Research Report: How states promote HIEs and engage them to support public health and health equity efforts

Maimonides Health / Community Care of Brooklyn Drive Collaboration, Engage Community and Promote Health Equity During COVID19 Pandemic

Facilitating Trust in Interoperability and Health Information Exchange

Establishing trust is a bedrock of interoperability. Third-party accreditation from a known, established, and highly regarded entity can help establish confidence that an accredited entity has met a high-bar of standards and compliance, creating trust between organizations with accreditation. In this panel, industry leaders in accreditation will discuss the role why and how accreditation is important for establishing trust as a means to expand interoperability.

Building the Infrastructure to Support Scalable FHIR Adoption is Key to Supporting Health Equity

The HL7 Fast Healthcare Interoperable Resources (FHIR) standard is being leveraged in several areas of healthcare to increase interoperability. Several HL7 FHIR Accelerators are focused on creating functional use cases to improve data exchange including the exchange of social determinants of health (SDOH). While these functional use cases are critical, building the infrastructure necessary for these use cases to be implemented in a scalable way is imperative.

This session will educate attendees on the work of the FHIR at Scale Taskforce (FAST), one of the newer HL7 Accelerators and formerly an ONC-convened initiative. FAST’s mission is to ameliorate common challenges such as identity management, finding FHIR endpoints and data exchange with or without intermediaries. While this work is not specific to health equity, it is work that is necessary in order for the functional use cases that are specific to health equity to unlock key data elements needed to support health equity initiatives

HIEs and health tech vendors can play a key role in moving this infrastructure work forward.

Developing a Roadmap for Democratizing Data for Housing and Homelessness Leveraging COVID-19 Funding

To expand and maximize COVID-19 relief funds in our community for housing and homelessness, we collaborated with the metropolitan Omaha Health and Housing Coalition to design a roadmap for data sharing using the health data utilities of CyncHealth. CyncHealth, a data company, believes in data democratization, data driven decision making and data for public good. In this project, we worked with our partners to pave a way forward to advance health care equity by developing a community roadmap for a shared data infrastructure among health care, social services, and public health that. Through this project we aimed to center equity, meet communities’ self-determined needs, and supports systems change for community health and well-being.

Data can democratize and that is the philosophy of CyncHealth. However, data without community input on what is valuable and important lacks impact. Therefore, we developed a community-driven roadmap to identify data needs for community-based organizations through Omaha’s Health and Housing Coalition. This effort could potentially allow community organizations to enhance the work they do in the community. Our approach utilized a participatory evaluation approach to build a meaningful data intermediary process in partnership with the community. We followed the 10 Principles for Trustworthiness for community engagement outlined by the American Association for Medical Colleges treating the community as the experts in a community-driven, diverse and transparent approach to understands and deliver housing SDOH data. The goal of these efforts was to advance public health solutions that take into consideration healthy equity and the social determinants of health.

Resource Directory Exchange: A Collaborative Model for Sustainable Community Engaged Health

Patient Care Intervention Center is developing the resource directory exchange for the Health Equity Collective in Greater Houston. The Health Equity Collective, a multi-sector effort focused on creating a more equitable health ecosystem representing over 180 organizations and more than 50 coalitions aligned with a shared mission to establish an impactful, sustainable, data-driven system to promote health equity and address the social drivers of health outcomes. A key effort of the Health Equity Collective is facilitating the development of Community Information Exchange using a federated model. This approach is linking existing technologies and cultivating interoperability across the ecosystem. The initial development is focused on the foundational resource directory exchange capacities, to improve information, access, and quality of resource directory data.

PCIC is developing this model to create a central hub for Houston’s multi-sectoral data sharing and synchronization of resource information. With existing connections to service providers in the community, state-wide and nationally, the focus of the work will be on interoperability between resource directories. The data structure standardization process includes mapping and analysis of database schemas, comparative analysis of the contents of the resource directory databases specifically around data structures and bringing resource directory exchange into alignment with both the Open Referral & AIRS standards. This is being implemented in along with a robust shared data governance process to facilitate multi-organizational data-sharing and cooperative workflows.

We will describe our process including
Phase I: Governance & Data Structure Standardization
Phase II: Resource API Engine and API SDK
Phase III: Deployment and Post Deployment Activities

COVID-19 has not only exposed the equity challenges faced by our communities, impacted by existing gaps in effective collaboration between agencies and our community members. The pandemic also exposed the need for trust building in and across communities, and in the health care system.

Dismantling Data Silos Through Public-Private Partnership: DC’s Vendor Agnostic, Community-Based Approach to Interoperability Across Health, Social, and Human Services

To promote whole person care, the DC HIE maintains a flexible infrastructure for SDOH data-sharing through DC HIE direct entry tools, EHR integrations and via third party vendors. The District’s unique community-driven strategy enables the exchange of social determinants of health data through a vendor agnostic approach that allows for social needs screening, referral and resource information to flow through the DC HIE without requiring the use of a single District-wide platform.

Reducing ED Visits One Orange Flag at a Time: A Claims and EMR Data Intervention

Treatment in an emergency department (ED) is situational and consists of a short-term relationship between patient and provider. Those with unmanaged complex conditions frequently string together many of these visits as a makeshift care plan. Meanwhile, the providers who see them struggle with the repeated visits for the same reasons and being unable to adequately address the patient’s needs.

Organizations in Colorado are piloting the use of electronic medical records and claims data to identify these high-need, high-utilizers and track them as they move throughout the health care system. Employing claims data from the Colorado All Payer Claims Database (CO APCD), the Center for Improving Value in Health Care (CIVHC) will generate a list of high-needs patients in the Denver metro area. This list will be transferred to the Colorado Regional Health Information Organization (CORHIO), one of the state health information exchanges (HIE), where an “Orange Flag” will be added to the records, visible to participating providers.

A provider, when seeing the flag, will be alerted that the patient is not currently enrolled in a coordinated care plan to adequately manage their needs. This will guide providers when they are working to support their patients, giving them additional information on which to base treatment recommendations. The flag will also afford real-time information about the high-needs population, supporting targeting interventions.

Distributed Care Teams to Address Inequity through Whole Person Care: Learnings from an Innovative Pilot in California

Communities across California have implemented programs aimed at improving health and social outcomes of their most vulnerable residents by creating distributed care teams that collaborate across sectors to meet complex needs. Hear learnings from one community that launched a program using a distributed care team model supported by a care management platform and the exchange of actionable information. Understand how this program addressed systemic inequities, improved health, and reduced the social burden of high-risk individuals, resulting in the success of reducing chronic homelessness by 28% in two years. Learn how this community leveraged technology to coordinate and collaborate across sectors, creating shared care plans and unified goals for clients they serve. Understand emerging best practices, including what solutions they will enhance and what they will abandon as they launch into new phases of work.

Leveraging an HIE to Scale Quality Improvement Programs for Chronic Disease and Advance Health Equity

The evidence is clear that minority and underserved populations suffer disproportionately from chronic disease and experience worse outcomes with the care that they do receive. While most health care providers appreciate the impact that social determinants of health have on their patients, data highlighting social needs and measuring disparities are not consistently incorporated into quality improvement interventions or value-based care models. Barriers include the administrative burden of capturing and integrating the relevant data on a timely basis to enable the QI process, as well as stakeholder reluctance to share more comprehensive data sets that are needed to measure outcomes. A multi-stakeholder group of payers, providers, community-care hubs, and a Health Information Network (MiHIN) have launched a project that involves developing statewide collaborative quality improvement programs targeting key chronic diseases with an emphasis on addressing health disparities. We will highlight an approach to establish data sharing infrastructure to accelerate quality improvement, reduce provider burden, and incorporate a health equity focus into the QI process by leveraging the services of an HIE.