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Health information exchange (HIE) is the mobilization of health care information electronically across organizations within a region or community. In 2009, Congress attempted to modernize HIE processes by passing the HITECH Act, offering grants and incentives to states and municipalities for developing regional HIE initiatives. Although there has been some progress toward effective mechanisms for data exchange, in many regions of the country it is no easier to share medical information than it was over a decade ago. That is not the case in the State of Nebraska and neighboring states where CyncHealth has achieved health care transformation through data democratization and community betterment collaboration. They have done this by becoming more than a HIE; instead they have become a true “population health utility” by building the roads and the infrastructure for better workflows and better patient care (not just improved data exchange).
This week, we are pleased to welcome three important guests from CyncHealth, Dr. Jaime Bland, President and CEO , Dr. Larra Petersen-Lukenda, Vice President of Population Health, and Dr. Joy Doll, Vice President of Community and Academic Programs. Their vision for a ‘population health utility’ builds upon the ONC’s vision for interoperability through data democratization and cross-sector collaboration. In this episode, we interview these leaders to better understand how to leverage data to create the greater good in societal health outcomes. You will hear from them how health care transformation can be realized through community partnerships and data sharing across the continuum of care, collaborative research in population health, and an empowered “health data competent workforce” to meet clinical and social needs in a more holistic way.
Episode Bookmarks:
03:45The purpose of a ‘population health utility’ is to create better workflows and improved patient care, not just improved data exchange
04:45 Fewer than half of office-based physicians can exchange patient health information outside their organization electronically
05:30 The HIE market is projected to double from $1 billion in 2020 to $2 billion in only 5 years
06:00 Jaime discusses how CyncHealth’s 15-year journey to build a HIE infrastructure to support population health in Nebraska
07:20 Jaime and Larra’s vision for leveraging a HIE as the basis for a clinically integrated network/ACO
08:00 Improving upon the cumbersome query-based exchange model to deliver better patient outcomes in complex care scenarios
09:00 Jaime explains how they have reframed the HIE into a “population health utility”
09:40 Joy describes the application of the population health utility to address the Quadruple Aim and improve patient outcomes
10:25 Larra on reaching the ONC’s 10-year vision for interoperability can improve clinical decision support and patient engagement
11:55 Larra on how “The ability to influence the future of healthcare through data is an amazing responsibility to benefit the greater good of the community.”
12:30 Jaime on the Nebraska Prescription Drug Monitoring Program (PDMP) — a stand-alone medication query platform integrated into the CyncHealth HIE
16:15 Larra on the benefits of the PDMP in improving completeness of the overall medical record, with impact on patient safety and care interventions
18:30 The Opioid Crisis and SUD (23.4 million have SUD causing 81,000 drug overdose deathsannually — two-thirds of which are related to opioids)
20:00 Jaime on how CyncHealth has responded to the Support for Patients and Communities Actin order to address the Opioid Crisis
21:15 Larra emphasizes the importance of the Support Act as a way to leverage technology in response to the national opioid epidemic
24:30 Joy on the opportunities for health policy and public sector funding to address disparities in care
27:30 Jaime on how transforming an HIE into a “Population Health Utility” is helping Nebraska fight COVID-19
30:00 Larra on how COVID-19 dashboards were used to drive population health interventions and resource allocations at the state-level
33:40 Joy on how CyncHealth formed a partnership with a local university to support data science research on COVID-19 and population health
34:30 Jaime on how Don Rucker (National Coordinator for HIT at the ONC) immediately recognized the value of the CyncHealth population health utility
35:30 The recent IMPACT Act report to Congress addressing the need for improved data sharing at the local level to improve Social Determinants of Health (SDOH)
37:00 The Gravity Project – collaboration with SMEs to develop national standards for SDOH data collected and exchanged in electronic record systems
37:50 Jaime comments on the CyncHealth SDOH platform that supports cross-sector collaborations in communities between providers and CBOs
39:30 Joy discusses the passion of CyncHealth to address health inequities associated with SDOH (e.g. meeting the health needs of the homeless)
40:30 Joy on how connecting health systems and CBOs together as a continuum of care will better address health inequities
41:30 Joy explains why structural racism cannot be addressed without improving data collection
42:30 Developing a closed-loop referral system to provide patients with assistance for social needs
43:00 Larra on the complexities of leveraging technology for SDOH when it disrupts workflows and how data standardization can lessen the burden
46:00 Joy discusses how social risk scoring and risk stratification can improve population health
47:00 The need for a holistic, multi-layered approach in addressing social needs and health inequities
48:00 Racial biases in predictive algorithms that lead to discriminatory treatment of minority populations
49:00 Joy on how data democratization and community-driven approaches will provide the best solutioning around health inequities
50:00 Understanding health literacy in our society will help providers better assess root causes for individualized behavioral decisions impacting utilization
52:00 Jaime on how the lack of infrastructure for the sharing of health information leads to data siloes and why that creates inequities in our communities
52:45 Larra reflects further on the distributional inequities that lead to unfair resource allocations and how CyncHealth is solving for this
53:30 Reducing structural inequities through partnerships to create more effective data governance models
54:00 Over-reliance on heuristics that assume data is representative of the entire population and how that leads to distributional inequities
55:00 Joy on why listening to partners and collaborating on research together can bring a voice to the underserved
56:00 Why education of the workforce is needed to transform data into information and how that can empower provider teams to improve population health
57:30 Joy discusses CyncHealth’s strategy to build a “health data competent workforce”
58:30 Bridging the knowledge gaps between Data Scientists and Healthcare Providers will mobilize a workforce to address population health
59:00 Joy provides an overview of several of CyncHealth’s population health research projects (e.g. opioid exposure in infants)
60:00 How population health research will drive health policy and community action for the pubic good and create a “health data competent workforce”
62:00 Larra explains the importance of data scientists and clinical teams coming together to improve data models in population health
63:00 How meaningful data visualizations can facilitate better understanding across a broader audience
63:30 Jaime on how research generated from a population health utility can be translated to clinical peers and why that is the differentiator for CyncHealth
64:30 Joy on how CyncHealth’s specialized approach to community-based partnerships and co-learning is transforming health outcomes