Health information exchange (HIE) continues to grow nationwide, with 88% of hospitals participating in electronic health data exchange as of 2021, according to a 2023 ONC data brief.
As digital health transformation progresses, some states are looking to drive interoperability through data sharing frameworks.
The California Health and Human Services Data Exchange Framework (DxF), for example, aims to support California’s plans for transforming healthcare, expanding care access and improving interoperability between healthcare and social service providers.
State law required many healthcare and social service providers to sign a Data Sharing Agreement (DSA) for the DxF by January 31, 2023, and fully implement the framework by January 31, 2024. Organizations can either use a qualified health information organization (QHIO) as a data exchange intermediary or share data through other means that comply with the DSA.
However, HIE is easier said than done for some organizations.
According to 2021 American Hospital Association survey data, small and rural hospitals are less likely to participate in HIE networks than medium and large hospitals due to fewer economic and technological resources.
“Areas where organizations are under-resourced may not have sophisticated technology stacks and have been left out of data sharing frameworks and structures for a very, very long time,” said Erica Galvez, CEO of Manifest MedEx, a nonprofit HIE network in California.
“We have been pushing the need for California to establish a health data safety net for a while now,” Galvez noted. “What I mean by that is a pathway for every provider in the state to be able to share information for their patients. We have massive gaps in that infrastructure today.”
Expanding HIE for care coordination
To address these gaps and help provider organizations comply with the new DxF, Manifest MedEx launched a free network for admission, discharge, and transfer (ADT) notifications.
ADT messages are a well-established data standard that provides information for events, including patient admissions, registrations, updates, and discharges.
“Based on our mission in establishing a health data safety net, we firmly believe that the best place to start is with ADTs,” said Galvez. “It’s a small set of information, but it’s really impactful because it allows that care team to know what’s happening with you to support you as you come out of the hospital.”
“Usually, the only people who know that you are leaving the hospital are the people who are discharging you and your health plan if they have a good utilization management structure established,” Galvez explained.
However, to drive care coordination, a patient’s primary care team needs to know key information about the patient’s episode of care, including prescriptions for new medications or needs for durable medical equipment.
“The information that we’re able to provide based on that ADT message helps that care team know what you were prescribed coming out of the hospital, especially if we can couple that ADT message with a discharge summary,” Galvez remarked.
The messages also include information on why the patient was admitted to the hospital, as well as where they were discharged, also known as discharge disposition.
“Disposition is a hugely important piece of information in ADT messages,” Galvez said. “Where did the patient go when they came out of the hospital? Sometimes they go to a skilled nursing facility or a rehab facility, and sometimes they go home or other places.”
Supporting DxF compliance
The California ADT network is available to DxF participants, including acute and post-acute organizations, as well as state-designated QHIOs.
“This service should help ease all of those data sharing requirements for participants,” Galvez noted. “It may evolve in the future to include other types of organizations, but for now, the high value that we see is around inpatient or acute and post-acute episodes of care.”
Galvez pointed out that brick-and-mortar healthcare facilities aren’t the only ones that will benefit from this service; mobile clinics associated with health systems connected to the network or other QHIOs will also receive ADT notifications.
“Even those mobile clinics have a pathway to manage and support their patients in ways that they don’t have if they’re disconnected,” Galvez emphasized. “You have to digital equity for your providers before you can start to really create health equity for your patients and your members.”
Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.
Wanda Parisien is a computing expert who navigates the vast landscape of hardware and software. With a focus on computer technology, software development, and industry trends, Wanda delivers informative content, tutorials, and analyses to keep readers updated on the latest in the world of computing.
