Health Information Exchange Growth Continues
By Scott Robertson
What we’re being asked to do by the government and everybody else, quite frankly, is prove that we’re providing quality. If they’re going to pay us a dollar they want to know if they got a dollar’s worth of quality out of this.
– Scott Fowler
The ability of healthcare providers to communicate quickly and accurately across the gaps between different companies and platforms in the Tri-Cities took a major step forward last month as Mountain States Health Alliance joined the OnePartner Health Information Exchange (HIE). The exchange acts as a universal translator and information storage center and clearinghouse for the disparate electronic medical records systems utilized by various physicians’ groups, lab facilities, and now hospitals in the region.
Scott Fowler.
Mountain States has a common electronic medical record system across all 14 of its hospitals in Northeast Tennessee and Southwest Virginia. Now that system can be linked to the systems of other providers with whom Mountain States shares patients.
“Mountain States Health Alliance is committed to enhancing quality patient care and improving the health of the community through innovative partnerships with our affiliated physicians and organizations like OnePartner,” said Alan Levine, president and CEO of Mountain States Health Alliance in a release. “We are pleased to join OnePartner to support our region’s medical community and enable our physicians to quickly and securely share clinical information about patients they have in common with other healthcare providers outside our system.”
The addition of Mountain States to the OnePartner HIE has been two years in the making, said Dr. Scott Fowler, president of OnePartner. “We’ve been working with both hospital systems for quite a while to get data to flow in the same way into a translated format where everybody could share the same data. So as that process has moved forward, the desire to manage some of the changes in reimbursement systems and the contracts that are out there in the marketplace have moved us closer and closer to a common understanding that this is something that is critical that we do. It’s a step that we have to take together.”
Fowler credited Levine for taking the lead on shifting the talks between OnePartner and Mountain States to a higher gear. “Well, we were engaged in talking to MSHA before Alan got here so we had moved the project, in people’s minds, pretty close to the decision point by the time he got here. But I think that when Alan came into town and sort of looked around the community, he said, ‘How do we do the right things not only for the hospital but for the community we serve?’ It was pretty obvious that this was a win/win for everybody. I think that’s really what happened. We finally got on the same page about how we need to work together.”
The addition of Mountain States greatly increased the value of the HIE, said Fowler. “When MSHA signed up not only did we get the data of our patients that we’re already caring for into this system, but also all of those doctors that are in those groups now sharing their data too. So it’s not just the hospitals it’s the hospital plus 300 – 400 doctors out in the community. That greatly sort of expands the importance of that record inside the system.”
Those records create not only a more complete picture of any particular patient’s care, but also can be used to create broader pictures of how patients are being treated and how they are responding.
“We use those records to go back and find all sorts of potential safety issues, gaps in care, medication contraindications, all kind of things that we wouldn’t be able to find about how a patient is being cared for,” said Fowler. “Most patients, even patients that are primarily Holston Medical Group patients, almost all of them see somebody else or go to a system that is involved with the hospital somehow. This is critical to us doing a better job for patient care. It’s also critical that this data reside in this doctor patient relationship or provider patient relationship, it’s protected in there, but we need all of it.
“I think there’s a level of collaborative intelligence that’s developing around this OnePartner project,” Fowler added. “Maybe the OnePartner project can be instrumental in having a system of collaborative intelligence that can break down the barriers that historically kept the systems from working together as well as they probably needed to and certainly will need too in the future.”
And yes, Fowler did say, “systems,” not just “system.” In addition to Mountain States joining the HIE that already has 85 practices and more than 1,000 providers in place, Fowler is optimistic Wellmont will join as well.
“I spoke with Bart Hove yesterday about this very topic,” said Fowler in early October. “We had delivered the full contract to (former Wellmont CEO) Denny (DeNarvaez) and of course we’d been talking to them a long time too. It’s been a year of discussion. I think right now the sand is shifting under Wellmont with the new CEO and we are very optimistic that that will eventually be something that we will have. It’s the right thing to do. It’s about breaking down barriers and building trust to get everybody to participate in this but it’s the best thing for the patients. I’m sure when Bart gets his feet underneath him and Wesley (Combs OnePartner’s chief information officer) is working tightly with Wellmont IT division so that connection can take place very easily if they decide to do that. We are hopeful.”
OnePartner is also hopeful that the data gleaned from the HIE can be used to show the Centers for Medicare and Medicaid Services that the accountable care organizations in the region are performing at a high level – thus making sure CMS continues to pay providers under the gradually implementing fee for quality model.
“It can be used to show whether we do a better job or a worse job,” Fowler said. “In other words, what we’re being asked to do by the government and everybody else, quite frankly, is prove that we’re providing quality. If they’re going to pay us a dollar they want to know if they got a dollar’s worth of quality out of this. In the old days they didn’t have a way to measure any of that. That’s part of this new system of value that’s moving everybody forward. We actually won’t be able to get paid if we can’t prove we actually are doing a better job or at least an average job.
The ACO model is based on national benchmarks. Qualuable, the ACO of Holston Medical Group, the company that started OnePartner did very well in its last accounting, said Fowler. “Across the entire United States we were one of the highest quality ACOs that was out there. Of the ones that made money we were in the top probably half of the ones that made money, only 25 percent made money or something like that. When I say made money, what I meant was, saved money for the system. We had a better quality at a lower cost, which is what we’re after. That data is critical for proving that you’re doing a better job. If you’re not in a system that has this type of thing you can’t prove you’re doing a better job. If you can’t prove you’re doing a better job you’re not going to get paid with the new models.”
