Ad: How one Regional Health Information Organization helped its partners grow reimbursements, cut costs, improve reporting and eliminate 500K duplicate patient records.
Here's how NYCIG cut costs, eliminated duplicate patient records, and grew reimbursements. This branded article is sponsored by InterSystems.
When most folks think about the goals of healthcare’s Triple Aim — reducing costs, delivering better patient experiences and improving the health of populations — they tend to fixate on events that take place within health systems, according to Nick VanDuyne, executive director of the New York Care Information Gateway (NYCIG).
“But it’s the non-events — the trip back to the emergency department that didn’t need to happen, the second blood draw that’s no longer necessary — that really improve patients’ lives,” VanDuyne said during a presentation at HIMSS 2019 in Orlando, Florida.
Eliminating such duplicative events is one of VanDuyne’s primary duties as executive director of NYCIG. He’s responsible for the massive Regional Health Information Organization’s (RHIO) 550 active participants and 6.5 million patient records across Long Island and New York City’s five boroughs.
At such a large scale, waste can quickly add up and become overwhelming. Eliminating it had to begin with getting a better grip on the data, VanDuyne said. “We had to locate the right data, get it to the right people, and make it actionable.”
For that task, VanDuyne turned to InterSystems solutions. NYCIG has been a customer since 2014 and recently added Patient Index functionality to the HealthShare products it was already using. Here’s how HealthShare is helping VanDuyne’s RHIO deliver the Triple Aim.
HealthShare Patient Index empowered NYCIG to deliver its participants the information needed to reduce readmission rates and support reimbursements under managed care models, VanDuyne explained.
After migrating to Patient Index from a previous tech supplier, NYCIG synced its patient records and uncovered more than 500,000 duplicates immediately. They were expediently removed, improving NYCIG’s ability to share real-time updates to the state’s master patient index, delivering more comprehensive patient care records to the entire RHIO.
“Value-over-volume is a critical metric for healthcare organizations at the local and national level, so it’s imperative that organizations like NYCIG, as a partner in their success, close any data gaps for our customers to help them meet their performance measures and deliver the highest quality in care delivery,” VanDuyne said.
One of NYCIG’s biggest challenges was supporting the comprehensive capture of HbA1c values and other test results for one of its Delivery System Reform Incentive Payment (DSRIP) partners in order to align with the Healthcare Effectiveness Data and Information Set (HEDIS), which is one of the most widely used sets of healthcare performance measures in the United States.
Only 37 percent of the primary care practitioners were associated with the Integrated Delivery Network (IDN), and that means 63 percent of their data existed outside of their control. With 835 community partners (only 39 with more than 50 members) and multiple EMRs involved, a tough question arose: How could NYCIG capture results from outside the IDNs’ system?
With HealthShare Patient Index, NYCIG uncovered the information it needed, retrieved the data from its own system, and then queried the entire state and pulled in additional data on 19,000 patients. Then, that data was combined with the IDNs’ internal results.
The health system was able to boost its HEDIS scores by 4.5 points, achieving value-based payment. Additionally, it was able to evidence doing better by accessing their state health information exchange (HIE) data.
“This HbA1c data integration meant that 850 patients did not have to have a care coordinator follow up, no extra blood drawn, and nobody was forced to search for their records across multiple providers,” VanDuyne said. “It’s our conservative estimate that we saved the system $85,000.”
NYCIG launched a pilot program to help one of its DSRIP partner multi-specialty practices with another costly pain point: reducing readmissions among a cohort of comorbid patients. VanDuyne wanted to track those patients, but like many other urban areas, multiple coverage is a big challenge in New York — patients choose where they want to go and don’t present consistently at a single health system.
“So the question becomes, ‘How do we get that data from multiple HIE systems across the area?’” VanDuyne said.
Leveraging HealthShare, NYCIG experts filtered strictly for emergency department discharges and then matched those discharges against the patient cohorts from the multi-specialty practice. Finally, they alerted practices with patients in need of care.
That resulted directly in a 158 percent increase in follow-up visits being scheduled and a transition of care reimbursement that grew 362 percent over the same quarter of the previous year.
Although it’s difficult to pinpoint exact cost savings within the framework of readmission avoidance, VanDuyne offered some thought-provoking context: A single pediatric asthma stay in New York at Medicaid rates is $3,600, so if you avoid a dozen asthma readmissions, you’ve saved your system more than $43,000.
“We’re all required to help in achieving the Triple Aim,” VanDuyne said. “It’s much easier when the information we have is valuable, it’s actionable, and it’s beneficial to your clients.”
Learn more about how InterSystems helps healthcare organizations extract value from data.