More than two years ago, Azara created a case study highlighting some of our connections to Health Information Exchanges (HIE) across the country and the fulfillment of some long awaited “last mile” connection promises. Since then, the COVID-19 pandemic has demonstrated the importance and criticality of being connected to your state HIE and gaining timely access to information about the acute and emergency services required by your patients. It is my assertion that it has always been a critical information gap when primary care providers are unaware that their patients are seeking emergency care, but the fast-moving nature of the pandemic and now the surge of problems caused by the large amount of deferred care has only magnified the void.
Even for those with some type of HIE connection or access to hospital ADT data, the pandemic has shown us the different types of information and communication necessary to both provide top notch care, but also understanding of the prevalence and magnitude of the infection. What we have seen is that these connections have made a difference in many places, but also that there is more work to be done.
I am very pleased that today Azara is able to offer its clients access to Transitions of Care data and reporting via 18 HIE connections across 13 different states, with active projects to add this functionality in at least 3 more states this year. Today, these connections serve more than 155 independent practices and two of the connections established in the past year utilize 3rd party commercial/private “HIE-like” networks that can potentially provide Admit, Discharge, Transfer data for patients of Azara clients in places lacking good HIE coverage.
In my opinion, this functionality in Azara DRVS and Azara Care Connect is some of the most important cost- and care-impacting information we can provide. Research has shown that the average cost of a single readmission is over $8,000, so identifying Emergency and Inpatient visits quickly and assuring proper post-acute care follow-up is critical to assuring a successful and lasting discharge.
Gaining access to the high-value information we are receiving from the HIEs and combining it with your EHR data should be at the top of everyone’s priority list. The good news is that over the past few years, the process of getting access to this data and making a connection like this has gotten much easier.
In the early years at Azara, I was regularly introduced by our clients to their HIE providers and almost every conversation dead-ended when we asked them to supply us data for the patients of our client practices—specifically ADT data. It was as if they viewed Azara as a fierce competitor, waiting to displace them across their state. The reality is that as a Population Health platform and statewide data warehouse, there was a bit of overlap, but Azara would NEVER be an HIE connected to hundreds of hospitals and thousands of practices for real-time data exchange, and they would not likely have the breadth and depth of reporting and analytics that Azara offered.
Thankfully, this perception is now mostly history and in the past few years, a number of HIEs have come to our conversations eager and willing to partner with Azara and our client’s Association to help provide the critical information necessary to care for their patients.
In addition, as Azara has developed relationships with the various HIEs around the country, a number of enhancements and additional projects have arisen. In a few places, we have moved from just receiving daily ADTs to a robust two-way exchange of data. In some cases serving as an “on-ramp” to the HIE for practices that don’t have the proper means (technology, staff, funds) to send their data directly to their HIE. In one novel case, we are supplying the HIE with data on patient social determinants of health that we retrieve from the practice EHR, as this is not information supplied in a standard EHR to HIE connection, nor in a CCD.
As our clients make adjustments to best serve their patients in our new COVID-19 informed world, I expect the need for HIE information at the practice level will only escalate. While we are already talking with some clients about logical enhancements to the data flow, I want to emphasize that the value of an HIE connection to DRVS and Care Connect can be realized today, and I encourage you to ask what would it take to get this information into Azara DRVS in your state.
We look forward to engaging in this conversation with you.
Additional information on the integration of DRVS with Health Information Exchange can be found at the links below:
Webinar: Transitions of Care Improving Follow-up with HIE Data