In July we reported that HealtheConnections (HeC), a Syracuse, N.Y.-based well being data trade, was awarded a contract to supply statewide encounter alerts on behalf of the Statewide Well being Info 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, just lately spoke with Healthcare Innovation concerning 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 just 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 vice chairman 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 data 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 now have actually sturdy relationships and actually excessive buyer satisfaction. We all know our our clients very effectively. By partnering with PCC and bringing of their actually particular and progressive tooling, I believe it simply made a number of sense for the state to pick us. 

HCI: Had HealtheConnections  been engaged on ADTs with PCC previous to that?

Amato: No, circuitously. For a very long time we had been providing a homegrown alerting resolution inside our legacy platform. We had been truly trying to transfer to one thing far more trendy anyway, as a result of we’re making a number of different modifications right here. So the timing was truly good.

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 had been imperfect. There have been a number 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 shifting throughout the state, however I believe NYeC realized that it was fairly inefficient, and was laborious to centrally monitor. All of this led to them realizing that there needed to be a greater approach — 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 place else 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 reveals up and says, “Oh yeah, I used to be within the hospital six weeks in the past.” I believe it may take away a few of these cracks that issues can slip by means of.

Drozdowicz: The know-how 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 the moment, with an enormous proportion of acute amenities on that, so actually it has been confirmed at scale. What we have seen is that reliability issues a complete heck of rather a lot. Uptime and standardization matter a complete lot, as does having the ability to devour the data in an ordinary format. We have additionally seen that a number of the well being plans that we work with have kind of defaulted to us as being their major supplier of alerts. If we have the community inside a geographical space, they will choose to work with us due to the reliability, the standardization, and the truth that it has been operating 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 instantly with an HIE supplier, much like HealtheConnections. After all, each state has distinctive necessities. We now have discovered that working with an HIE inside the state with such a association yields one of the best outcomes for suppliers, payers and sufferers inside the state. I believe the key sauce to make this work greatest for everybody inside New York is having an area HIE associate 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 reside someday within the fall. What are some issues which might be taking place now behind the scenes to make that occur? Is there piloting taking place? 

Amato: Really, 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 present individuals that we’re now shifting over to this new resolution. Then by means of the month of September, we will proceed with migrating our present buyer base, and begin to get on the market and promote this throughout all areas of New York — particularly to organizations which might be actually depending on alerts and have to know what’s taking place with their sufferers.

HCI: I needed to change subjects and ask about another interoperability developments there. We have written slightly bit about NYeC’s uniform statewide widespread participation settlement. Are you able to clarify just a few of the methods that may enhance the SHIN-NY’s skill to make information accessible throughout the state or break down silos?

Amato: I believe it’s actually about streamlining the operations of the statewide well being data 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 generally 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 had been carried out in a different way throughout the state. So the state made the choice to maneuver to a statewide widespread participation settlement. And I believe that they’d a objective of accelerating effectivity, unifying the information, and shifting to a extra statewide really feel. I believe it is nearly making the whole community slightly extra nimble and adaptable, and likewise 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 more likely to see extra? 

Amato: I do not need to converse for the parents at NYeC, however I believe there is a realization that every one six Certified Entities need not do all of the issues all on the similar time and that possibly a centers-of-excellence method might work.

HCI: A number of years in the past, I wrote a couple of presentation from any person at NYeC about their work to shift to a FHIR basis to allow SHIN-NY individuals to entry discrete items of affected person data by means of APIs. Are they persevering with that work to shift to a FHIR-based platform, and does that require you to alter your tech stack?

Amato: Properly, we’re truly doing that on our personal. Within the subsequent month or two, we’re shifting to a totally cloud-native FHIR-based HIE platform that is actually going to open up a number of doorways for our individuals to get some significant insights out of their very own information, in addition to the group information that now we have entry to.


HCI: Are you able to say which vendor you are working with on that platform?

Amato: It is truly one thing that’s utilizing commercially accessible cloud applied sciences that our workforce with a improvement associate 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 number of flexibility and the flexibility to regulate our personal future into the long run.

HCI: Do you continue to hear from the parents at NYeC about utilizing FHIR to share information?

Amato: Sure, we do. There’s a number of work in New York across the 1115 Medicaid waiver. A lot of that’s utilizing FHIR information. However I believe it is in some pockets greater than others.

HCI: Talking of the 1115 waiver, I learn that you just partnered with Unite Us and three social care networks throughout the Hudson Valley and central New York to deal with 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 challenge?

Amato: We’re taking part in a few essential roles there. One is that we’re serving because the pipes to get the data 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 instantly 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, although it is kind of on the periphery of the official waiver boundaries. The sufferers are then related to community-based sources to deal with any health-related social wants they’ve.

HCI: Among the many companies your HIE provides is picture trade, which permits suppliers to view pictures by means of 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 converse to different states and HIEs. I believe it is slightly bit combined right here in New York. Possibly 50 p.c of the HIEs supply a picture trade resolution. Our individuals who use it completely adore it. HIEs have all the time served up radiology reviews. You would see that your affected person had a chest X-ray, however that was it. By picture trade, you possibly can truly see the chest X-ray. And in the event you’re one other radiology observe or a hospital, you possibly can truly pull that picture into your personal PACS, and that eliminates the necessity for sufferers to go and get a CD of their pictures. Radiologists can truly 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 will share that with you. So not all HIEs do it, however we have discovered that it provides a number of actual worth to our clients.

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 now have a really sophisticated consent mannequin. However relating to Half 2 information, SUD information, behavioral well being information, that sophisticated consent fashions truly helped us, as a result of when a affected person has granted consent, it consists of 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 had been capable of truly see the information 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, but it surely’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 matter, 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 prognosis after which facilitating real-time referral out to inpatient psych amenities to assist drive down price and enhance that affected person expertise.

HCI: Lastly, I additionally needed to ask each of you the way you’re fascinated about TEFCA proper now.

Amato: We’re staying very near it. TEFCA is taking part in an important position 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 turn out to be QHINs or take part simply due to the consent mannequin right here, however the state’s working very laborious to reform sure items in order that that does not turn out to be a barrier for New York. We all know that we have to keep related and keep related, 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 associate. We work carefully with Kno2. They have been a improbable associate through the years. We’re regularly evaluating the position that we should always play in serving to to advance interoperability. It is going to be tremendous attention-grabbing to see what occurs within the subsequent 12 to 18 months, and we’re protecting 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, acceptable, safe information trade. It is good to see issues advancing.