Your Input Sets our Direction

Thursday, December 7, 2017

Earlier this year, we sent out a survey to everyone participating in Hixny’s health information exchange (HIE). To the 539 of you who responded: Thank you!

Every time we do one of these surveys, the information you provide feeds conversation among our member representatives and our board members. In this case, the results of the survey provided a foundation for the board’s annual strategy session in May—which then set up the annual business plan that we are currently developing for implementation in 2018.

We’ve asked quite a few different types of questions over time, trying to gauge information and perceptions from the field that can help us understand how Hixny is being used, where we’re doing well and where we can improve.

This year, we focused on your experiences—as users—with Hixny. We looked especially at how the types of organizations you represent, and your roles, determined the way you used Hixny and what you think of the HIE in general.

What we learned is that there are big differences in who uses the information that is (or should be) available through Hixny, for what purposes, and how they access that data. Over the next three posts, I’ll dig into three of the findings that really caught our attention:

  • Users accessing Hixny through integrated systems reported few problems—but for those who get access through our online portal, logging in has been the biggest barrier to using Hixny to date; we have a solution.
  • Phone, fax and specialized systems are still used much more than Hixny  to access data, which likely requires a change of habits.
  • Admin-side users are more likely to use Hixny  than clinicians, despite the proven value of HIEs in patient care.

Overall, though, we’re encouraged by what we see as incremental steps toward full engagement with the HIE. The board took away useful information that helped prioritize our plans for the coming year. We appreciate the time you took to offer your feedback.

Mark McKinney – CEO

Honoring Visionaries in Health IT in New York State

Wednesday, November 8, 2017

Recently, I joined healthcare technology leaders from around the state at the New York eHealth Collaborative (NYeC) Gala & Awards at The Edison Ballroom in New York City.

The event is an annual opportunity to recognize individuals who are contributing to the ideals of the Statewide Health Information Network of New York (SHIN-NY) by advancing the use of electronic records, healthcare technology and related data-sharing efforts.

This year, the Transformative Leadership Award went to David Blumenthal, MD, president of The Commonwealth Fund, a national philanthropy engaged in independent research on health and social policy issues. He’s served in several national-level positions in health information technology, laying the groundwork for a nationwide health information system and is recognized as a thought leader on the use of electronic records.

The gala also honored four additional individuals who reflect the efforts of people across the state to advance the SHIN-NY. In fact, listening to Paul Francis, Deputy Secretary for Health and Human Services, and NYeC Board of Director Chair David Klein, it was apparent that everyone has great faith in the leadership at NYeC and is pleased with the progress of the SHIN-NY over the past year.

All four of these recipients have made significant contributions that have helped shape the direction of Hixny and the SHIN-NY:

  • Pat Roohan, currently vice president of data management and analytic solutions at MVP, helped advance the goals of the SHIN-NY in his role as Director of the Office of Quality and Patient Safety at the New York State Department of Health (NYSDOH).
  • Gene Heslin, MD, First deputy commissioner at NYSDOH, primary care physician and former NYeC board member, has long been a big proponent of the SHIN-NY – emphasizing the need to seamlessly exchange information across all regions of the state.
  • Jim Tallon, president emeritus of the United Hospital Fund and former NYS Assembly majority leader, working with Bill Schroth at NYSDOH developed the idea for a public-private partnership that became NYeC in the earliest days of this effort.
  • Paul Macielak, Esq. president and CEO of the New York Health Plan Association, and current chair of Hixny’s Board of Directors and Hixny co-founder, recognized early on the value of getting parties together for a common good that didn’t typically work together.

As I watched all the presentations, it really struck me how all of these individuals shared a common vision and contributed to bringing people together across the healthcare spectrum to solve a problem. When you look at the success of the SHIN-NY—allowing electronic information to flow seamlessly and securely across the state from border to border— it is directly the result of the leadership these four individuals showed early on.  Working without a roadmap or existing models of success to copy, these men forged ahead when it might have been much easy to ignore the problem or let someone else solve it. We owe these four a great debt of gratitude for their perseverance and commitment.

I felt really good to be among so many people who were there to see these individuals honored. NYeC should be congratulated for building a community intent on delivering on the promises of the SHIN-NY that these honorees envisioned years ago.

Mark McKinney – CEO

Paving the Way for Efficient, Complete Data Sharing

Wednesday, August 21, 2017

A few weeks ago, the New York eHealth Collaborative (NYeC) and the Department of Health (DOH) requested proposals for the use of about $3 million in excess budgeted funds. While Hixny has never responded to this kind of proposal before, I thought this opportunity was well worth the time and effort.

Of the $3 million total, DOH divided $1 million equally among all eight qualified entities in the state—Hixny and its seven counterparts. The remaining $2 million went into a pool for competitive bids, with top-ranked entities like Hixny invited to propose a “thoughtful and strategic” project focused on data quality or data completeness.

In the end, we proposed a project called the “Wire-Once System to Improve Data Completeness.” It recognizes the governor’s vision to connect things effectively one time, rather than paying to connect the same things eight separate times.

This pilot project would connect two national dialysis/organ center organizations to our electronic health records (EHR) gateway. All told, these organizations have 73 clinics across the state—including several within our region. They are also required to connect to the Statewide Health Information Network for New York (SHIN-NY) this fiscal year, so they are both generating important information and motivated to connect.

Our gateway would allow them to establish a single connection, regardless of their locations, to the SHIN-NY in a way that would distribute the data entered by these providers to the appropriate entity based on the location of the clinic where the data was entered. In other words, data entered by the provider’s clinic in Buffalo would be routed to the QE for Buffalo; data from the clinic in Albany would stay in our health information exchange (HIE).

The project addresses the biggest concern people have about connecting to a single entity, which is that data wouldn’t flow in a way that allows it to be analyzed properly or used for alerts. It also creates the foundation for future connections of this type. Ultimately, Hixny would set up the SHIN-NY to accommodate future quality-of-care analysis.

Our proposal, which is based on technology and know-how we already have, is estimated at just over $425,000. The greatest part of the project is making the connections to the other QEs and EHR vendors.

We won’t know until September if we win the award. If we do, we’ll have until March to put the connections and agreements in place. In the meantime, keep an eye out for updates!

Mark McKinney – CEO

Alert of Malicious Cyber Activity from NYSIC

Wednesday, April 19, 2017

Yesterday, Hixny received an unclassified memorandum from the New York State Intelligence Center (NYSIC) regarding cyber activity targeting multiple sectors in New York.  This notice reported that several trusted third parties have identified various malicious Internet Protocol (IP) addresses originating from overseas which are targeting multiple state government, financial services, healthcare and transportation services sectors.Mark at Desk Unfortunately, cyber-attacks have become all too common, which is why Hixny has established many layers of cyber-security to protect the privacy and security of the patients in our region. I would like to take a minute and talk about one of our most basic layers of defense in our security infrastructure called geo-fencing.  Geo-Fencing is implemented in our firewalls and enables us to allow or deny access based on an end-user’s geographic location. This prevents users outside of the geo-fence from getting through our firewall and attempting to authenticate to our systems’ services.  In the case of this specific security notice, the recommendation from NYSIC is to block access to systems from the listed IP addresses.  In Hixny’s case all of the identified IP addresses reside outside of our geo-fence and are therefore already blocked. Geo-fencing is only the first of many lines of cyber-security defense Hixny has established.  This level of protection is often not a standard “out of the box” firewall system configuration, but is considered best practice for networks like ours which can establish geographic boundaries of users.  It is important to reiterate that we take many other additional precautions above and beyond this layer of protection including performing regular independent third party tests of our system to ensure that we are not vulnerable to external attacks. You can be sure that while these notices and attacks are likely to continue, Hixny will remain vigilant and proactive in maintaining its cyber-security defenses to keep data and patients secure.

Mark McKinney – CEO

Our Drive for More Data

Thursday, April 13, 2017

For the last few years, we’ve worked to make your job easier—and to support patient care—by providing more of the data you need, when you need it.

Because of this, Hixny brings you more comprehensive data than you can find anywhere else. On average each patient in our service area has data from 3.9 sources of data in the health information exchange. Every hospital in our region contributes data to Hixny; so do 76% of primary care practices. Every time a provider adds its data, we move one step closer to data completeness.

You can also find more types of data thanks to Hixny. Our patient records now routinely include consult notes, progress notes, EKG tracings and other unstructured data.

We should be seeing a great deal more data within the next year. Article 28 hospitals recently passed an important deadline in March to begin to contribute specific amounts and types of information.  Clinics, nursing homes, diagnostic treatment centers, certified home health agencies and urgent care centers have until March 2019 to contribute similar data. Once they contribute their data, you will be even closer to a 360-degree view of every patient. You can read about our achievements in data completeness elsewhere in this issue.

Ultimately, though, they all come down to one message: make Hixny part of your workflow with every patient. Check it first before you call or fax. Doing so will save you time, get you essential information faster, and help you deliver patient care more efficiently.

Ready for Change

Message from Mark

Wednesday, December 21, 2016

The health information technology industry finds itself in a challenging spot right now.  Systems are maturing rapidly, but there is still work to be done to achieve the Triple Aim.  Everyone is looking at the systems they have in place and the data they are capturing, and asking how everything is going to come together to get us to that goal.

We at Hixny are doing the same.  We understand that you, and your use of health information technology (HIT), will change as state and federal initiatives shift, and that it is up to us to keep pace with the tools and services you need to navigate these shifting tides successfully.

There are a number of changes coming, but one of the biggest is the continuing impact of the Medicare Access and CHIP Reauthorization Act (MACRA) of 2015.  MACRA changed future Medicare compensation with a shift to value-based payments.  It will eventually affect almost all physician practices and how they care for their most complicated patients, the elderly.

MACRA sets two paths from which providers can choose—Advanced Alternative Payment Models (APMs) and Merit-based Incentive Payment Systems (MIPS).  APMs will reward the formation of care teams and coordinated activities.  MIPS—the route most providers appear likely to take will base compensation on the quality of care provided, including the effective use of HIT.  There will be requirements for connectivity, how providers distribute information to their patients, how they obtain information from other providers, and how they capture information from patients and non-healthcare settings.

We are focused on ensuring that you have access to complete, quality data from a wide variety of healthcare and non-healthcare settings, and the tools and services to put that data to work for you and your patients.

For example, our Individual Care Manager (ICM) application enables all members of a care team, including those who are not traditional health care providers, to communicate with each other and monitor patients using their mobile devices.  We are working to bring patients into the care team, enabling them to upload data from home monitoring devices directly into our system.

But it is complicated, because there is no one-size-fits-all solution.  MACRA will be a focus for many of our participants in 2017, and we are committed to supporting them and their efforts in this ever-changing industry to provide the best possible care while reducing healthcare costs.

Mark McKinney – CEO

New York State DOH Selects Hixny as Statewide Vendor

Message from Mark

Sunday, November 20, 2016

I wanted to share with you a recent accomplishment which shows that Hixny is seen as more than a trusted organization which can securely deliver information from point A to B, while also not forgetting just how valuable this expertise is in the marketplace.

In addition to having a robust health information exchange (HIE), Hixny has several tools and services which support our participants to improve workflow efficiency and support our healthcare professionals.  Hixny has recently taken another step in supporting our region but also the New York State Department of Health (DOH) through a new project.

DOH needed a statewide vendor to help build direct standards and Hixny was selected for the project.   Providers from around the state continually send records to DOH for use in its public health initiatives. The records come from a dizzying array of electronic health record systems—most include the federal government’s Direct standards for secure messaging.

Think of all the ways you can send contents in an email: copy and paste, attach a file, and create a zip file, among others.  This was the challenge facing DOH on a statewide level.  First the struggle was dealing with all of these different files and forms of communications, before they could take action.  Second was to develop direct standards for DOH which would be compatible with state and federal laws.

Hixny worked with DOH and NYSTEC, a not-for-profit consulting company on this project.  NYSTEC supported DOH in selecting the vendor and with project work as well.  “Hixny’s people have shown themselves to be extraordinarily proficient on the technical side,” said Shama Mehendale, Consultant at NYSTEC. “Their ability to work with different platforms and develop effective solutions more than justified NYSDOH’s selection of them.”

When you get right down to it, taking in a lot of different information and making it standardized to increase efficiency is what Hixny did years ago when we created the HIE.  So with this expertise, Hixny was uniquely qualified to tackle this challenge with DOH.

Through our technical proficiency and understanding of the customers’ unique business needs, we were able to design a solution, create special software and integrate a new Direct-based processing pipeline into the Hixny system. The resulting solution converts both incoming and outgoing emails to a standard format before forwarding them to the intended recipient (DOH or a healthcare provider).  This is saving time for DOH employees and allowing them to work more effectively and efficiently.

This is a great example of how organizations must evolve to continue to support their customers’ needs. This is done by the willingness and dedication to reach for new goals, while building on the successes of the past.

Message from Mark – Growth

Friday, September 9, 2016

As you may know, Hixny moved into new offices in Albany earlier this year.

The relocation was necessary to accommodate our growth, both in terms of the people we have added and those we still plan to add. At last count Hixny employed about 24 people. When I started here, in 2011, there were 18 employees—and that was before the organization split in two with the launch of XchangeWorx, which currently employs 20.

The employment increase, in turn, is necessary to support all the other growth Hixny has witnessed.  By every measure, this organization continues to expand.

Let’s start with participation.  More than two dozen organizations joined the Hixny network so far in 2016, as both contributors of patient information and end users who are now better informed in delivering and coordinating care.  Even more significant, for the first time this year, the newcomers included behavioral health facilities, public health organizations, community-based organizations and other ancillary providers who are vital to creating a 360-degree view of every patient.

We also hit a milestone this year, surpassing 1,000 participant locations.   You can think about that in a couple of ways.  As a provider, this means access to electronic medical records at more than 1,000 locations.  As a patient, that means there are more than 1,000 places where data can be safely and securely accessed.  It also means that there are 1,000 locations collecting Hixny consents, and raising public awareness of our organization.

That brings me to our master patient index, which continues to grow and will soon reach 1.5 million unique individuals.  Think about that.  There are 1.7 million people in the Hixny region. This means almost everyone in the region has placed their trust in Hixny with their private health information.  Most have consented at more than one place, as we are approaching three million total consents on file.

Those of you who attended our 2014 annual meeting may remember me saying that we had half of the people in the region signed up.  That is tremendous growth in just two years.

Not only do we have more organizations sharing information on more patients, we also continue to expand the types of data these organizations contribute.   For example, when comparing July 2015 to July 2016, we have witnessed a 167% increase in the number of documents being shared in real time.

We have also increased use, by developing new ways for people to get information from Hixny or have it pushed out to them.   The number of reports we are generating continues to rise.

I was recently asked how I felt about all the growth Hixny has experienced since I came on board.  Of course I am pleased.  I joined Hixny because of its mission to improve healthcare in this region.   I am a member of this community, as are my friends and family members.   If there is a way to improve the quality of care they receive, and lower the cost of care for them and myself, than for the most selfish reason of all I want to continue to do that.  The growth makes me feel great because it reaffirms for me that we’re continuing to execute on that mission.