Earlier this yr, the New York eHealth Collaborative (NYeC) made an software developed by Hixny, one of many state’s six well being info networks, accessible to all suppliers in New York. Hixny CEO Mark McKinney not too long ago 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 information factors to linked healthcare suppliers in an easy-to-navigate format, surfacing actionable info 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 speak about functions 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 gaggle of upstate hospitals. Hixny stands for Healthcare Data 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 info organizations. Then when the state fashioned, the SHIN-NY (Statewide Well being Data Community for New York), it determined that every one the RHIOs wanted to have certification, so that they began to name them Certified Entities. Now they’ve began to confer with all people as well being info networks (HINs). However we’re nonetheless Certified Entities, as a result of that is what we’re outlined as below the state regulation, so any a kind of is acceptable.
HCI: I wrote one thing not too long ago about one other New York well being info 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 companion 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 targeted extra on workflow integration. We’ve had a regional alerting service accessible for no less than a dozen years. And in that point, what we have realized is that suppliers actually need that information pushed to them of their EHR. In August, previous to going dwell 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 suppose different well being info networks will look to innovate and supply statewide companies that they’ve developed of their area?
McKinney: I’d say sure. As an HIE, it’s essential to be modern. And I’d suspect that many of the different QEs within the state are serious about several types of innovation. The largest query is how nicely these translate to statewide companies. Is it one thing that is uniquely tailor-made to their neighborhood, or is it one thing that’s extra typically relevant to suppliers anyplace?
HCI: Let’s speak about 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 accessible statewide? Might you speak about the way it works and what it brings into the supplier’s workflow?
McKinney: Simply earlier than the pandemic, we created a undertaking we known as a hackathon, the place we let staff bid on the thought of getting two weeks to simply concentrate on a undertaking. What got here out of it was a prototype for a SMART-on-FHIR software that was meant to make it simpler to deliver all the information collectively.
After I first bought right here, once we had been in a position to lastly deliver the information collectively, and we had a supplier portal, we would launch the information to the portal, and I believed folks would like it, proper? Folks had been saying they only needed entry to all this information in a single place, so we gave it to them, and guess what occurred? No one used it. As a result of it was not proper of their EHR workflow.
So one of many huge issues that Snapshot solves is it eliminates numerous person administration capabilities or issues. It gives some further ranges of safety, as a result of we do not have to have a person configured inside each the affected person supplier portal and in addition then in an EHR. Simply by being provisioned within the EHR, you are mechanically 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 might open a window to allow different apps to function inside our window. So basically, it is like a window in a window contained in the EHR. What that offers us the chance to do is to usher in different information sources. We’ve had some success working with the New York State Division of Well being to deliver a few of their functions into our software after which make them accessible.
HCI: Just like the state’s prescription monitoring program question software and an 1115 Medicaid waiver accepted screening software?
McKinney: Precisely. It is a method 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 huge complaints we get from suppliers is, nicely,I’ve to go and verify 5 totally different sources from DOH, and that is 5 totally different logins and passwords. This offers us the flexibility to make issues slightly bit simpler for the customers by placing the whole lot 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 arrogance to supply this statewide?
McKinney: We have taken a really enterprise mannequin strategy to this, the place we took this prototype, and convened quite a few focus teams from throughout the neighborhood and requested them to assist us refine it into one thing helpful. What got here out of it on the interface facet and the utility facet was what the supplier mentioned that they wanted. By way of that course of, we have give you some modern, 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 trying on the information we get from that hospital, in addition to from 11 different hospitals in our area. So now you both wish to see your information alongside all people else’s information, otherwise you’re already seeing your information in your EHR, and also you wish to cover your individual information. So that they got here up with a quite simple little button that lets you toggle and switch off your individual information. Truthfully that’s one thing that I do not suppose we’d have give you on our personal.
HCI: I noticed that Hixny was the primary validated information 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’ve one other one for information aggregation validation. Effectively, NCQA’s huge focus is on major supply verification. What they wish to know is the information on the supply matches the information that Hixny has and gives to the tip level.
That offers us two advantages. One is that we’re in a position to inform all people that an impartial third celebration with an impressive fame for scrutiny and focus has validated that the whole lot that’s in our system matches what was within the system we sourced it from. Within the particular case of the HRSN software, they needed to validate that the information that was integrated into that software made it all over the system after which out of the system with none sort of modification.
HCI: I wrote a few presentation in 2020 by somebody from NYeC about shifting to a FHIR basis to allow contributors to entry discrete items of scientific info via open APIs. Is that taking place?
McKinney: It is taking place, however not as rapidly as some had thought. FHIR was launched possibly a dozen years in the past, however 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 information. However we’re utilizing it fairly a bit. I will offer you a few fast examples. As a part of New York State’s 1115 waiver, we’re accumulating all of the HRSN screening information across the state. Every of the QEs is accumulating a number of the screening information coming straight 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 information is accessible to suppliers across the state for quite a lot of totally different use circumstances.
We’re additionally engaged on another initiatives with NYeC the place we’re supplying them information in a FHIR format. We have achieved some packages the place we have been efficiently ready to connect with and retrieve information from EHRs straight utilizing FHIR. What we’re discovering is that the know-how continues to be evolving when it comes to its capacity for use, however it has nice promise for all of these functions.
HCI: Anything you wish to point out about present initiatives?
McKinney: We all know that what is occurring in our neighborhood is basically all about value-based care, and we’re targeted on working with suppliers to grasp what it’s that makes them profitable in value-based care, and be sure that our instruments are doing these issues. As information turns into simpler to maneuver and interoperability turns into much less of a barrier, now the issue is simply the amount of information, so we’re actually targeted on how we are able to flip that firehose right into a water fountain, or no matter cliche you wish to use and be sure that we are able to make it simpler for folk to do the issues that they should do.
