As the healthcare industry continues to move towards true interoperability through completely connected systems, activities are underway to test use cases designed to advance value-based care among providers and payers through standards-based data exchange.
In January, Michigan Health Information Network Shared Services (MiHIN) supported a Connectathon to test a use case framework advanced by Health Level Seven® (HL7®). The Da Vinci Use Case Clinical Data Exchange (CDex) seeks to streamline the data flow from clinical settings to payers to facilitate quality measurement and care coordination.
The HL7 FHIR Accelerator Program, Da Vinci Project (Da Vinci), founded in 2018, was assembled to focus on collaboration between payers and providers that would accelerate information exchange through utilizing Fast Healthcare Interoperable Resources (FHIR®) based data queries to bridge the gap in clinical, quality, cost, and care management outcomes.
As an Implementation Partner of Da Vinci, MiHIN is responsible for assisting in the pilot and deployment of Da Vinci Use Cases. The CDex Use Case focuses on the integration of clinical data generated by providers and funneled to payers to improve care coordination through streamlining information received from electronic medical records in a variety of formats including Consolidated-Clinical Document Architecture (C-CDA) C-CDA on FHIR, bundles, and discrete resources. Payers obtain clinical records for members to assist in executing care coordination decisions as well as to gather Healthcare Effectiveness Data and Information Set (HEDIS®) related data for accurate quality measures. The HEDIS measure for Transitions of Care was introduced in 2018 to collect data on the care coordination given by the member’s primary care provider and includes notification of a patient discharge, patient discharge information, patient engagement after discharge and medication reconciliation after discharge.
During the Connectathon, initial testing of the CDex Improve Care Coordination Use Case was conducted within Interoperabilty Land™, a simulated healthcare ecosystem designed to power the future of interoperability through the integration, acceptance, and testing of technologies and open standards within a collaborative, digital platform, available through Amazon Marketplace. “As an implementation partner of DaVinci, MiHIN plans to use the Interoperability Land sandbox for Da Vinci Use Cases,” said Tim Pletcher, DHA, executive director, MiHIN. “Interoperability Land is a synthetic environment that enables where users can test and validate systems and SMART on FHIR applications – a solution to comply with the 21st Century Cures Act and the Centers for Medicare and Medicaid Services Proposed Rule 9115-P to improve patient access to healthcare data while minimizing reporting burdens on healthcare providers or payers.”
During the event, attendees worked on developing solutions to improve care coordination, including accessing patient information from electronic medical records, accessing patient needs and goals, monitoring and follow up, knowledge sharing and responding to patient needs during follow up.
At the conclusion of the Connectathon, attendees presented the solutions developed which included: an A1C data exchange solution using Salesforce that enables patients to receive discounts on their health insurance by regularly checking their A1C level and working to keep it within the normal parameters; a mobile medication reconciliation tool for health insurance members to log in to confirm the medications they are taking following a hospital discharge; a web-based Transitions of Care dashboard that accesses a patients real time transitions of care information received from health data exchanges using a FHIR-enabled Application Programming Interface; an emergency department utilization tool that measures HEDIS and identifies potential unnecessary visits to the emergency department, and an application that focused on reducing the number of patient’s hospital admissions while improving quality measure scores by calculating risk measures and notating these in the electronic health record to be addressed a the patients next appointment with their physician.
For additional information on hosting a Connectathon to pilot CDex within Interoperability Land, send an email to firstname.lastname@example.org.