UConn Health Furthering Discussion of State Health Information Exchange

Image provided by the Connecticut Health IT Advisory Council and the CedarBridge Group.

A series of health information technology community stakeholder roundtables is taking place next week at UConn Health and five other locations throughout the state. Allan Hackney, Connecticut’s health information technology (HIT) officer, will lead the discussions and review the findings of a report prepared for the Health IT Advisory Council.

The UConn Health roundtable is scheduled for Thursday, July 20, from 8 to 9:30 a.m. in the Cell and Genome Sciences Building.

Stakeholder groups include physician, nursing, patient advocacy, consumer-oriented, business, academic health center, health care delivery network, insurer, government agency, business and others. Attendees are asked to register in advance, as space is limited.

Dr. Thomas Agresta is director of clinical informatics at the Center for Quantitative Medicine at UConn Health. (Photo by Janine Gelineau)

Dr. Thomas Agresta, director of clinical informatics at UConn Health’s Center for Quantitative Medicine, also serves as informatics leader of the Connecticut Institute for Primary Care Innovation. He recently became the principal investigator on a memorandum of agreement between UConn Health and the Connecticut Office of the Health care Advocate focused on providing advice and assistance to the state’s HIT officer, who works directly for Lt. Gov. Nancy Wyman and is tasked with helping develop a state approach to support a health information exchange (HIE). We asked him about his work with the Health IT Advisory Council and the upcoming roundtables.

What does the Center for Quantitative Medicine offer to this project?

The Center for Quantitative Medicine (CQM) is an interdisciplinary center at UConn Health that has faculty, postdocs and trainees with a broad range of expertise. Its focus is on interpreting, analyzing and performing research using quantitative (mathematic, algorithm and analytic) methods and health care data to better understand and improve health ranging from a molecular and genetic focus all the way up to a health care systems and population health focus.

CQM offers a unique partner in the HIE / HIT support, in that we can provide expertise that ranges from how to optimally design, adopt and use an HIE for clinical care purposes, all the way to helping design unique methods to better analyze and interpret the meaning of data collected through an HIE to support clinical quality and cost improvements as well as develop novel methods to abstract new meaning from this data at the state level.

What is the significance of these stakeholder roundtables?

Connecticut has had several attempts (some I’ve been involved in) to develop an HIE at the state level in the past six years that have ended due to a variety of challenges, one of which was the lack of full buy-in and development of a sufficient business case from potential users, consumers and benefactors of the HIE.

In this recent approach, a major attempt has been made to specifically hear from stakeholders regarding their needs and desires for specific functions that HIE might provide through a series of meetings and focus groups held with nearly 300 individuals from over 130 organizations statewide. The recommendations from these stakeholder meetings were summarized into an environmental scan.

I would encourage readers to try to attend one of the roundtables, either here, or if they’re unable to join us, then at one of the other locations. These sessions will provide a forum to present these findings and then hear from attendees about their priorities for what the state should support first and creative ideas for how to accomplish these actions. They will also be used to help inform the several workgroups (called design groups) already focused on some of the top priorities that have been identified.

What would you say are the key findings and recommendations?

The major findings of this environmental scan show that there is strong support from all the stakeholder groups surveyed for development of a set of HIT services to support a secure, privacy-protected HIE for transmission of health care data to improve care, quality, public health outcomes and costs.

Several examples of the top-level priorities include:

  • Development of a process or service to help uniquely identify clinical providers and share that electronically across all collaborating HIE participants (a provider directory).
  • Development of a method to accurately, rapidly and electronically query and receive appropriate health care data from other health care organizations with different HIT systems in a format that can be integrated into the electronic health record (EHR).
  • Development of an updated state-level immunization registry at the Department of Public Health capable of bi-directionally sharing immunization information for Connecticut citizens of all ages electronically as an integrated and embedded part of the workflow within the EHR.
  • Development of an electronic clinical quality measure (eCQM ) system capable of receiving quality data electronically through an HIE from the various EHRs within the state to provide a single site where all insurers, organizations and providers agree can be used to evaluate and analyze quality metrics for comparison and pay for performance purposes. This would vastly simplify the challenges of varied metrics, methods and data sources currently in use by these entities.

What needs to happen for this effort to be a success?

This project will be measured for success both in short-term wins (Can we develop achievable designs, plans and supportable business cases?) for the priorities we’ve identified, as well as in the longer term. For instance, can Connecticut routinely, securely, accurately and efficiently develop and use HIE services for a number of the more complex use cases also laid out in the environmental scan, such as data sharing between hospitals, ERs, physicians, patients, home health agencies to improve care coordination and planning?

How do the state’s health IT and HIE services fit in to the larger picture of health care?

With the advent of interconnected and secure HIE service we should, over time and with determined focus, be able to:

  • Better engage patients and their caregivers in promoting their own health habits
  • Lower their overall health care costs
  • Improve the means by which clinical teams, including virtual ones, provide evidence-based, person-centered health care

This should improve the overall health of Connecticut’s citizens and result in less costly care for better outcomes, while at the same time improving the work-life balance of the care providers, public health employees and clinicians.

What else should we know about this?

In order for this vision to become a reality, it will take time measured in years, determination, funding and most importantly the support and input from a wide variety of stakeholders. Many if not all members of the UConn Health community stand to gain from an optimally functioning HIE and supporting services as both a provider organization and as current and future patients and caregivers ourselves.