Earlier this 12 months, the New York eHealth Collaborative (NYeC) made an software developed by Hixny, one of many state’s six well being data networks, out there 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 offered by the SMART-on-FHIR app referred to as Snapshot NY.
Hixny says that since 2020, its affected person file Snapshot has delivered insights and knowledge factors to related healthcare suppliers in an easy-to-navigate format, surfacing actionable data inside current workflows. Up to now 12 months, Hixny has launched new capabilities, together with direct entry to the state’s prescription drug monitoring program question instrument and a health-related social wants (HRSN) screening instrument 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 Info eXchange of New York.
HCI: What are the regional HIEs in New York referred to as? I’ve seen them known as Certified Entities and QHINs….
McKinney: Initially, they began out being referred to 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 seek advice from 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 kind of is acceptable.
HCI: I wrote one thing just lately about one other New York well being data community referred to as HealtheConnections starting to supply ADT feeds statewide. Hixny additionally gives a notification service. Is it a home-grown answer or do you accomplice 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 completely different from theirs in that we’re actually centered extra on workflow integration. We’ve had a regional alerting service out there for no less than a dozen years. And in that point, what we have realized is that suppliers actually need that knowledge 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 domestically.
HCI: We’re going to speak about your Snapshot NY software in a second, however do you suppose different well being data networks will look to innovate and supply statewide providers that they’ve developed of their area?
McKinney: I might say sure. As an HIE, it is advisable to be revolutionary. And I might suspect that a lot of the different QEs within the state are interested by several types of innovation. The most important query is how effectively these translate to statewide providers. Is it one thing that is uniquely tailor-made to their neighborhood, or is it one thing that’s extra usually relevant to suppliers wherever?
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 out there 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 challenge we referred to as a hackathon, the place we let staff bid on the concept of getting two weeks to simply give attention to 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 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 might launch the information to the portal, and I assumed individuals would find it irresistible, proper? Folks had been saying they only needed entry to all this knowledge 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 massive issues that Snapshot solves is it eliminates plenty of consumer administration capabilities or considerations. 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 likewise then in an EHR. Simply by being provisioned within the EHR, you are robotically 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 basically, 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 deliver a few of their functions into our software after which make them out there.
HCI: Just like the state’s prescription monitoring program question instrument and an 1115 Medicaid waiver accredited screening instrument?
McKinney: Precisely. It is a approach for the state to increase what it has with out giving up the management and it places it multi function place, proper? So one of many massive complaints we get from suppliers is, effectively,I’ve to go and verify 5 completely different sources from DOH, and that is 5 completely different logins and passwords. This offers us the power to make issues a little bit bit simpler for the customers by placing every little thing there in a single place.
HCI: Have you ever had some expertise in your area with the Snapshot instrument 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 aspect and the utility aspect was what the supplier mentioned that they wanted. Via that course of, we have give you some revolutionary, easy capabilities that we would not have considered on our personal that make an enormous 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 wish to see your knowledge alongside all people else’s knowledge, otherwise you’re already seeing your knowledge in your EHR, and also you wish to cover your individual knowledge. So that they got here up with a quite simple little button that means that you can toggle and switch off your individual knowledge. Actually 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 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 wish to know is the information on the supply matches the information that Hixny has and gives to the top level.
That offers us two advantages. One is that we’re in a position to inform all people that an impartial third get together with an excellent status for scrutiny and focus has validated that every little thing that’s in our system matches what was within the system we sourced it from. Within the particular case of the HRSN instrument, they needed to validate that the information that was integrated into that instrument made it all over the system after which out of the system with none type of modification.
HCI: I wrote a couple of presentation in 2020 by somebody from NYeC about shifting to a FHIR basis to allow contributors 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 perhaps a dozen years in the past, however it’s actually solely now that we’re lastly getting to a degree the place it’s turning into an alternative choice to the usual methods of transferring 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 accumulating all of the HRSN screening knowledge across the state. Every of the QEs is accumulating among the screening knowledge coming instantly 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 obtainable to suppliers across the state for a wide range of completely different use circumstances.
We’re additionally engaged on another initiatives with NYeC the place we’re supplying them knowledge in a FHIR format. We have carried out some applications the place we have been efficiently ready to connect with and retrieve knowledge from EHRs instantly utilizing FHIR. What we’re discovering is that the know-how continues to be evolving when it comes to its means 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 absolutely all about value-based care, and we’re centered on working with suppliers to know 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 are able to flip that firehose right into a water fountain, or no matter cliche you wish to use and be certain that we are able to make it simpler for folk to do the issues that they should do.
