New York RHIO Helps its Participants Get the Most from Interoperable Information
Successful Use Cases Grow with Volume of Data
NY Care Information Gateway (NYCIG), a regional health information organization (RHIO) covering the five boroughs of New York City and Long Island, collects, stores, and shares patient health information with participants to improve the quality and safety of healthcare, enhance patient privacy, and reduce costs.
With over 550 participants, NYCIG manages the healthcare records for more than 6.5 million people. Accessing this information has become a best practice for many of NYCIG’s participant organizations. This membership has grown to include skilled nursing facilities, home health care agencies, and Coordinated Care Organizations complementing the data from over 17 hospital partners and ambulatory care practices of Long Island and the five boroughs of New York City.
An InterSystems customer since 2014, NYCIG has dedicated itself to helping its participants use patient information more effectively to manage care for conditions such as diabetes, COPD, and asthma, helping to reduce hospital and emergency department readmissions.
Most recently, NYCIG changed its master patient index to HealthShare – and realized immediate value from the switch.
Creating More Connections
“Our goal is to advance interoperable health information,” says NYCIG Executive Director, Nick VanDuyne, and the actions of his organization follow those words.
NYCIG ran into some limitations with the technology underpinning its previous patient index solution, the single source of truth for patient identity and demographics. Since realizing success from other InterSystems HealthShare products within its suite of connected health solutions, NYCIG decided to expand its use of InterSystems technology to solve the problem.
In a transition VanDuyne refers to as “seamless,” the RHIO switched to InterSystems HealthShare Patient Index so that it could better provide the comprehensive records its participants needed to improve patient care, reduce readmission rates, and qualify for reimbursements under managed care models.
But the switch came with a surprise.
“We implemented Patient Index and noticed we had 500,000 fewer patients,” VanDuyne explains. “We were initially alarmed, but through investigation, we found the system combined 500,000 redundant records. The merged information made those patient records immediately more accurate and comprehensive.”
NYCIG could also now link its patient records with the records of all the patients across the state in real time. With its previous system, manual batch updates to the state MPI system was required.
Data Proves Success
One particular participant organization needed to demonstrate the effectiveness of their diabetes management program to meet Healthcare Effectiveness Data and Information (HEDIS) performance measures.
The problem? Many patients in their program were missing expected HbA1c results, indicating a possible gap in care or missing medical reports. However, many of these patients could have had blood tests performed outside the participant’s network of hospitals. Furthermore, the blanks in the data counted those patients as uncontrolled diabetics. So, at first glance, the organization was not meeting the HEDIS threshold for nondiabetic patients.
Could NYCIG help fill in these gaps with data?
“We took this organization’s 19,000 diabetic patients and queried their records across the state, which exposed existing results for a number of the missing HbA1c tests that were actually completed and were not available to the participant,” says VanDuyne. “This has a huge impact on the reduction of downstream operational costs.”
Access to NYCIG’s unified care record provided a more complete view of this patient populations’ care and increased the participant’s score by 4.5 points, which was enough to satisfy the HEDIS requirements.
“With the added test results, the organization was able to accurately document their HEDIS score, which qualified them for value-based payment and helped them avoid a scramble to get patients in for unnecessary blood draws or manually search for results performed elsewhere,” says VanDuyne. “The result is more time to focus on people who actually do need care follow-up.”
Customization of Alerts
Many RHIOs issue alerts, but sometimes this results in a deluge for providers. What if you are interested in alerts for very specific events? This was the case with another participant, which wanted to reduce its readmission rate.
InterSystems HealthShare Health Insight, another member of the HealthShare suite of connected health solutions, is a robust analytics development solution that, among many other things, can draw upon unified health records to create customized alerts.
“We’re really excited about Health Insight for a lot of reasons,” says VanDuyne. “It allows us to provide highly customized alerts and specific customized paneling for our clients, and we see this as something that is going to be really huge for us and beneficial to our participants as a partner in their success. The ability to refine and focus alerting to specific patients will advance services and resource allocation across the care continuum.”
Using Health Insight, NYCIG participated in a pilot program with the organization to test issuing only alerts related to avoiding hospital readmissions. The participant used admissions, discharge, and transfer alerts to contact recently discharged patients for seven- and 14-day follow-up visits that can be key to preventing readmissions.
The results of the pilot were excellent. Follow-up visits more than doubled and transition care management reimbursement more than quadrupled from 2017 to 2018. These numbers contributed greatly to the participant’s ability to increase its monetary remuneration for readmission avoidance.
“The important thing to look at,” says VanDuyne, “is the 362 percent increase in revenue for readmission avoidance this organization realized with access to the NYCIG data. That’s a huge amount of money, and we’re proud to have become a partner in their success.”