Providence Saint Joseph Health Liberates Data for Innovation with InterSystems HealthShare

Providence Saint Joseph Health (PSJH) operates in seven states, with 119,000 caregivers serving a population of 9 million. It is a microcosm of healthcare in the United States. Diverse. Growing. Sprawling. Pressured to contain costs while caring for populations with complex needs. Trying to keep pace with rapid changes in business models, clinical practice, and technology. But instead of just keeping pace, Providence Saint Joseph Health has found a way to turn these challenges into opportunities for innovation.

Providence Saint Joseph Health was created from a merger in 2016 between two healthcare delivery organizations – Providence Health and Services, and Saint Joseph Health. “At the time of the merger we were doing innovation exercises at Saint Joseph’s,” says Theo Siagian, executive director of health information exchange and interoperability at PSJH. “Our goal was to access the data from our acute and ambulatory electronic medical records (EMRs) for use in new ways, without affecting those systems or clinician workflows.” The organization invested in InterSystems HealthShare® as its core platform for health information exchange, and for securely aggregating and normalizing patient data from more than 45 unique EMRs used by communities of Providence in California and Texas. With this data, Providence used HealthShare to create a single, unified care record for each patient.

PSJH HIE provides secure electronic clinical data exchange amongst providers and healthcare organizations. The HIE enhances coordination of care, reduces costs, and improves healthcare delivery and quality of life for the people in the communities they service. For more information please see their website: stjhs.org/our-programs/health-information-exchange

Along with this organizational investment in HealthShare and support from consultants, such as those at Himformatics and NTT Data, came expectations for return. “It was important,” says Siagian, “for patient care and our credibility, that providers could see the benefit of the new system early on. With HealthShare we were able to quickly set up applications using unified care record data to do alerting and results delivery.”

The big test for Siagian, her team, and HealthShare came when Providence decided to create a portal giving providers access to the unified patient record. The goal was to help affiliated hospitals and physicians in Texas and California share information and improve care coordination and outcomes. They needed access to all information, not just the acute data, for nine million patients, across 7,000 providers, practicing in 16 hospitals, 257 medical groups and physician networks, 9 community clinics, 9 skilled nursing facilities, plus imaging centers, and reference labs. “We were told in April that we had to get this portal and a unified record live, for 7,000 users, in 3 months,” says Siagian. “Projects like this usually take about 6 months. One of our proudest moments was when we met that 3-month deadline and went live in July.” Siagian noted that with the right tools and the right resources they were able to drive success.

In a sign of true engagement, portal users frequently propose new features or request changes to the system, called ShareVue. Siagian established a product management function to prioritize these changes and seek input from the wider user community on this and other projects. “It’s all about clinical relevancy,” Siagian says.

“We’ve built multidisciplinary product management teams that are strong on the clinical side and engagement, in addition to IT.” ShareVue is updated quarterly with new features typically focused on care management and performance improvement, such as proxy quality measures and tools that address care gaps. As a demonstration of their success, ShareView currently has almost 10,000 registered users.

With the success of ShareVue, Siagian has been able to strengthen the business case for requested enhancements and new projects leveraging HealthShare. Studying a PSJH High Performance Network (HPN) with affiliated providers in Southern California, Siagian found that about 35% of the ambulatory clinical data in the unified care record comes from outside the network via HealthShare. Without HealthShare, physicians participating in a value-based care initiative might be missing 35% of the clinical visit data needed to make it work. “It’s really hard to improve organizational performance when you don’t have all of the data,” Siagian says.

Data quality has been one of the keys to success with HealthShare at PSJH. “It’s so important for provider trust,” says Siagian. “Another large part of our business case is that we offer a curated view of aggregated patient data. We take care to make sure the data is in a useful state for our providers, and that’s been a big win for us.”

Aggregating and normalizing the data from multiple EMR systems with HealthShare enables PSJH to innovate rapidly. Projects in its pipeline include:

• Identification and stratification of patients for targeted, personalized interventions and management of high-risk disease conditions
• Creating tools that assist and automate referral coordination between community and hospitals
• Developing dashboard and reporting solutions that support near real-time clinical and operational decisions to drive patient care in a constantly changing healthcare environment

“With HealthShare we have this great, agile, dynamic platform that we can use anywhere,” Siagian says. “It gives us the data layer and the application layer for building innovative solutions.”