In July we reported that HealtheConnections (HeC), a Syracuse, N.Y.-based well being info change, was awarded a contract to supply statewide encounter alerts on behalf of the Statewide Well being Data Community for New York (SHIN-NY) and is partnering with vendor PointClickCare (PCC) to supply the service. Elizabeth Amato, the HIE’s president and CEO, lately spoke with Healthcare Innovation in regards to 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 companies administration.
Becoming a member of the dialog was Brian Drozdowicz, chief income officer at PCC, which has partnerships with 16 well being info exchanges and companions with 21 state businesses and hospital associations.
Healthcare Innovation: How did it come about that HealtheConnections was awarded the contract to supply statewide encounter alerts?
Amato: It was a aggressive procurement. We’re the biggest footprint HIE in New York. We have now actually sturdy relationships and actually excessive buyer satisfaction. We all know our our prospects very effectively. By way of partnering with PCC and bringing of their actually particular and modern tooling, I feel it simply made a whole lot of sense for the state to pick out us.
HCI: Had HealtheConnections been engaged on ADTs with PCC previous to that?
Amato: No, indirectly. For a very long time we had been providing a homegrown alerting resolution inside our legacy platform. We have been really seeking to transfer to one thing rather more trendy anyway, as a result of we’re making a whole lot of 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 positively 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 have been imperfect. There have been a whole lot of 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 transferring throughout the state, however I feel NYeC realized that it was fairly inefficient, and was onerous to centrally monitor. All of this led to them realizing that there needed to be a greater manner — not simply in selecting 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 degree 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 some other place 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 exhibits up and says, “Oh yeah, I used to be within the hospital six weeks in the past.” I feel it’ll take away a few of these cracks that issues can slip via.
Drozdowicz: The expertise 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 present, 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 a complete heck of so much. Uptime and standardization matter a complete lot, as does with the ability to devour the knowledge in an ordinary format. We have additionally seen that a whole lot of the well being plans that we work with have type of defaulted to us as being their major supplier of alerts. If we have the community inside a geographical space, they’re going to favor 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 immediately with an HIE supplier, just like HealtheConnections. After all, each state has distinctive necessities. We have now discovered that working with an HIE inside the state with any such association yields one of the best outcomes for suppliers, payers and sufferers inside the state. I feel the key sauce to make this work finest for everybody inside New York is having a neighborhood HIE accomplice that really understands the completely different dynamics inside 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 make it possible for we’re assembly the wants of people inside the state.
HCI: The statewide alert system is scheduled to go stay someday within the fall. What are some issues which are occurring now behind the scenes to make that occur? Is there piloting occurring?
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 transferring over to this new resolution. Then via the month of September, we will 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 are actually depending on alerts and have to know what’s occurring with their sufferers.
HCI: I needed to modify matters and ask about another interoperability developments there. We have written slightly bit about NYeC’s uniform statewide frequent participation settlement. Are you able to clarify a number of of the methods that can enhance the SHIN-NY’s capacity to make data accessible throughout the state or break down silos?
Amato: I feel it’s actually about streamlining the operations of the statewide well being info community. It’s nonetheless a federated community with six completely different HIEs, and in some instances, whether or not it was governance-wise or contract-wise, that typically created friction, as a result of whereas we had a typical set of flow-down agreements or flow-down phrases, there have been nonetheless issues that have been carried out in a different way throughout the state. So the state made the choice to maneuver to a statewide frequent participation settlement. And I feel that that they had a objective of accelerating effectivity, unifying the info, and transferring to a extra statewide really feel. I feel it is nearly making the whole community slightly extra nimble and adaptable, and in addition permitting us to leverage a few of these statewide companies, like our new alerting service.
HCI: So is that this providing of a statewide service a mannequin and we’re prone to see extra?
Amato: I do not need to communicate 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 strategy may work.
HCI: A couple of years in the past, I wrote a few presentation from any person at NYeC about their work to shift to a FHIR basis to allow SHIN-NY members to entry discrete items of affected person info via APIs. Are they persevering with that work to shift to a FHIR-based platform, and does that require you to vary your tech stack?
Amato: Nicely, we’re really doing that on our personal. Within the subsequent month or two, we’re transferring to a very cloud-native FHIR-based HIE platform that is actually going to open up a whole lot of doorways for our members to get some significant insights out of their very own information, in addition to the group information that we’ve 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 accessible cloud applied sciences that our workforce with a improvement accomplice are constructing from the bottom up. We’re not going to one of many conventional off-the-shelf HIE platforms, which we predict goes to permit us a whole lot of flexibility and the flexibility to regulate our personal future into the longer term.
HCI: Do you continue to hear from the parents at NYeC about utilizing FHIR to share information?
Amato: Sure, we do. There’s a whole lot of 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 undertaking?
Amato: We’re enjoying a few vital roles there. One is that we’re serving because the pipes to get the knowledge 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 immediately with hospitals, doctor practices, and Federally Certified Well being Facilities that will even be screening their sufferers for health-related social wants, and bringing that in, regardless that it is type of on the periphery of the official waiver boundaries. The sufferers are then linked to community-based assets to handle any health-related social wants they’ve.
HCI: Among the many companies your HIE gives is picture change, which permits suppliers to view photos via a common viewer or obtain them into their very own system. Do most HIEs supply one thing like that? Or is that pretty uncommon? And will you speak about how that will get probably the most utilization within the system?
Amato: I am unable to actually communicate to different states and HIEs. I feel it is slightly bit combined right here in New York. Possibly 50 % of the HIEs supply a picture change resolution. Our members who use it completely find it irresistible. HIEs have all the time served up radiology stories. You would see that your affected person had a chest X-ray, however that was it. By way of picture change, you may really see the chest X-ray. And for those who’re one other radiology follow or a hospital, you may really pull that picture into your individual PACS, and that eliminates the necessity for sufferers to go and get a CD of their photos. Radiologists can really collaborate in actual time, which has been actually attention-grabbing, significantly when there is a concern {that a} affected person is likely to be 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 a whole lot of actual worth to our prospects.
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 have now a really sophisticated consent mannequin. However with regards to Half 2 information, SUD information, behavioral well being information, that sophisticated consent fashions really helped us, as a result of when a affected person has granted consent, it contains 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 have been capable of really see the info 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, nevertheless 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 accomplished a bunch of labor round behavioral well being and emergency division avoidance. It’s a completely 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 price and enhance that affected person expertise.
HCI: Lastly, I additionally needed to ask each of you ways you’re fascinated about TEFCA proper now.
Amato: We’re staying very near it. TEFCA is enjoying a vital function 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 change into QHINs or take part simply due to the consent mannequin right here, however the state’s working very onerous to reform sure items in order that that does not change 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 effectively. We do have a QHIN accomplice. We work carefully with Kno2. They have been a implausible accomplice over time. We’re frequently evaluating the function that we must always play in serving to to advance interoperability. Will probably be tremendous attention-grabbing to see what occurs within the subsequent 12 to 18 months, and we’re maintaining our choices open by way of one of the best ways in which we may be within the entrance seat of serving to to allow secure, applicable, safe information change. It is good to see issues advancing.
