Health information exchanges (HIEs) have been around for over a decade since they were introduced as a critical part of the HITECH Act. To make provider collaboration easier, states have slowly been adopting HIE programs. Most significantly, California has developed its first data exchange framework for Health and Human Services.
These changes are a significant undertaking to improve collaboration and eliminate silos in medical care. Most Californian healthcare providers and organizations must soon sign the data-sharing agreement. Integrating and leveraging health records is an overwhelming process, but the right tools can make it easier for providers to share critical information with health officials and other providers.
Here is what you need to know about California’s Health Information Exchange, how it benefits healthcare organizations and tips for improving interoperability.
For more than two decades, state and federal have tried to encourage electronic health record (EHR) and health information technology (HIT) adoption with varied levels of success. In the wake of the pandemic and the challenges that came with information silos, California legislators were again encouraged to create a framework for health information collaboration.
In July 2021, lawmakers passed Assembly Bill (AB) 133, which sought to create a technology-agnostic way to share health information across the state. By July 2022, California Health and Human Services Agency (CalHHS) released the policies and procedures that will govern the data sharing agreement (DSA).
This agreement allows healthcare organizations and agencies to share information more effectively and collaborate in patient care. Health information exchange clinical data types that providers will share include:
- Patient admission information
- Social determinates of health (or SDOH)
- Lab test results
- Visit notes
- Medication history
- Vital signs
- Lab orders
- Progress notes
- Patient histories
- Operative notes
- Cardiology studies
- Lab test results
- Discharge summaries
- Other clinical data
- Other transcribed reports
Deadlines for the Data Exchange Framework vary for different groups. An agreement is mandatory by January 31, 2023, for the following groups:
- Physician organizations and medical groups
- General acute care hospitals
- Health plans
- Skilled nursing facilities
- Disability insurers
- Clinical laboratories
- Medi-Cal managed care plans
- Acute psychiatric hospitals
Most providers will have to share information for treatment, healthcare operations, and payment by January 31, 2024. Practices with less than 25 physicians, specified hospitals, and nonprofit clinics with under 10 healthcare providers will be required to share data by January 31, 2026.
These changes offer providers, organizations, and health agencies multiple benefits that include the following:
Collaboration between healthcare organizations is critical to provide greater insights into the patients they serve and their whole-person care needs. Providers can share vital patient information to facilitate care better and give a complete view of each patient. It helps reduce duplicate and unnecessary treatments and tests and improves accuracy.
In the wake of the pandemic, health officials are finding better ways to manage. With the changes in HIE, health authorities can better assess and manage conditions across the population. It allows officials to evaluate program impacts, payment arrangements, and operations to identify and implement opportunities to enhance care and health outcomes.
Today, many patients and their caregivers struggle to get a complete health record to share with other providers or for their own purposes. With better data sharing, patients and their caregivers can access their electronic health information better.
One of the most significant developments in the HIE is social determinants of health (SDOH). It is the first step to promoting health equity by addressing environmental concerns that impact health, such as food or housing insecurity. It aims to improve outcomes for minority, low-income, and multicultural patients.
Because providers will have access to a patient’s entire history, there is less need to repeat or reenter any information. Plus, they will have less reporting to registries because all the information will automatically be sent to the specified registries.
While most organizations will not have to implement changes until 2024, most providers should start early to ensure they comply with the regulations. Here are some ways to ensure data sharing is a success.
Buy-in is critical to any organizational changes, especially regarding technology. Stakeholders need to be invested in the transformation. It is essential that everyone understands the community benefits of HIE.
Take time to explain to everyone involved—leadership, physicians, and staff—the benefits of implementing HIE and sharing data. Also, discuss possible consequences if your organization fails to implement HIE by the state’s deadline. Although the consequences are unclear, potential enforcement mechanisms will likely include civil penalties and remediation plans. It could also potentially impact your compliance with federal information-blocking regulations.
Implementing HIE technology can be a long and sometimes frustrating process. It requires learning new platforms and ways of inputting information. Investing in quick wins upfront and finding where you will get swift payback will encourage momentum during the implementation process.
Meet your vision for a tightly knit and integrated connection of EHR and ancillary data with breakthroughs that provide early value and satisfaction to your stakeholders, whether physicians, hospital executives or patients.
Find your pain points that data will help solve. For example, you might find getting reports from the emergency department (ED) challenging before the patients have a follow-up with their primary care provider (PCP). Integrating your ED’s EHR to HIE might provide an immediate, significant improvement for PCPs that can access reports immediately.
Finding where your organization can experience the most immediate improvements will make HIE implementation a much smoother process.
The experience for your providers, staff, and patients is crucial for ensuring implementation success. Too often, the user experience (UX) is second to providing the technical side is perfect. While integration between systems is paramount to implementation success, your organization will have problems getting traction and accessing actionable data if the digital tools are cumbersome and poorly developed.
It is critical to focus on tools that are reliable and intuitive. They should provide leaders, providers, nurses, and staff with a comprehensive view and easy-to-understand data to make work efficient and enhance accuracy and productivity.
Data exchange is critical for complete patient care, health equity, and efficiency. With deadlines firmly in place to implement HIE in California, healthcare organizations need to have a plan in place for sharing information. Communication, quick wins, and the right software are critical for ensuring success before DSA deadlines.
If you are looking for the right solution to maximize your processes, improve your revenue, and maintain compliance, GeBBS Healthcare Solutions can help. GeBBS is a KLAS-rated leading provider of Revenue Cycle Management (RCM) services and Risk Adjustment solutions. GeBBS’ innovative technology, combined with over 12,000-plus strong global workforce, helps clients improve financial performance, adhere to compliance, and enhance the patient experience.
Contact us today at www.gebbs.com to see how GeBBS can help your organization become more effective than ever.