Earlier this yr, the New York eHealth Collaborative (NYeC) made an software developed by Hixny, one of many state’s six well being data networks, obtainable to all suppliers in New York. Hixny CEO Mark McKinney just lately sat down with Healthcare Innovation to explain the info entry and workflow integration supplied by the SMART-on-FHIR app known as Snapshot NY.

Hixny says that since 2020, its affected person report Snapshot has delivered insights and knowledge factors to linked healthcare suppliers in an easy-to-navigate format, surfacing actionable data inside present workflows. Up to now yr, 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 purposes 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 Data eXchange of New York.

HCI: What are the regional HIEs in New York known as? I’ve seen them known as Certified Entities and QHINs….

McKinney: Initially, they began out being known 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 each one the RHIOs wanted to have certification, so that they began to name them Certified Entities. Now they’ve began to consult 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 beneath the state regulation, so any a type of is suitable.

HCI: I wrote one thing just lately about one other New York well being data community known as HealtheConnections starting to supply ADT feeds statewide. Hixny additionally gives a notification service. Is it a home-grown answer or do you companion with a third-party vendor on that? 

McKinney: Ours is extra of a homegrown answer, The state determined to award statewide alerting to 2 suppliers, us and HealtheConnections. Our answer is barely totally different from theirs in that we’re actually centered extra on workflow integration. We’ve had a regional alerting service obtainable for a minimum of a dozen years. And in that point, what we have discovered is that suppliers really need that knowledge pushed to them of their EHR. In August, previous to going dwell 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 provide statewide companies that they’ve developed of their area?

McKinney: I’d say sure. As an HIE, it is advisable be progressive. And I’d suspect that many of the different QEs within the state are enthusiastic about several types of innovation. The most important query is how properly these translate to statewide companies. Is it one thing that is uniquely tailor-made to their group, or is it one thing that’s extra usually relevant to suppliers anyplace?

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 obtainable statewide? May you discuss the way it works and what it brings into the supplier’s workflow? 

McKinney: Simply earlier than the pandemic, we created a mission we known as a hackathon, the place we let workers bid on the concept of getting two weeks to only deal with a mission. 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 had 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 assumed individuals would adore it, proper? Individuals had been saying they only  needed entry to all this knowledge 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 massive issues that Snapshot solves is it eliminates numerous person administration capabilities or issues. It gives 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 might 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 knowledge sources. We’ve had some success working with the New York State Division of Well being to carry a few of their purposes into our software after which make them obtainable.

HCI: Just like the state’s prescription monitoring program question software and an 1115 Medicaid waiver accredited screening software?

McKinney: Precisely. It is a approach 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 massive complaints we get from suppliers is, properly,I’ve to go and verify 5 totally different sources from DOH, and that is 5 totally different logins and passwords. This offers us the flexibility to make issues somewhat bit simpler for the customers by placing all the things 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 boldness to supply this statewide?

McKinney: We have taken a really enterprise mannequin strategy to this, the place we took this prototype, and convened a lot of focus teams from throughout the group 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 way of that course of, we have provide you with some progressive, easy capabilities 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 wanting on the knowledge we get from that hospital, in addition to from 11 different hospitals in our area. So now you both wish to see your knowledge alongside everyone else’s knowledge, otherwise you’re already seeing your knowledge in your EHR, and also you wish to disguise your individual knowledge. In order that they got here up with a quite simple little button that permits you to toggle and switch off your individual knowledge. Actually that’s one thing that I do not assume we’d have provide you with on our personal.

HCI: I noticed that Hixny was the primary validated knowledge stream for health-related social wants acknowledged by NCQA. What was concerned in incomes that recognition, and what does it enable the group to do?

McKinney: We’ve one other one for knowledge aggregation validation. Properly, NCQA’s massive focus is on main supply verification. What they wish to know is the info on the supply matches the info that Hixny has and gives to the tip level. 

That provides us two advantages. One is that we’re in a position to inform everyone that an unbiased third social gathering with an impressive repute for scrutiny and focus has validated that all the things that’s in our system matches what was within the system we sourced it from. Within the particular case of the HRSN software, they needed to validate that the info that was integrated into that software made it all over the system after which out of the system with none sort of modification.

HCI: I wrote a few presentation in 2020 by somebody from NYeC about shifting to a FHIR basis to allow members to entry discrete items of medical data via open APIs. Is that taking place? 

McKinney: It is taking place, however not as shortly as some had thought. FHIR was launched possibly a dozen years in the past, nevertheless it’s actually solely now that we’re lastly getting to a degree the place it’s turning into a substitute for the usual methods of shifting knowledge. However we’re utilizing it fairly a bit. I will offer you a few fast examples. As a part of New York State’s 1115 waiver, we’re amassing all of the HRSN screening knowledge across the state. Every of the QEs is amassing a number of the screening knowledge 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 knowledge is obtainable to suppliers across the state for a wide range of totally different use instances. 

We’re additionally engaged on another tasks with NYeC the place we’re supplying them knowledge in a FHIR format. We have carried out some applications the place we have been efficiently ready to hook up with and retrieve knowledge from EHRs straight utilizing FHIR. What we’re discovering is that the expertise remains to be evolving when it comes to its potential for use, nevertheless it 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 group is admittedly all about value-based care, and we’re centered on working with suppliers to grasp what it’s that makes them profitable in value-based care, and be certain that our instruments are doing these issues. As knowledge turns into simpler to maneuver and interoperability turns into much less of a barrier, now the issue is simply the amount of information, so we’re actually centered on how we will flip that firehose right into a water fountain, or no matter cliche you wish to use and be certain that we will make it simpler for people to do the issues that they should do.