HIE Case Study: Use of Data Analytics for MACRA - HEALTHeLINK

HEALTHeLINK is a culmination of several years of collaborative efforts by many stakeholder groups in the Western New York community. HEALTHeLINK is the Western New York Clinical Information Exchange, and is a non-profit organization established to develop a privacy-protected, community-based system for health care providers and consumers to securely and electronically share important medical and clinical information more efficiently.

HEALTHeLINK is a collaborative consortium of 900 organizations. The charter members are The Catholic Health System, The Erie County Medical Center Corporation, BlueCross BlueShield of Western New York, Independent Health Association, Kaleida Health, Roswell Park Cancer Institute and Univera Healthcare.

HEALTHeLINK was established in 2006 and serves eight (8) counties in Western New York.  These counties are a mix of metropolitan and rural communities with 1.4 million people in the coverage area. A couple of the counties overlap with the Rochester RHIO as some rural hospitals participate in both. Their stated mission is to create and maintain a secure and reliable infrastructure for timely and accurate electronic exchange of clinical information among health care providers and others involved in the delivery of health care services in Western New York and connected via the State Health Information Network for New York (SHIN-NY). The ultimate goal of the organization is to enable and promote the use of technologies to support the Triple Aim: Better Health, Better Care, and Lower Costs.

As of December 2016, HEALTHeLINK consisted of 891 participating provider organizations representing 5,086 providers, 99% of all hospital beds, 85% of doctors and 5,838 trained users.

Dan Porreca, Executive Director, HEALTHeLINK, answers our questions below to address how HEALTHeLINK is positioned to support the MACRA reporting needs of its members.

Yes, we are currently evaluating adding this service to our portfolio. There are some compelling reasons to have the community HIE perform the measures calculations and reports. Whether we as the HIE do the calculations or not, we have focused on improving the quality of data we are importing into the HIE. We have developed a scorecard to be used as part of a service to support MACRA requirements in the future. These scorecards identify and assess both gaps in and quality of data we are receiving from provider organizations.

The initial opportunity for realizing value is by helping eligible providers identify if their data is adequate for reporting purposes. There is still much work to do regarding completeness and quality of data. A specific value that this service will provide is a gap analysis of their data. If the data sent to HEALTHeLINK is incomplete, it will likely also be incomplete when scores are generated for quality reporting and thus have a negative impact on the score.

We feel that if our members ask us to assist with meeting MACRA reporting requirements, we are fully capable of supporting them based on the foundational framework we have put in place. We know there is a need, but we struggle with receiving consistent data from all members. Consistency of data is not only required in order to help prepare members for comparisons across their peer group, but also to allow analytic reporting to be performed. Already inconsistent data is made more inconsistent due to providers’ use of EHRs capturing data in both structured and unstructured fields, as different EHRs do not have the same types of validation regarding which fields are to capture which data when documenting the encounter. 

It will all start with assessing the quality of data entered and sent by providers. If providers are not capturing all of the work they are doing, then quality measures will be impacted. HEALTHeLINK can pull data from the HIE today, but only for members’ data. No MACRA reporting parameters exist yet.

Some of the biggest challenges we face are the quality of data, data gaps and breaking through data blocking barriers. Additionally, convincing EHR vendors to improve consistency in the data is difficult and products vary by the version release.

HIMSS is a global, cause-based, not-for-profit organization focused on better health through information technology (IT). HIMSS leads efforts to optimize health engagements and care outcomes using information technology. The inclusion of an organization name, product or service in this publication should not be construed as a HIMSS endorsement of such organization, product or service, nor is the failure to include an organization name, product or service to be construed as disapproval. The views expressed in this white paper are those of the authors and do not necessarily reflect the views of HIMSS.

 

Learn more about the HIMSS I&HIE Community.

Related Documents: