Data as a Catalyst for Improving Health Care Quality and Lowering Costs
As Comagine Health moves forward following our recent merger of HealthInsight and Qualis Health, we bring a variety of skills, talents and business lines together. How will we capitalize on the new capabilities and become an even stronger and more capable organization? That’s a question that’s just now coming into focus. One of Comagine Health’s more interesting and unique business lines is managing the state of Nevada’s only health information exchange, HealtHIE Nevada. HealtHIE Nevada is a private not-for-profit organization that contracts with Comagine Health to operate and staff the HIE.
The primary function of all HIEs is to build a network between providers’ electronic health record (EHR) systems and offer master data management (MDM) services to participant organizations. They aggregate data from numerous sources, manage interfaces, index that data, measure its quality, store it and make it available for providers, payers, public health and other organizations to make informed clinical decisions. Advanced HIEs also get into technologies like terminology normalization or natural language processing to make data even more effective for analytics. The goals are to improve transitions of care, support public health reporting, reduce costs and improve health care quality. By providing a single source of clinical data statewide, we support population health management and quality improvement.
Over my first 15 months here at Comagine Health, I’ve become more familiar with our work as a Medicare Quality Innovation Network Quality Improvement Organization (QIN-QIO). As the Center for Medicare & Medicaid Services (CMS) begins to look at additional data beyond claims to meet their goals, this is where one of the biggest opportunities presents itself for our work with the HIE. HIEs already collect much of the real-time clinical data that is needed for quality reporting, and they are experts at collecting data from HIEs despite a lack of standards. A single clinical data interface from an HIE could result in collecting data from hundreds of providers. Before joining Comagine Health, I was the chief technology officer for the HIE in Vermont. We developed data-sharing capabilities with both our patient-centered medical home (PCMH) and our accountable care organization (ACO) to provide real-time clinical data for their quality improvement efforts. While these organizations are not QIOs, the data they needed was the same type of clinical data that CMS is looking for to manage quality improvement projects.
As we move into our next phase of contracts, I believe we are uniquely positioned to provide real-time clinical data from HealtHIE Nevada and other state and regional HIEs to augment claims and provide new insights and capabilities for CMS.