Philadelphia, Pa. — HealthShare Exchange (HSX) is helping its region’s underserved and vulnerable populations by providing health information exchange services to clinics and health centers on the front lines of care. HSX is the nonprofit health information exchange for the Greater Philadelphia/Delaware Valley area (including southeastern Pennsylvania and southern New Jersey). Its membership includes Federally Qualified Health Centers (FQHCs), two of which have now come online with full integration of HSX services, including an ability to access HSX’s Clinical Data Repository (CDR), which contains recent healthcare information on more than 6.5 million patients in the region.
This year, Delaware Valley Community Health (DVCH) and Community Health & Dental Care (CHDC) (both members of the Health Federation of Philadelphia) became the first of HSX’s FQHC members to gain the ability to receive recent patient care information on individuals from the CDR. As with HSX’s other FQHC members, these centers also take advantage HSX’s Encounter Notification Service, which alerts the center when one of its patients has an emergency or inpatient encounter at an area medical facility, and the Direct Messaging service, which establishes secure email-based communication between providers.
“This has allowed us to put in place a protocol in which we try to get patients into the office for a follow-up appointment when they’ve had a healthcare event involving a hospital visit,” says Bridgette McGivern, MBA, Chief Executive Officer at CHDC, which has locations in Pottstown, Pennsylvania, and serves a patient population of 70 percent Medicaid members. The registration process at CHDC and DVCH triggers a query to HSX, which then returns healthcare summaries for the patients from its CDR to the electronic health record (EHR) system used by the centers (NextGen Healthcare).
Says McGivern, “If we don’t have records on a patient, we can query HSX’s CDR directly to see if patient has been to any medical centers or physician offices that participate with the CDR. If they have been recently seen and the participating entity furnishes the CDR with their info, we can pull it into our EHR and view the problem list, encounter-level details, medications, allergies, insurance coverage, and other information. We also receive a provider roster weekly from HSX with Direct secure email addresses that we can use to exchange clinical information on patient care with other providers.”
Jennifer Kabir, DNP, FNP-BC, the Director of Performance Improvement & Clinical Informatics at DVCH, explains, “The use of different electronic health record systems between multiple independent clinical practices creates serious obstacles to patient care, and this project is a step in the right direction toward bridging this communication gap. All of our providers — physicians, nurse practitioners, physician assistants, and nurses — are now using this information from HSX. They are working diligently to review and implement the abundance of data we’ve started receiving since the project went live. Our primary goal is to ensure appropriate coordination and follow-up of care after healthcare encounters or events. The CDR and ENS have enhanced our ability to engage patients in a timely fashion while providing informed care.”
Kabir, who works out of Norristown Regional Health Center, one of eight FQHCs operated by DVCH notes, “The infrastructure provided by the CDR is a critical component in DVCH’s commitment to the Meaningful Use program. We are confident that, as HSX develops and improves this system, the CDR will become an indispensable tool in patient care.”
At these centers, the providers access the HSX-delivered information without leaving the workflow of their EHR-based clinical work stations. So far, elements in the HSX summary document include patient medications, allergies, immunizations, procedures, and social history. When these centers conclude a visit with a patient, their NextGen EHR submits a summary of the encounter back to HSX to update the patient’s longitudinal record within the CDR.
“We’re thrilled to provide these data services to FQHCs and have them, in turn, enrich our data repository with their care information,” says Jennifer Natale, HSX’s Senior Manager of Engagement & Adoption. “In this way, we’re happy to be able to support safety net providers, such as these FQHCs, that are serving communities in need across the region.”
The Public Health Management Corporation is the third among HSX’s ten FQHC members that is part of the current CDR-onboarding project, and PHMC’s use of the CDR will begin soon as well. All three centers accessing the CDR, received grant support through Pennsylvania’s Department of Human Services to offset the costs of technical implementation of the project.