If you know someone with a heart-related condition, then you know how complicated their care can be. In the course of a year, they’re likely to see a primary care physician, a cardiologist, one or more pharmacists and lab technicians—not to mention, potentially, imaging center, emergency department and hospital staff, including at least one surgeon.
“A lot of the time, I’m just desperate for information before my patient is sitting in front of me, so I can know more about them,” says self-described data junkie Vincent Wong, M.D., who practices at Albany Associates in Cardiology, a practice of St. Peter’s Health Partners Medical Associates.
Wong has been using Hixny since about 2016 to prepare for office visits by creating a framework on which he can build a profile of each patient he sees. He uses lab results, radiology reports, encounter notes, diagnoses, information from emergency department (ED) visits and any other available data. “I pull whatever is there, really. Anything clinical can help me.”
Heart of Gold
Nearly half of American adults have some form of cardiovascular disease, the American Heart Association (AHA) reports. That’s more than 121 million people. And, in 2015, the National Ambulatory Medical Care Survey (NAMCS) showed that heart disease was the primary diagnosis driving 15.5 million annual visits to physicians. Neither of those numbers include people with congenital defects or other needs for cardiac care.
It’s little wonder, then, that medical costs associated with heart conditions are high. In 2015, the AHA also reported that cardiovascular disease and stroke accounted for 14 percent of total health expenditures—more than any other major diagnostic group. That number is expected to double by 2030, as the population ages and more people’s lifestyles put them at risk for heart disease.
Heart attacks and coronary heart disease, at $12 billion and $9 billion respectively, are among the 10 most expensive conditions treated in U.S. hospitals, industry sources report. Here at home, a stay at a Capital Region hospital costs an average of $12,300 for a person with uncomplicated heart disease.
Straight from the Heart
“The more informed I am in advance, the more that information translates into preventing unnecessary testing or ordering of medications. It helps avoid the situation where, ‘If I had known that, I wouldn’t have done that,’” Wong explains. “It also means I won’t need to use time in the clinical encounter to accomplish that goal. A lot of people don’t know their histories, so it’s good to have a support system [including Hixny] to gather pieces of information.”
Hixny and other public health information exchanges (HIEs) like it hold significant potential to improve cardiac care. Imagine if all members of a person’s care team contributed vital information during their clinical encounter—and consulted the HIE at the same point to review their colleagues’ contributions. Each encounter would be more efficient, so it could move beyond chart completion into more substantive conversation. At the same time, test and image duplication would decrease, medication management and patient safety would improve, and the length and cost of hospital stays might even decline.
There’s no need to imagine that scenario. A study published in the September 2018 edition of the Journal of the American Medical Informatics Association (JAMIA) showed that rigorous reviews of multiple HIEs revealed those specific benefits across the care spectrum. And community HIEs, like Hixny, outperformed proprietary or enterprise HIEs in the study.
The Heart Won’t Lie
“Can Hixny support better care?” Wong asks. “Oh, absolutely it can. It has the potential to. I have faith in it.”
Regionally, cardiology providers use information pulled through Hixny to establish baselines for a person’s disease progression, to determine what lab result ranges are meaningful, to identify the presence of atrial fibrillation and to spot blood chemistry markers that indicate heart failure—among many other tasks. They also often rely on Hixny to help prompt a person’s memory, since the multi-medication regimens common among heart patients can be difficult to recall under even the best of circumstances.
For Wong, in concept and when all members of his patients’ care teams are using the HIE to its greatest capacity, Hixny helps improve quality of care for people with cardiac problems. All hospitals frequented by his patients share data through Hixny, as do three out of four physicians in the area. Yet, he says, there is still an opportunity to improve what is being shared—and by whom—to close the gaps in his patient profiles.
“I just need more information,” Wong says.
