Introduction

HEALTHeLINK: It’s Working.

After spending the last 12 years building Western New York’s health information exchange, HEALTHeLINK is delivering more and better ways to serve physicians and health care organizations in the secure electronic exchange of clinical information. Focusing on enhancing patient care, HEALTHeLINK is streamlining care coordination and care transitions, improving the quality of data, and exploring how best to serve the health care community of the future through population health measures and reporting.

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A message from our board chair.

A message from our executive director.

Meet the people leading the way for HEALTHeLINK – our Board of Directors.

HEALTHeLINK Board of Directors.

David Scamurra, MD – Chair

Pathologist, Eastern Great Lakes Pathology/X-Cell Laboratories of WNY

Art Wingerter – Vice Chair

President, Univera Healthcare

Anthony J. Billittier IV, MD, FACEP

Emergency Physician, UBMD – Emergency Medicine

Chief Medical Officer, Millennium Collaborative Care

Michael Cain, MD

Vice President of Health Sciences and Dean, School of Medicine & Biomedical Sciences, University at Buffalo

Michael W. Cropp, MD – Past Chair

President & Chief Executive Officer, Independent Health Association

Andrew L. Davis, MBA

Chief Operating Officer, Erie County Medical Center

Cletis Earle

Vice President & Chief Information Officer, Kaleida Health

Michael F. Galang, DO

Senior Vice President & Chief Information Officer, Catholic Health System

Ann Marie Odrobina

Administrative Vice President & Manager, Employee Benefits Administration, M&T Bank

Paul Pettit

Commissioner of Health, Orleans County Department of Health

Thomas E. Schenk, MD

Senior Vice President & Chief Medical Officer, BlueCross BlueShield of Western New York

Everett Weiss, MD

Chief Medical Informatics Officer, Roswell Park Comprehensive Cancer Center

Chapter 1

From participants to data sources.

To realize the full potential of health information exchange (HIE), individual practices are now joining hospitals and other health care organizations in sharing patient visit data every day via HEALTHeLINK, adding to the robust set of clinical information now available to treating providers. This means having the information needed to make better health care decisions.

Uploading EHR data.

Practices continue to deepen their utilization of HIE by uploading patient data directly from electronic health records (EHRs) to HEALTHeLINK. Not only do patient encounter record uploads allow for more complete patient medical records that other treating providers can access, which saves time, but they also reduce the number of calls a practice receives from other practices for patient information on patients they both treat. HEALTHeLINK can also support the delivery of data on behalf of practices to health insurers to assist with HEDIS or quality improvement (QI) reporting.

Number of practices and providers that are sending HEALTHeLINK data from EHRs:

351 practices

2,089 providers

1 million patient encounter records (CCDs) are uploaded annually through HEALTHeLINK

Leveraging HIE for care continuity during crisis situations.

Through HIE, HEALTHeLINK can ensure care continuity and patient safety by providing instant and secure access to data that may have become inaccessible for treating providers through their own EHRs.

For instance, when a cybersecurity attack shut down the computer network of one of the region’s health care systems, HEALTHeLINK was in a unique position to serve as a backup system during the recovery effort. This was because the system was already a data source prior to the attack and had been uploading its patient care data to HEALTHeLINK.

Conversely, the sudden closing of an oncology practice could have resulted in significant patient safety issues due to a lack of medical records. Even though the practice had been accessing patient data through HEALTHeLINK, it had not shared clinical data. Therefore, physicians who took on the practice’s former patients were basically flying blind and piecing together medical history and current treatment.

While these examples are worst-case scenarios, they demonstrate the efficacy of HEALTHeLINK in enhancing patient care, and they provide valuable lessons in the importance of accessing clinical data during a crisis.

Chapter 2

Optimizing operations.

Through HEALTHeLINK, participants have secure access to the most up-to-date clinical information where and when it’s needed most. What’s more, HEALTHeLINK is helping to simplify this information gathering for more efficient and effective care.

Increased utilization.

Since data began flowing via HEALTHeLINK in 2009, year after year has shown increased utilization of HEALTHeLINK services by WNY providers.

Use of our services:

Results delivery

HEALTHeLINK’s results delivery service enables practices and care coordination networks to receive their patients’ medical results directly into their EHRs from other linked sources. This functionality enhances the ability to conduct pre-visit planning and reduces the number of repeat tests because information is immediately available for better medical decision-making.

1 million patient encounter records (CCDs) are uploaded annually through HEALTHeLINK

Patient record lookup

Patient record lookup allows authorized users to access a consented patient’s clinical record, providing instant access to information – such as lab tests, radiology reports, medication history, and other information from EHRs across the community – that is crucial for care management.

Patient record lookup totals – 4,259,396

Alert notifications

With alert notifications, participating HEALTHeLINK providers can be notified in real time of their patients’ admissions, discharges, and transfers – including local emergency department visits. With this timely information, providers can schedule follow-up visits with patients to review diagnoses and new medications to likely reduce the chance of future readmission. In 2018, in addition to the delivery of alerts at the time of admission or discharge, HEALTHeLINK launched batch alerts, which enable all of a provider’s alerts to be delivered as a daily batch file first thing in the morning for the previous 24 hours.

Patients subscribed for alert notifications to be sent to their doctors: 642,123

761 providers subscribed

2,553,188 alerts delivered in 2018

Incorporating HIE into practice workflow.

HEALTHeLINK conducted a pilot study with three primary care and three specialty care practices to assess what impact incorporating HIE into office workflow would have on quality of care, assessment, and both patient and staff satisfaction. These six practices were not regular users of HEALTHeLINK, so there was an opportunity for deeper adoption and usage of HIE to solve pain points for the practices regarding obtaining patient information and proactively supporting office visits. A practice workflow tool kit was developed to assist these practices and other practices in the community with increased integration of HEALTHeLINK, which resulted in sustained utilization after the pilot study was completed.

Up to seven hours a week saved with patient chart preparation and pre-visit planning by utilizing HEALTHeLINK's patient record lookup

A reduction of up to 30 minutes in patient cycle time by accessing test results and records in advance via HEALTHeLINK

Chapter 3

Enhancing HIE capability.

As more physicians and staff experience the value of HEALTHeLINK firsthand, our work continues to ensure the quality of information for effective patient care and advancing population health initiatives in our community.

Data quality scorecards.

The quality of patient information that is accessed via HEALTHeLINK depends on the quality and completeness of the information received from data sources. HEALTHeLINK developed data quality scorecards, which contain information about the types and quality of data that participating data sources provide via HIE. Each scorecard also provides a level of detail to indicate exactly what the data errors are (if any) and where they occurred. Initially focusing on the contributing hospital data sources, HEALTHeLINK is now reviewing scorecards with primary care and specialty practices.

Advancing regional initiatives.

In 2018, HEALTHeLINK was awarded multiple grants to leverage its HIE technology in advancing population health and supporting regional value-based care initiatives. The grants included:

A $325,000 Interoperability and Innovation grant from the New York eHealth Collaborative (NYeC) to combine clinical and claims data. This grant will create a regional, unified repository to provide a more complete picture of a patient’s health from all care settings and give treating providers the information needed for outcome-based reporting and population health analytics with a focus on the Comprehensive Primary Care Plus (CPC+) measures.

A State Innovation Model (SIM) grant through New York State Department of Health and NYeC totaling $384,000 focused on supporting the development of statewide patient-centered medical home (PCMH) scorecard measures.

In support of the Delivery System Reform Incentive Payment (DSRIP) Program and Community Partners of WNY, HEALTHeLINK was awarded $181,000 as a subcontractor to the Value Network IPA (which includes behavioral health practices) to support the upload of and access to patient care plans and alert notifications to primary care providers.

Support for value-based care.

HEALTHeLINK is developing a population health system to support clinical transformation at the practice level. The goal is to link patients to their primary care doctor and help identify gaps in care and cost-of-care trends. The system will integrate clinical and claims data with a user interface enabling practices to monitor their quality and cost of care to drive better care at lower costs. Once active, HEALTHeLINK will also be able to aggregate clinical and claims data at a practice level to support both the value-based and the patient-centered medical home programs.

Chapter 4

Collaborating state- and nationwide.

HEALTHeLINK continues to grow its network and best practices through collaboration both statewide through participation in the Statewide Health Information Network for New York (SHIN-NY) and nationally as a founding member of the Strategic Health Information Exchange Collaborative (SHIEC).

Statewide connectivity.

While most health care is local, there may be times when care is needed away from home. Through SHIN-NY, WNY patients can have their clinical information made available to treating doctors anywhere in the state. In addition, WNY physicians are alerted if their patient has been seen outside the region, and clinical information is available via SHIN-NY. With this connection, participating providers involved in that patient’s care receive a more complete medical picture.

HIE at the national level.

HEALTHeLINK’s involvement with SHIEC from its inception has proven to be a valuable opportunity to share best practices and collaborate with more than 65 other HIEs from across the country. SHIEC provides HIEs with a platform for advocacy at the federal level, which is critical for ensuring the value of HIE is recognized as legislation is passed. Daniel Porreca, HEALTHeLINK’s executive director, continues to serve as board chair for SHIEC’s board of directors.

Chapter 5

Progress by the numbers.

With dozens of data sources already connected and more in the pipeline, HEALTHeLINK is building its network to enable information when and where our participants need it – at the point of care. Today, a provider securely accesses records via HEALTHeLINK every five seconds.

HEALTHeLINK has 433 data sources including:

351 physician practices

35 long-term care facilities

27 hospitals

10 regional radiology providers

6 independent laboratory practices

3 medication history sources

1 home health care agency

Nearly 100% of laboratory results generated in WNY are available through HEALTHeLINK

More than 90% of radiology reports, including radiology images, generated in WNY are available through HEALTHeLINK

reports available in HEALTHeLINK: ### million (includes ADT, laboratory, radiology, transcriptions, telemonitoring, and discharge medications)

reports added monthly: approximately ## million

Total participating providers – 5,344

Total participating practices – 1,203

Total number of users – 17,191

Percentage of WNY population consented 87% of adults consented, including minors - 82% consented

Epilogue

Looking ahead to 2019.

There’s no doubt that HEALTHeLINK is working and enhancing both patient care and safety. However, there is still more work to do. The time is now for physicians and providers to move beyond just accessing health information and on to contributing and utilizing HEALTHeLINK to its full potential.

To join or learn how to make better use of HEALTHeLINK, visit our website or call a member of our account management team at (716) 206-0993.

HEALTHeLINK: 2018 Report to the Community