HIE For Population Health Management: A Case Study

HIE can step up its game from serving one healthcare organization or health system to becoming a population health management tool. Here’s how.

By Lola Koktysh, Healthcare Industry Analyst, ScienceSoft

The primary goal of health information exchange (HIE) is to give providers an access to a patient’s clinical data and enable cooperation between their care team members across organizations. But HIE can also bring the cooperation between providers to a higher level – population health management, enabled through data aggregation and subsequent health data analytics. Thus, multiple health information exchange vendors start to enable the capabilities for identifying the health needs and risks across the nation.

This is exactly what happened to one of our HIE clients. The customer decided to extend the capabilities of HIE from just notifying providers about changes in patient health status to a more proactive approach. As a result, our recent HIE project included creation of reporting module for event monitoring and prevention.

Event Monitoring Module

Within the HIE, organizations and communities send information about the events occurred with patients in an automatic mode. The list of events can include:

• ADT encounter
• ER visit
• Adverse reaction to medications
• Medication non-compliance
• Accident requiring treatment
• Suspected abuse
• General change in functioning
• Event that requires relocation of services for 24 hours and more (e.g. fire)
• Experienced barrier to service (e.g., lack of transportation)
• Signs of depression and more

The module allows connecting the events with patients’ demographic state, medications and diagnoses in order to find interrelations and help patients better, similar to what we’ve overviewed in our health data analytics blog post.

Let’s figure this module top down. First, providers can see the patients with the highest number of events. They can also see the distribution of events according to gender, age and marital status.

Now, to see how a patient’s diagnoses and medications affect the occurrence of events, each event type can be analyzed separately.

For example, let's take the change in behavior. Providers can see the chart with the distribution of conditions within this particular event type, including:

• Subacute delirium
• Major depression
• Conversation disorder with motor symptoms
• Bipolar disorder
• Anxiety and more

Then, providers also see the distribution of medications that were prescribed to the patients who experienced the event. This way, caregivers can detect the most unfitting and even harmful treatment and eliminate it. Seeing the number of patients with a particular event, providers can track the influence of medications on this event’s probability.

Moreover, the module also analyses the most common patients’ condition and medication in relation with the event. For example, a medical emergency event may occur mostly in patients with major depression, taking a certain medication (we can’t name medications here).

Event Prevention Module
Within the prevention module, providers can identify the patients with recurrent events, e.g., hospitalization. They can connect and compare this information to the list of patients without a care team to define the reason for recurrent events.

Another way to tackle event reduction is to look into the percent of notifications across care team members, including:

• Case manager
• Case coordinator
• Parent / guardian
• Primary physician
• Behavioral health specialist
• Community member and more

Providers can see, whether the guardian or primary physician don’t get enough notifications about events occurred with a patient, therefore they can’t efficiently intervene and help the patient to reduce or eliminate event occurrence in the future.

Moreover, caregivers can see the distribution of events across notification channels: email, secure message, fax, text message, etc.

HIE As Population Health Management Tool
Health information exchange is moving towards ensuring data transfer across multiple domains, not only one organization or a health system, but a whole state and then a whole country. The reason why we celebrate every move it makes towards massive data aggregation and use is that multiple challenges are on the way, such as PHI security, for instance. Nevertheless, HIE is evolving and we were honored to help it step up just a little and introduce more capabilities of healthcare data analytics to ensure proper treatment and timely interventions.

About The Author
With five years’ experience writing on business and technology, Lola is a Healthcare Industry Analyst at ScienceSoft, a software development and consulting company headquartered in McKinney, TX. Being a HIMSS member, she focuses on healthcare IT, highlighting the industry challenges and technology solutions that tackle them. Lola’s articles explore chronic disease management, mHealth, healthcare data analytics, value-based care delivery, CMS regulations, and more.