San Diego Health Connect (SDHC)

 

The aim of the San Diego Health Connect (SDHC) is to unify the San Diego Area healthcare landscape. They engage patients, securely connect providers, and work with other HIEs to improve care in their community. The SDHC began as the San Diego Beacon Community in 2010, with the goal of strengthening local health information technology infrastructure and implementing new approaches for improving care. The HIE was transitioned into the SDHC in 2013, and continues the work to bring health information exchange to every member of the San Diego Community.

Dan Chavez, Executive Director of the San Diego Health Connect, shares his experiences and advice for other HIEs including using a pragmatic approach to onboarding providers. Among the challenges faced and lessons learned, he discusses the changing landscape of healthcare technology, the importance of a willingness to share, and striking a balance in the governance and leadership of an HIE.

I don’t remember exactly as it was over 30 years ago.  I remember going to a precursor of HIMSS called electronic computing healthcare oriented (ECHO) which was largely attended by IBM healthcare users.  As I recall, HIMSS was a natural extension of ECHO.

A long term industry and networking relationship that I can count on year after year.  HIMSS adds a lot of value to a long term career HIT professional.  Besides personal and professional relationships, HIMSS has assisted in education, career development and transition, product selection, as well as, policy formation and implementation at several levels.

Some of San Diego Health Connect's milestones are as follows:

  • Oct. 2013 – Transition of the Beacon Grant to San Diego Health Connect
  • Aug. 2014 – Public Health Hub for labs, immunizations and syndromic surveillance goes live as first demonstration of wide-scale public HIE value
  • Jan. 2015 – San Diego Health Connect moves into its own office space
  • Jun. 2015 – San Diego community moves to Opt-out
  • Jul. 2015 – Two large integrated delivery networks, Sharp and Scripps, go-live
  • Nov. 2015 – San Diego Health Connect identifies 3.2 million of its population in the MPI/RLS
  • Dec. 2015 – San Diego Health Connect crosses the 2 million citizen threshold to share patient information

The biggest changes that I have observed in our field is a real change in attitude to really move to standards adherence and interoperability.  Health information exchange is fundamental to healthcare transformation.  One thing I really admire about the folks implementing HIEs is their willingness to share.  HIE professionals are willing to share so much for the good of expanding information exchange in the industry.  New HIEs are really fortunate to have the benefit of the lessons learned of existing HIEs which will significantly reduce their costs and time to market.

Obstacles:

  • Consent
  • Patient Matching
  • Data consistency and quality

Lessons Learned:

  • Commitment is key
  • Communication is more key
  • Extend your horizons to between 36 and 60 months
  • Find the right champions
  • Iteration and change management fundamental to operations
  • Demonstrate value and wins every chance

San Diego Health Connect has taken a very pragmatic strategy to on-boarding the largest providers in our region.  Why? To ensure we have maximum patient information access and coverage.  Providers need to know when they query the HIE they will receive a positive response and will receive information on the patient they queried.  Fundamental to this was San Diego’s focus on public health inherited from the Beacon grant.  The HIE is like a shopping mall, you have to emphasize getting maximum traffic and transactions.  This means you must focus on high value, high volume transactions.  A concentration on the anchor tenants will drive participation by the rest of the continuum of care.

HIE organizations need to spend a lot of time establishing the proper governance.  This provides a proper foundation for success as expectation, commitment and criteria for success are instituted by a strong governance structure.  Balance is key here, SDHC governance is one-third clinical, one-third administrative and one-third technical. 

Secondarily, focus on the formation of the collaborative workgroups. Workgroup charter, leadership and composition are key to driving use cases, adoption and utilization. Try to achieve the same balance as governance.  Execution has to fixate on workflow, data and transactions.

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