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 lately sat down with Healthcare Innovation to explain the info 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 information factors to related healthcare suppliers in an easy-to-navigate format, surfacing actionable data inside present workflows. Up to now 12 months, Hixny has launched new capabilities, together with direct entry to the state’s prescription drug monitoring program question software and a health-related social wants (HRSN) screening software that meets all the necessities of the state’s 1115 Medicaid waiver modification.
Healthcare Innovation: Mark, earlier than we discuss 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 bunch 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 shaped, the SHIN-NY [Statewide Health Information Network for New York], it determined that every one the RHIOs wanted to have certification, in order that they began to name them Certified Entities. Now they’ve began to discuss with everyone as well being data networks (HINs). However we’re nonetheless Certified Entities, as a result of that is what we’re outlined as below the state regulation, so any a kind of is suitable.
HCI: I wrote one thing lately about one other New York well being data community referred to as HealtheConnections starting to supply ADT feeds statewide. Hixny additionally supplies a notification service. Is it a home-grown resolution or do you companion with a third-party vendor on that?
McKinney: Ours is extra of a homegrown resolution, The state determined to award statewide alerting to 2 suppliers, us and HealtheConnections. Our resolution is barely completely different from theirs in that we’re actually targeted 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 information pushed to them of their EHR. In August, previous to going reside on the statewide system, we did one thing like 700,000 alerts that month regionally.
HCI: We’re going to speak about your Snapshot NY software in a second, however do you assume different well being data networks will look to innovate and supply statewide companies that they’ve developed of their area?
McKinney: I’d say sure. As an HIE, you want to be progressive. And I’d suspect that a lot of the different QEs within the state are eager about several types of innovation. The largest query is how properly these translate to statewide companies. 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 discuss 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 discuss the way it works and what it brings into the supplier’s workflow?
McKinney: Simply earlier than the pandemic, we created a venture we referred to as a hackathon, the place we let workers bid on the thought of getting two weeks to only deal with a venture. What got here out of it was a prototype for a SMART-on-FHIR software that was meant to make it simpler to carry all the info collectively.
Once I first received right here, after we have been in a position to lastly carry the info collectively, and we had a supplier portal, we might launch the info to the portal, and I believed folks would adore it, proper? Individuals had been saying they simply wished entry to all this information 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 large issues that Snapshot solves is it eliminates a number of person administration capabilities or issues. It supplies some further ranges of safety, as a result of we do not have to have a person configured inside each the affected person supplier portal and likewise then in an EHR. Simply by being provisioned within the EHR, you are mechanically 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 primarily, it is like a window in a window contained in the EHR. What that offers us the chance to do is to herald different information sources. We’ve had some success working with the New York State Division of Well being to carry a few of their functions into our software after which make them out there.
HCI: Just like the state’s prescription monitoring program question software and an 1115 Medicaid waiver authorised screening software?
McKinney: Precisely. It is a manner for the state to increase what it has with out giving up the management and it places it multi functional place, proper? So one of many large complaints we get from suppliers is, properly,I’ve to go and test 5 completely different sources from DOH, and that is 5 completely different logins and passwords. This provides us the flexibility to make issues a bit bit simpler for the customers by placing every thing there in a single place.
HCI: Have you ever had some expertise in your area with the Snapshot software 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 numerous 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 stated that they wanted. By means of that course of, we have give you some progressive, easy features that we would not have considered on our personal that make a giant distinction. If you concentrate on it, our software is embedded inside a hospital’s EHR, so that you’re trying on the information we get from that hospital, in addition to from 11 different hospitals in our area. So now you both wish to see your information alongside everyone else’s information, otherwise you’re already seeing your information in your EHR, and also you wish to conceal your individual information. In order that they got here up with a quite simple little button that lets you toggle and switch off your individual information. Actually that’s one thing that I do not assume we’d have give you on our personal.
HCI: I noticed that Hixny was the primary validated information 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’ve got one other one for information aggregation validation. Effectively, NCQA’s large focus is on major supply verification. What they wish to know is the info on the supply matches the info that Hixny has and supplies to the tip level.
That offers us two advantages. One is that we’re in a position to inform everyone that an unbiased third social gathering with an excellent repute for scrutiny and focus has validated that every thing that’s in our system matches what was within the system we sourced it from. Within the particular case of the HRSN software, they wished to validate that the info that was integrated into that software made it throughout the system after which out of the system with none form of modification.
HCI: I wrote a couple of presentation in 2020 by somebody from NYeC about shifting to a FHIR basis to allow members to entry discrete items of scientific data by open APIs. Is that taking place?
McKinney: It is occurring, however not as rapidly as some had thought. FHIR was launched perhaps a dozen years in the past, but it surely’s actually solely now that we’re lastly getting to some extent the place it’s turning into an alternative choice to the usual methods of shifting information. However we’re utilizing it fairly a bit. I am going to offer you a few fast examples. As a part of New York State’s 1115 waiver, we’re accumulating all of the HRSN screening information across the state. Every of the QEs is accumulating a few of the screening information coming straight 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 information is out there to suppliers across the state for a wide range of completely different use circumstances.
We’re additionally engaged on another tasks with NYeC the place we’re supplying them information in a FHIR format. We have performed some packages the place we have been efficiently in a position to connect with and retrieve information from EHRs straight utilizing FHIR. What we’re discovering is that the know-how continues to be evolving when it comes to its means for use, but it surely has nice promise for all of these functions.
HCI: Anything you wish to point out about present tasks?
McKinney: We all know that what is occurring in our neighborhood is absolutely all about value-based care, and we’re targeted on working with suppliers to grasp what it’s that makes them profitable in value-based care, and be sure that our instruments are doing these issues. As information turns into simpler to maneuver and interoperability turns into much less of a barrier, now the issue is simply the quantity of knowledge, so we’re actually targeted on how we will flip that firehose right into a water fountain, or no matter cliche you wish to use and be sure that we will make it simpler for folk to do the issues that they should do.
