Earlier this yr, the New York eHealth Collaborative (NYeC) made an software developed by Hixny, one of many state’s six well being data networks, obtainable to all suppliers in New York. Hixny CEO Mark McKinney just lately sat down with Healthcare Innovation to explain the information entry and workflow integration supplied by the SMART-on-FHIR app known as Snapshot NY.
Hixny says that since 2020, its affected person report Snapshot has delivered insights and knowledge factors to linked healthcare suppliers in an easy-to-navigate format, surfacing actionable data inside present workflows. Up to now yr, Hixny has launched new capabilities, together with direct entry to the state’s prescription drug monitoring program question software and a health-related social wants (HRSN) screening software that meets all the necessities of the state’s 1115 Medicaid waiver modification.
Healthcare Innovation: Mark, earlier than we discuss purposes and workflow integration, are you able to remind our readers of Hixny’s geographic area and its origins?
McKinney: Hixny serves the upstate area, from the Hudson Valley north to the Canadian border after which west to the Mohawk Valley. We have been round for nearly 26 years. We began off as a three way partnership between the New York State Well being Plan Affiliation and Iroquois Healthcare Affiliation, which is a bunch of upstate hospitals. Hixny stands for Healthcare Info eXchange of New York.
HCI: What are the regional HIEs in New York known as? I’ve seen them known as Certified Entities and QHINs….
McKinney: Initially, they began out being known as RHIOs for regional well being data organizations. Then when the state fashioned, the SHIN-NY [Statewide Health Information Network for New York], it determined that each one the RHIOs wanted to have certification, in order that they began to name them Certified Entities. Now they’ve began to confer with all people as well being data networks (HINs). However we’re nonetheless Certified Entities, as a result of that is what we’re outlined as beneath the state regulation, so any a type of is acceptable.
HCI: I wrote one thing just lately about one other New York well being data community known as HealtheConnections starting to supply ADT feeds statewide. Hixny additionally gives a notification service. Is it a home-grown answer or do you associate with a third-party vendor on that?
McKinney: Ours is extra of a homegrown answer, The state determined to award statewide alerting to 2 suppliers, us and HealtheConnections. Our answer is barely totally different from theirs in that we’re actually centered extra on workflow integration. We’ve had a regional alerting service obtainable for no less than a dozen years. And in that point, what we have discovered is that suppliers actually need that knowledge pushed to them of their EHR. In August, previous to going stay on the statewide system, we did one thing like 700,000 alerts that month regionally.
HCI: We’re going to speak about your Snapshot NY software in a second, however do you assume different well being data networks will look to innovate and provide statewide providers that they’ve developed of their area?
McKinney: I’d say sure. As an HIE, it’s essential be progressive. And I’d suspect that a lot of the different QEs within the state are interested by various kinds of innovation. The largest query is how properly these translate to statewide providers. Is it one thing that is uniquely tailor-made to their group, or is it one thing that’s extra typically relevant to suppliers anyplace?
HCI: Let’s discuss Snapshot NY. Is that this one thing Hixny developed and has been in use in your area for some time and also you at the moment are making it obtainable statewide? May you discuss the way it works and what it brings into the supplier’s workflow?
McKinney: Simply earlier than the pandemic, we created a challenge we known as a hackathon, the place we let staff bid on the concept of getting two weeks to simply deal with a challenge. What got here out of it was a prototype for a SMART-on-FHIR software that was meant to make it simpler to convey all the information collectively.
Once I first acquired right here, after we have been capable of lastly convey the information collectively, and we had a supplier portal, we might launch the information to the portal, and I assumed individuals would find it irresistible, proper? Folks had been saying they simply wished entry to all this knowledge in a single place, so we gave it to them, and guess what occurred? No person used it. As a result of it was not proper of their EHR workflow.
So one of many massive issues that Snapshot solves is it eliminates lots of consumer administration capabilities or issues. It gives some further ranges of safety, as a result of we do not have to have a consumer configured inside each the affected person supplier portal and in addition then in an EHR. Simply by being provisioned within the EHR, you are routinely on this system. The opposite factor is we realized that not solely can the EHR open a window to allow our app to run inside it, we additionally realized we may open a window to allow different apps to function inside our window. So primarily, it is like a window in a window contained in the EHR. What that provides us the chance to do is to herald different knowledge sources. We’ve had some success working with the New York State Division of Well being to convey a few of their purposes into our software after which make them obtainable.
HCI: Just like the state’s prescription monitoring program question software and an 1115 Medicaid waiver authorized screening software?
McKinney: Precisely. It is a manner for the state to increase what it has with out giving up the management and it places it multi functional place, proper? So one of many massive complaints we get from suppliers is, properly,I’ve to go and examine 5 totally different sources from DOH, and that is 5 totally different logins and passwords. This provides us the power to make issues slightly bit simpler for the customers by placing all the pieces there in a single place.
HCI: Have you ever had some expertise in your area with the Snapshot software and obtained some suggestions from suppliers that gave you the boldness to supply this statewide?
McKinney: We have taken a really enterprise mannequin method to this, the place we took this prototype, and convened numerous focus teams from throughout the group and requested them to assist us refine it into one thing helpful. What got here out of it on the interface aspect and the utility aspect was what the supplier stated that they wanted. By that course of, we have give you some progressive, easy features that we would not have considered on our personal that make a giant distinction. If you consider it, our software is embedded inside a hospital’s EHR, so that you’re wanting on the knowledge we get from that hospital, in addition to from 11 different hospitals in our area. So now you both need to see your knowledge alongside all people else’s knowledge, otherwise you’re already seeing your knowledge in your EHR, and also you need to cover your individual knowledge. So that they got here up with a quite simple little button that lets you toggle and switch off your individual knowledge. Actually that’s one thing that I do not assume we’d have give you on our personal.
HCI: I noticed that Hixny was the primary validated knowledge stream for health-related social wants acknowledged by NCQA. What was concerned in incomes that recognition, and what does it permit the group to do?
McKinney: We now have one other one for knowledge aggregation validation. Nicely, NCQA’s massive focus is on major supply verification. What they need to know is the information on the supply matches the information that Hixny has and gives to the top level.
That provides us two advantages. One is that we’re capable of inform all people that an unbiased third social gathering with an impressive repute for scrutiny and focus has validated that all the pieces that’s in our system matches what was within the system we sourced it from. Within the particular case of the HRSN software, they wished to validate that the information that was included into that software made it all over the system after which out of the system with none form of modification.
HCI: I wrote a couple of presentation in 2020 by somebody from NYeC about shifting to a FHIR basis to allow members to entry discrete items of medical data by open APIs. Is that taking place?
McKinney: It is occurring, however not as shortly as some had thought. FHIR was launched possibly a dozen years in the past, nevertheless it’s actually solely now that we’re lastly getting to some extent the place it’s turning into an alternative choice to the usual methods of shifting knowledge. However we’re utilizing it fairly a bit. I will provide you with a few fast examples. As a part of New York State’s 1115 waiver, we’re amassing all of the HRSN screening knowledge across the state. Every of the QEs is amassing among the screening knowledge coming immediately from the EHRs. When that happens, the QE takes it, codecs it, converts it to FHIR, after which sends it to a central repository in order that that knowledge is on the market to suppliers across the state for quite a lot of totally different use instances.
We’re additionally engaged on another initiatives with NYeC the place we’re supplying them knowledge in a FHIR format. We have performed some packages the place we have been efficiently in a position to connect with and retrieve knowledge from EHRs immediately utilizing FHIR. What we’re discovering is that the know-how continues to be evolving when it comes to its capacity for use, nevertheless it has nice promise for all of these functions.
HCI: The rest you need to point out about present initiatives?
McKinney: We all know that what is going on in our group is de facto all about value-based care, and we’re centered on working with suppliers to grasp what it’s that makes them profitable in value-based care, and be certain that our instruments are doing these issues. As knowledge turns into simpler to maneuver and interoperability turns into much less of a barrier, now the issue is simply the quantity of information, so we’re actually centered on how we will flip that firehose right into a water fountain, or no matter cliche you need to use and be certain that we will make it simpler for people to do the issues that they should do.
