HEALTHeLINK: 2013 Report to the Community

Introduction

HEALTHeLINK: It’s Working.

We’re excited to share some great news. HEALTHeLINK – one of the leading clinical information exchanges in the United States – is making a significant and positive difference for health care in Western New York. By safely and successfully connecting health care professionals to vital information about their patients when it’s needed most, HEALTHeLINK is paving the way for a more efficient and more effective delivery of care. We invite you to read our report – and we hope you’ll find the results as inspiring as we do.

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Who We Are.

HEALTHeLINK, the Western New York Clinical Information Exchange, is a collaboration involving the region’s hospitals, physicians, health plans, and other health care providers to serve the eight counties of Western New York. HEALTHeLINK was created to enable the exchange of clinical information in secure and meaningful ways to improve both efficiency and quality, while also helping to control health care costs. Patients who provide consent allow physicians and providers directly involved in their treatment to securely access relevant medical information via HEALTHeLINK, resulting in more timely and effective treatment at the point of care. To view our Board of Directors listing, click here.

A Message from Our Board Chair.

David Scamurra

More than 10 years ago, a group of payers and providers launched a project that has developed into HEALTHeLINK. Lack of patient information and antiquated communication systems among providers was a major contributor to an unsafe, costly, and inefficient health care system. Our goal was to have all relevant patient health data follow that patient in a secure way so that any provider anywhere, anytime, caring for the patient had full knowledge of past history, tests, and medications. To many outside of health care this seems like a given, but we all know how rare these circumstances are when we care for patients.

Through truly unprecedented collaboration among health care professionals and New York State, we have set ourselves apart nationally as a community in making tremendous strides in accomplishing this task. The past few years have been dedicated to building the basic infrastructure of this system, increasing physician and hospital adoption and obtaining significant patient consent, all of which are critical factors in the ultimate success of HEALTHeLINK.

We have already seen solid evidence of the positive impact on costs and patient care efficiency from studies of Western New York providers using HEALTHeLINK regularly. I use HEALTHeLINK daily in my Pathology practice and can say the positive impact on cost, efficiency, and quality of patient care exceeds what we even thought possible in the original founding group.

We want to focus on working with providers to make the system more and more user-friendly and continually add to the ranks of consented patients through educational efforts and cooperative actions with our provider community. This effort will be every bit as difficult as the building of the basic infrastructure, but it is vital to the ultimate goal of transforming health care into an accountable industry.

If we can maintain our vision and continue the spirit of collaboration as we have done to date, I am confident we will remain ahead of the rest of the country and create a model for health care reform.

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David Scamurra, MD
Chair, HEALTHeLINK Board of Directors
Pathologist, Eastern Great Lakes Pathology/X-Cell Laboratories of WNY

A Message from Our Executive Director.

Daniel E. Porreca

With a continued focus on expansion and deeper use of our health information exchange, HEALTHeLINK marked a number of significant milestones in 2013. It’s been five years since the completion of our initial pilot program, where we tested the technology and processes necessary to make HEALTHeLINK the success it is today. This success is evident in the usage numbers, but most gratifying is hearing from those among the more than 3,000 physicians and other health care providers who utilize HEALTHeLINK daily. Their feedback affirms the value we provide in improving the quality, safety, and efficiency of care for their patients.

This year, we continued to connect more data sources such as hospitals, radiology practices, long-term care facilities, home health agencies, and others, providing participating physicians with even more of the most current patient medical information. I am happy to report that all of Western New York’s full-service hospitals are now connected to HEALTHeLINK. As a result of our growth in data sources and increased participation, we marked the one-millionth patient record lookup through our health information exchange. With more physicians and data sources participating, that number will continue to grow along with the value to the Western New York community.

Patients are also understanding the benefit of HEALTHeLINK, as more than 550,000 Western New Yorkers have authorized consent to enable their treating physicians to access their body of information via HEALTHeLINK.

Our three-year Beacon Community project came to an end in 2013. This federally funded initiative enabled us to expand the data available within HEALTHeLINK and facilitate the effective use of technology in practices and health care facilities throughout our region. This resulted in the utilization of technology for better care coordination and measurable improvement for diabetic patients. Many of the technologies implemented by the Beacon project will continue to support improved and effective monitoring of the health care of those afflicted with diabetes.

In addition, we completed work on our HEAL 17 project, which focused on integrating primary care practices with care managers and linking them with a consulting psychiatrist in order to improve coordination in behavioral health care. We also continued our partnership with the New York State Department of Health in utilizing health information technology for the betterment of public health, including launching an automated immunization reporting service.

It was a collaborative spirit among our region’s major health insurers and hospitals that got HEALTHeLINK up and running. It is this same spirit of collaboration that continues today, along with the dedicated and passionate HEALTHeLINK staff, that is enabling more physicians, health care organizations, and patients to experience firsthand the value we are providing to Western New York’s health care. HEALTHeLINK: It’s working!

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Daniel E. Porreca
Executive Director
HEALTHeLINK

Chapter 1

Strengthening
Our Infrastructure.

By the end of 2013, more than 110 million total results from nearly 50 data sources were available through HEALTHeLINK. To view the list of current data sources, click here.

The facts:

26 hospitals

HEALTHeLINK has 46 datasources including:

8 regional radiology providers

3 independent laboratory practices

4 home health care agencies

3 long-term care facilities

2 surescripts

98% of laboratory results generated in WNY are available through HEALTHeLINK

90% of radiology reports generated in WNY are available through HEALTHeLINK

“The Brothers of Mercy Nursing and Rehabilitation Center staff has continually focused on ensuring that our patients receive the very best care. Streamlining communication among physicians and other health care professionals and our facility via HEALTHeLINK is another important component in those efforts.”

Valerie Kane
Administrator
Brothers of Mercy Nursing and Rehabilitation Center

reports available in healthelink: >102 million

reports added monthly: approximately 1.9 million

Results Delivery into their EHR System

Practices 23 / 222.

Providers 180 / 1,06.

2011 / 2013.

“It is extremely important that our referring physicians promptly receive test results. HEALTHeLINK now affords almost immediate access to Dent imaging reports, and as such plays a critical role in improving quality and efficiency of care.”

Vern Bates, MD
President
Dent Neurologic Institute

Over 188,500 Continuity of Care documents have been transmitted for referrals from primary care physicians to specialists.

In 2013, HEALTHeLINK upgraded its HEALTHeCOMMUNITY portal by adding new enhancements to improve the overall user experience as well as adding an additional level of security for providers and patients. The portal now provides access to both HEALTHeLINK and HEALTHeNET in one location, and with a single user name and password.

“Having access to the information in HEALTHeLINK has helped our Emergency Room personnel to get a more complete picture of the patients they are treating, in a fraction of the time that it would have taken previously. There are many instances where providers have been able to access information that they otherwise would not have been made aware of. The HEALTHeLINK team has been very diligent in understanding our needs and quite helpful in the rollout of this important tool. HEALTHeLINK has become a trusted resource in the Kenmore Mercy Hospital Emergency Department and I would highly recommend it for all EDs.”

Heather Telford
Nurse Manager
Kenmore Mercy Hospital Emergency Department

Accelerating adoption.

The numbers are encouraging – approximately 600 practices and 3,000 providers currently participate in HEALTHeLINK, and close to 600,000 patients have given their consent.

Total participating providers – 3,020

Total participating practices – 608

Total number of users – 11,294 / Each icon = 564.7 users

“Our partnership with HEALTHeLINK has had a tremendously positive impact on our ability to continue to provide healthy, safe organs and tissues. HEALTHeLINK not only assists us in being able to carry out our donors and donor families’ wishes, but also provides us with the necessary tools required for us to continue to save and enhance the lives of recipients in the Western New York community.”

Jason P. Bridge, BS, CEBT, CTBS
Vice President of Eye and Tissue Services
Upstate New York Transplant Services

Patient Record Lookup Annual Totals Graph

Patient Consents in WNY Graph

“Our partners in healthcare now have the ability to easily access Windsong images via HEALTHeLINK. It fulfills our commitment to enhance access to care and allows patients' providers the ability to view important diagnostic images online. We know that the entire community benefits when we reduce the need to duplicate imaging exams.”

Thomas Summers, MD
President
Windsong Radiology Group

Pharmacy scripts e-prescribed

2012 – 67%

2011 – 51%

2009 – 17%

Chapter 2

Using HIE for Improved
Care and Outcomes.

The use of HEALTHeLINK’s health information exchange (HIE) has greatly improved efficiencies in the delivery of care.

Solutions for Medicaid Health Homes.

HEALTHeLINK is working with six of the region’s Medicaid Health Homes to provide a communitywide solution for the coordination of patient care as well as the secure exchange of health information through its communitywide electronic messaging service. This service allows any member of the care team (medical, behavioral, and social) within Western New York to share clinical records and care plans securely, even if they do not have an electronic health record (EHR) system.

In order to utilize its HIE services to access the information needed to best coordinate care for Health Home patients, HEALTHeLINK is currently working with:

15 Health Home or related organizations

Approximately 125 provider and staff users

Fewer Duplicate CT Scans.

Through HEALTHeLINK, providers can see what tests have been performed on their patients, which in turn can help avoid ordering what may be potentially unnecessary and duplicative tests, saving both money and improving patient safety if the required test involves exposure to radiation. HEALTHeLINK conducted an analysis to study the number of multiple computed tomography (CT) scans ordered for the same body part, for the same patient, within a six-month timeframe.

Some key findings included:

Approximately 90% of the potentially unnecessary duplicative CT scans were ordered by physicians who either never or infrequently used HEALTHeLINK.

About 50% of the patients who had a duplicative CT scan had already consented to have their information accessed through HEALTHeLINK.

Percent of duplicate CT scans in relation to HEALTHeLINK usage or duplicate CT scans given within a 6-month period between 07.1.11 and 12.31.12.

70.8% – 0 queries

19.1% – 1-499 queries

8.1% – 500-1,999 queries

2.0% – 2,000+ queries

A query is the number of times a physician accesses HEALTHeLINK

These and other findings illustrate opportunities to enhance patient safety and reduce costs in the health system, especially among providers who do not use HEALTHeLINK. To view the entire analysis, click here.

“WILLCARE is committed to providing the best possible care for our patients, and the pre-authorized sharing of medical information [through HEALTHeLINK] will be invaluable in meeting the medical needs of our patients and providing optimum care across multiple care settings.”

Todd Brason
Chief Executive Officer
WILLCARE

Chapter 3

Raising the Bar
for Health IT.

HEALTHeLINK has been recognized for its work in building a regional health information technology infrastructure and for testing innovative approaches by both state and federal agencies.

The following initiatives were led by HEALTHeLINK, with great success.

WNY Beacon Community

In 2013, HEALTHeLINK, in collaboration with Catholic Medical Partners, P2 Collaborative of Western New York, and more than 40 other health care organizations, marked the completion of its three-year Beacon Community project, which was focused on producing real-life clinical improvements for diabetes patients.

The WNY Beacon was one of 17 Beacon Communities nationwide funded by a $16.1 million grant through the Office of the National Coordinator for Health Information Technology (ONC). The three-year initiative was tasked with building and strengthening local health IT infrastructure as well as testing innovative approaches to make measurable improvements in health, care, and cost.

The project provided documented improvement of quality of care and outcomes for diabetic patients and also improved provider communication and care coordination through the use of health information technology. In addition, the work of the WNY Beacon project will guide the future use of information technology in health care. Click here to view the results.

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New York State Immunization Reporting

HEALTHeLINK, in conjunction with the New York State Department of Health, launched an automated immunization reporting web service for its participating providers. The service allows for more coordinated communication between providers and public health agencies to advance the overall quality of public health.

Buffalo’s Elmwood Health Center became the first practice to submit immunization data to the New York State Immunization Information System (NYSIIS) via this automated method. Previously, providers or their designees had to sign on to a separate system and manually enter individual immunizations or upload a file to the application. With this new automated web service, immunizations that are documented by clinicians in the patient’s EHR are securely transported to NYSIIS without the need for clinicians to disrupt their electronic health record workflow.

Immunization reporting is just one of four public health use cases currently being tested between HEALTHeLINK and NYSDOH. Other use cases include the ability for a provider to request a child’s immunization history, for hospitals to report newborn bloodspot screening information to NYSDOH’s Wadsworth lab as well as to receive lab screening results electronically, and for Emergency Departments to automate reporting of syndromic surveillance data.

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“Immunization history is an essential component to pediatric care, and this groundbreaking service helps ensure that this key information is available when and where needed. The automated service allows seamless transmission of immunization records to NYSIIS, making them immediately available to any provider giving care to a child. It also eliminates many steps in both the entry and retrieval process, both for our practice that administers the immunizations as well as other providers involved in a child’s care.”

Barbara Johnson
Director of Clinical Services
Elmwood Health Center

HEAL 17 – Behavioral Health

With the support of a New York State Health Care Efficiency and Affordability Law (HEAL) Phase 17 grant, HEALTHeLINK completed the development of a model integrating primary care physicians and their care coordination teams with behavioral health providers to monitor patient outcomes and provider consultation. Nine behavioral health agencies were added to the grant in addition to the original four, encompassing more than 101 primary care providers, and 503 behavioral health providers participating in the overall project.

To enable utilization of technology in behavioral health care, HEALTHeLINK assisted in the installation of electronic health records software at 16 behavioral health sites and implemented results delivery capabilities at five behavioral health agencies. HEALTHeLINK’s communitywide electronic messaging service was also initiated at all participating behavioral health agencies to allow for secure messaging among treating providers.

Care coordination education and awareness training was conducted for more than 75 participating providers who oversaw 1,300 patients with an initial Patient Health Questionnaire-9 (PHQ9) score of 14.88. These patients saw an average of 50% improvement in their outcomes at the end of their 12-month participation.

In addition, behavioral health telemedicine and the use of a patient portal were also piloted as part of the HEAL 17 project.

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“2013 was a year of profound transformation for behavioral health providers, with widespread adoption of electronic health records prompted by health care reform at the state and national levels. Here in Western New York, HEALTHeLINK has been a key partner in helping providers to make this very challenging transition. Through the HEAL 17 project, Catholic Charities and many other provider agencies have benefitted from both technical assistance and financial support from HEALTHeLINK. We are extremely grateful for their support.”

Brian O’Herron
Director
Catholic Charities Department of Clinical and Aging Services

Better Public Health Reporting

Since 2010, the Erie County Department of Health (ECDOH) has been utilizing HEALTHeLINK for its epidemiology and disease surveillance. One area where value has been recognized is sexually transmitted disease (STD) reporting and partner notification to more accurately and efficiently improve contact tracing and case reporting.

ECDOH epidemiology staff and disease intervention specialists use HEALTHeLINK to access lab, radiology, medication, and demographic data to determine if appropriate treatment is administered and to monitor demographic and contact information on cases and partners.

With access to this information via HEALTHeLINK, the percentage of reported chlamydia cases with unknown treatment in Erie County decreased from 46% in 2006 to 8% in 2012. Also during that same timeframe, reported gonorrhea cases with unknown treatment decreased from 19% to 4%. HEALTHeLINK’s continued use by ECDOH and other public health agencies will translate into improvements in accurate and efficient STD identification, reduction of adverse outcomes, and more timely treatment.

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“Having secure access to public health statistics and other data through HEALTHeLINK provides our public health practitioners with important and timely information to monitor the health status of Erie County residents. This information indicates where we need to focus our attention to provide access to adequate healthcare resources and to educate the community on topics such as disease prevention. We have already noticed significant improvements in our STD prevention efforts that have been aided by our collaboration with HEALTHeLINK. The Erie County Department of Health will continue to utilize the health information exchange to assist in our efforts to help residents deal with other health conditions and diseases and to protect the public's health moving forward.”

Gale Burstein, MD
Commissioner of Health
Erie County Department of Health

Epilogue

Stay Connected
to HEALTHeLINK.

We’re encouraged by the many stories of success being shared by doctors, clinics, and medical practices throughout Western New York. We know that through continued collaboration, HEALTHeLINK can make even greater improvements in health, care, and cost for our region.

For more information about HEALTHeLINK, call us at 716.206.0993, ext. 311, or visit us at wnyhealthelink.com.