate Sequoia or Carequality. Epic did that for us.”
“Even before that was available, Epic made sure that between Epic customers, we can share data,” said Minear.
Working with EHR companies and developers to design user-friendly interfaces and integrate health data sharing into the provider workflow is key to improving interoperability with outside clinics and hospitals.
Lastly, Minear emphasized the importance of educating and training clinicians on new tools and EHR functionality. Minear and his team at LVHN have visited several user conferences hosted by their EHR vendor to learn about new and existing functionality and identify gaps in health IT use.
“There’s an Eastern Seaboard Epic Users Group,” said Minear. “When I was in California, there was a similar one. And one of the topics addressed at these conferences revolves around sharing data within the community.”
For LVHN, boosting its own level of interoperability is only the beginning. The health system also reaches out to smaller community hospitals and healthcare organizations to ensure all local providers have the tools and knowledge necessary to engage in health data exchange.
“We have an IT group, and for ten years we’ve had community meetings,” said Minear. “We ask how we can help local partners and answer any questions about standards. In some cases, we’ve helped local providers get ahold of their EHR vendor to help walk them through this.”
Collaborating with area hospitals, clinics, physician practices, pharmacies, and other providers enables clinicians across organizations to take a standardized approach to health data exchange.
“The vast majority of what we need to do involves other care providers and pharmacies,” said Minear.