In July we reported that HealtheConnections (HeC), a Syracuse, N.Y.-based well being data trade, was awarded a contract to offer statewide encounter alerts on behalf of the Statewide Well being Info Community for New York (SHIN-NY) and is partnering with vendor PointClickCare (PCC) to offer the service. Elizabeth Amato, the HIE’s president and CEO, lately spoke with Healthcare Innovation concerning the alert program and the HIE’s transition to a cloud-native FHIR-based platform.
Amato succeeded Rob Hack as the corporate’s president and CEO in January 2025 after most lately serving as chief working officer there. Beforehand she labored for a number of years on the New York eHealth Collaborative (NYeC), together with as vp of packages and providers administration.
Becoming a member of the dialog was Brian Drozdowicz, chief income officer at PCC, which has partnerships with 16 well being data exchanges and companions with 21 state companies and hospital associations.
Healthcare Innovation: How did it come about that HealtheConnections was awarded the contract to offer statewide encounter alerts?
Amato: It was a aggressive procurement. We’re the biggest footprint HIE in New York. We’ve actually sturdy relationships and actually excessive buyer satisfaction. We all know our our clients very properly. By partnering with PCC and bringing of their actually particular and progressive tooling, I feel it simply made numerous sense for the state to pick out us.
HCI: Had HealtheConnections been engaged on ADTs with PCC previous to that?
Amato: No, in a roundabout way. For a very long time we had been providing a homegrown alerting answer inside our legacy platform. We had been really trying to transfer to one thing way more fashionable anyway, as a result of we’re making numerous different adjustments right here. So the timing was really excellent.
HCI: Earlier than this contract, have ADT alerts been shared simply inside every HIE’s personal area, and never throughout areas within the state?
Amato: There are undoubtedly ADT alerts inside every of the six HIE areas in New York. Since about 2016 or so, there have been cross-region alerts in New York, however they had been imperfect. There have been numerous handshakes that needed to land to ensure that an alert to maneuver from, say, New York Metropolis to Syracuse. So it sufficed. It was higher than the absence of alerts shifting throughout the state, however I feel NYeC realized that it was fairly inefficient, and was exhausting to centrally observe. All of this led to them realizing that there needed to be a greater means — not simply in choosing alert suppliers that will do that on behalf of the state, like HeC and PointClickCare, however in addition they modified a number of the under-the-covers structure on the statewide stage to make it extra dependable.
HCI: Will the statewide alerts add extra worth for care managers, managed care organizations or ACOs who beforehand haven’t been capable of see particulars about when a affected person went to the hospital elsewhere within the state?
Amato: Completely. I do assume standardizing this in order that it is a statewide ADT pipe goes to take away a few of these potential failure factors that did ache a number of the care managers, as a result of they didn’t obtain an alert till the affected person reveals up and says, “Oh yeah, I used to be within the hospital six weeks in the past.” I feel it is going to take away a few of these cracks that issues can slip via.
Drozdowicz: The know-how that we’re utilizing right here is basically one thing that we have confirmed nationwide. We function the biggest real-time notification community within the nation at the moment, with an enormous proportion of acute services on that, so actually it has been confirmed at scale. What we have seen is that reliability issues an entire heck of quite a bit. Uptime and standardization matter an entire lot, as does with the ability to devour the data in a regular format. We have additionally seen that numerous the well being plans that we work with have kind of defaulted to us as being their main supplier of alerts. If we have got the community inside a geographical space, they will choose to work with us due to the reliability, the standardization, and the truth that it has been working at scale and really predictably for fairly a while.
HCI: Does PointClickCare have expertise with offering statewide alerts in different states?
Drozdowicz: There are greater than a dozen states the place we’re working straight with an HIE supplier, much like HealtheConnections. In fact, each state has distinctive necessities. We’ve discovered that working with an HIE throughout the state with such a association yields the perfect outcomes for suppliers, payers and sufferers throughout the state. I feel the key sauce to make this work greatest for everybody inside New York is having a neighborhood HIE accomplice that really understands the totally different dynamics throughout the markets. New York is a brilliant distinctive place, proper? And Elizabeth and her workforce will actually be capable of present that native taste and be sure that we’re assembly the wants of people throughout the state.
HCI: The statewide alert system is scheduled to go dwell someday within the fall. What are some issues which can be taking place now behind the scenes to make that occur? Is there piloting taking place?
Amato: Truly, that is pilot week for us. With PointClickCare, we’re bringing on near 10 pilots. Some are model new to the HealtheConnections household. Some are current members that we’re now shifting over to this new answer. Then via the month of September, we’ll proceed with migrating our current buyer base, and begin to get on the market and promote this throughout all areas of New York — particularly to organizations which can be actually depending on alerts and have to know what’s taking place with their sufferers.
HCI: I needed to modify matters and ask about another interoperability developments there. We have written a bit bit about NYeC’s uniform statewide widespread participation settlement. Are you able to clarify a couple of of the methods that may enhance the SHIN-NY’s capacity to make information out there throughout the state or break down silos?
Amato: I feel it’s actually about streamlining the operations of the statewide well being data community. It’s nonetheless a federated community with six totally different HIEs, and in some instances, whether or not it was governance-wise or contract-wise, that generally created friction, as a result of whereas we had a standard set of flow-down agreements or flow-down phrases, there have been nonetheless issues that had been carried out in a different way throughout the state. So the state made the choice to maneuver to a statewide widespread participation settlement. And I feel that they’d a objective of accelerating effectivity, unifying the information, and shifting to a extra statewide really feel. I feel it is nearly making your complete community a bit extra nimble and adaptable, and likewise permitting us to leverage a few of these statewide providers, like our new alerting service.
HCI: So is that this providing of a statewide service a mannequin and we’re more likely to see extra?
Amato: I do not need to converse for the parents at NYeC, however I feel there is a realization that each one six Certified Entities need not do all of the issues all on the identical time and that perhaps a centers-of-excellence method might work.
HCI: Just a few years in the past, I wrote a couple of presentation from someone at NYeC about their work to shift to a FHIR basis to allow SHIN-NY members to entry discrete items of affected person data via APIs. Are they persevering with that work to shift to a FHIR-based platform, and does that require you to alter your tech stack?
Amato: Nicely, we’re really doing that on our personal. Within the subsequent month or two, we’re shifting to a very cloud-native FHIR-based HIE platform that is actually going to open up numerous doorways for our members to get some significant insights out of their very own information, in addition to the neighborhood information that we have now entry to.
HCI: Are you able to say which vendor you are working with on that platform?
Amato: It is really one thing that’s utilizing commercially out there cloud applied sciences that our workforce with a growth accomplice are constructing from the bottom up. We’re not going to one of many conventional off-the-shelf HIE platforms, which we expect goes to permit us numerous flexibility and the flexibility to regulate our personal future into the long run.
HCI: Do you continue to hear from the parents at NYeC about utilizing FHIR to share information?
Amato: Sure, we do. There’s numerous work in New York across the 1115 Medicaid waiver. A lot of that’s utilizing FHIR information. However I feel it is in some pockets greater than others.
HCI: Talking of the 1115 waiver, I learn that you simply partnered with Unite Us and three social care networks throughout the Hudson Valley and central New York to handle health-related social wants. This was about exchanging health-related social want information between the social care networks and the SHIN-NY information lake. Are you able to give an replace on that venture?
Amato: We’re taking part in a few essential roles there. One is that we’re serving because the pipes to get the data out of their Unite Us platform as much as the statewide information lake and again into their platform. We’re additionally working with the communities that these three SCNs function in — the Hudson Valley, Central New York and the Southern Tier of New York — and dealing straight with hospitals, doctor practices, and Federally Certified Well being Facilities which will even be screening their sufferers for health-related social wants, and bringing that in, despite the fact that it is kind of on the periphery of the official waiver boundaries. The sufferers are then linked to community-based sources to handle any health-related social wants they’ve.
HCI: Among the many providers your HIE gives is picture trade, which permits suppliers to view photographs via a common viewer or obtain them into their very own system. Do most HIEs provide one thing like that? Or is that pretty uncommon? And will you discuss how that will get probably the most utilization within the system?
Amato: I am unable to actually converse to different states and HIEs. I feel it is a bit bit combined right here in New York. Perhaps 50 p.c of the HIEs provide a picture trade answer. Our members who use it completely like it. HIEs have all the time served up radiology experiences. You may see that your affected person had a chest X-ray, however that was it. By picture trade, you possibly can really see the chest X-ray. And when you’re one other radiology follow or a hospital, you possibly can really pull that picture into your personal PACS, and that eliminates the necessity for sufferers to go and get a CD of their photographs. Radiologists can really collaborate in actual time, which has been actually fascinating, significantly when there is a concern {that a} affected person is perhaps having a stroke, particularly in a rural setting. So it is actually thrilling stuff. It’s costly to function. I am going to share that with you. So not all HIEs do it, however we have discovered that it provides numerous actual worth to our clients.
HCI: One other use case talked about in your web site is behavioral well being. How do behavioral well being suppliers take part within the HIE, and are there nonetheless points round sharing behavioral well being information or substance use dysfunction information within the state?
Amato: Not a lot in New York. We’ve a really difficult consent mannequin. However with regards to Half 2 information, SUD information, behavioral well being information, that difficult consent fashions really helped us, as a result of when a affected person has granted consent, it consists of their behavioral well being information. So we actually have not had the challenges that different states have had in participating and bringing behavioral well being suppliers into the fold, as a result of they had been capable of really see the information that they wanted on their sufferers. We nonetheless deal with it as delicate information. We nonetheless have to carry that information again when we have to, however it’s been an actual differentiator for New York, as a result of we have been capable of take away that barrier.
Drozdowicz: We have completed a bunch of labor round behavioral well being and emergency division avoidance. It’s a totally different subject, however we have launched a program within the state of Massachusetts that is in each emergency division. It has a portal that helps to evaluate sufferers upon admittance to the ED and figuring out if there is a prior behavioral well being analysis after which facilitating real-time referral out to inpatient psych services to assist drive down value and enhance that affected person expertise.
HCI: Lastly, I additionally needed to ask each of you the way you’re excited about TEFCA proper now.
Amato: We’re staying very near it. TEFCA is taking part in a vital position nationwide. As I discussed a couple of minutes in the past, our consent coverage right here in New York makes that troublesome for New York HIEs to both develop into QHINs or take part simply due to the consent mannequin right here, however the state’s working very exhausting to reform sure items in order that that does not develop into a barrier for New York. We all know that we have to keep related and keep linked, however there’s just a bit little bit of a course of that we’re having to undergo to get right here.
Drozdowicz: We’re super-close to it as properly. We do have a QHIN accomplice. We work intently with Kno2. They have been a incredible accomplice through the years. We’re regularly evaluating the position that we must always play in serving to to advance interoperability. It is going to be tremendous fascinating to see what occurs within the subsequent 12 to 18 months, and we’re conserving our choices open by way of the perfect ways in which we will be within the entrance seat of serving to to allow protected, acceptable, safe information trade. It is good to see issues advancing.
