Healthcare Standards

Pandemic spotlights utility of HIEs for population health, cost savings

While the COVID-19 pandemic has shown us all the fragility of life, the disease also has indisputably revealed shortcomings in our U.S. health system. Our frontline healthcare providers, though an extraordinary testament to resiliency, are greatly in need of a better, more streamlined health information technology infrastructure to care for all patients, today and tomorrow.

In this spirit, the new year tilts the health information exchange in exciting directions in keeping with providers’ move from the practice of episodic, siloed care to consideration of the patient’s full spectrum of needs.

As part of this shift, accelerated population health capabilities now offered by many HIEs empower providers to identify rising risk patients and high-risk cohorts, where care management resources are most needed.

HIE data is also flagging high patient users of unnecessary healthcare resources and when the problem is appropriately addressed, expenses are reduced and clinician time is allocated properly.

To help innovative providers achieve population health advancements and more, the Los Angeles Network for Enhanced Services, or LANES, is providing clinical data insights – medical, behavioral and socioeconomic – to close the data gaps and better inform their decision-making.

At its core, this data enrichment service translates to critical 24/7 accessibility of structured, high quality and complete patient information in real time. Our regional HIE generates actionable information in a dashboard view with drilldown capability to identify gaps in a fragmented healthcare system.

Built upon a solid technology infrastructure, LANES is making giant leaps in 2021 to streamline healthcare delivery across L.A. County’s care continuum. We see a path toward a better future, made possible thanks to state and federal government involvement to propel interoperability. Widespread use of HIE technology is proven to contain cost while improving care quality.

LANES increasingly connects with the L.A. provider community

LANES applauds its dedicated provider network, which treats 7.7 million unique patients across 32 hospitals and health systems and 500-plus community clinics and medical practices

Our vision is forming partnerships with healthcare organizations that support the L.A. communities we serve. We are grateful to the many providers who contribute health data to the LANES HIE, as well as utilize this data at the point of care to improve patient outcomes. Our clinical data repository has captured the documentation of 56 million ordered prescriptions, 200 million clinical results and 51 million patient encounters.

Understanding the value of relevant patient data, the L.A. medical community’s demand for data exchange is a powerful driver to advance our initiatives.  Encouraged by active provider participation, LANES continuously invests in tools to generate cross-community data insights within a patient’s longitudinal record.

Healthcare workers are heroes

Never before do I remember our nation coming together to bestow such generous praise upon healthcare professionals. They deserve our utmost gratitude and support in recognition of their courage, perseverance and self-sacrifice in caring for patients suffering from COVID-19. And despite the hardships and health risks, millions of essential frontline workers show up daily to do their jobs. They are the true heroes of this health crisis.

The severity of this dreadful disease has hit California particularly hard. Los Angeles – the most populous U.S. county, with more than 10.4 million residents representing more than 140 cultures, 224 languages and considerable income variation – continues to dominate headlines as a national hotspot.

And, since 80% of LANES’ clinical data originates from L.A.’s safety net population, our participants have access to tool sets to leverage our data assets to manage this population deemed most vulnerable to outbreaks like the coronavirus pandemic.

Against this backdrop of COVID-19 challenges, we’re proud to play a role helping our primary care providers deploy new solutions to care for patients complying with social distancing. In March 2020, LANES participant CSC Health implemented our HIE platform in conjunction with telehealth technology.

CSC Health previously relied on a “horse and buggy delivery system” to obtain patients’ paper-based medical records from local hospitals and physician offices. The request process entailed antiquated communication methods ─ mail, fax and phone calls, sometimes repeated multiple times.

The federally qualified health center implemented LANES at the onset of the pandemic which dramatically improved timely access by 75% in the online retrieval of hospital emergency room and hospitalization records from participating providers.

“Fast access to patient records during the COVID-19 pandemic has become more precious, medically necessary and urgent,” said Dr. Felix Aguilar, chief medical officer at CSC Health. “The LANES platform provides fast access to community medical records including a comprehensive medical historical snapshot. The clinical portal is well designed and easy to use, and that’s important in a time of national crisis when clinicians need tools to give us immediate access to real-time patient data.”

To further support frontline healthcare workers, LANES is collaborating with state and county public health agencies and lab companies to collect and share COVID-19 lab test results and soon, immunization information.

LANES focuses on three key areas in 2021

Although healthcare has traditionally lagged other industries in digital adoption, we’ve observed that the pandemic has forced many provider participants to transition rapidly to remote services and become population health enabled. Bearing that in mind, the following is our health information exchange’s strategic roadmap for 2021 anchored in three key areas:

1. Data asset acquisition

Rich clinical and population-health data holds the potential to help transform our regional healthcare ecosystem.

For LANES, the acquiring of our high quality HIE data depends on the availability and sharing of patient information from our valued public and private healthcare provider partners. This year as part of our vision, we’ll continue to build new participant partnerships to leverage our clinical data assets. Participants can access our dynamic data and technology service powering patient information flow across the L.A. healthcare continuum.

The LANES clinical data assets offer 360o insights to patients’ personal health information to help providers make informed care decisions, treatments and actionable interventions. Studies have well established that the power of clinical information collected on a patient’s medical history, coupled with behavioral and social determinants of health factors, can predict or diagnose illnesses to better manage the outcome of a condition.

Aggregating, normalizing and delivering high quality data at the regional level has always been the hallmark of the LANES technology infrastructure as the majority of all healthcare is delivered and consumed at a local level. We see this as a distinct advantage over national HIEs such as CommonWell and Carequality.

Our deeply fragmented Los Angeles healthcare system demands a proven data aggregation solution to resolve inequities and discontinuity in care. Establishing a coordinated, connected care system via the value of accumulated HIE information and making use of its ability is one answer.

2. Privacy and security

LANES is committed to a strong, secure HIE organization and has implemented policies, procedures and practices over the last few years to support that commitment. The protection of sensitive patient information is of utmost priority amid the rise in data threats.

HITRUST CSF Certified, the gold standard for information security globally ─ or as our chief information security officer likes to describe the certifiable framework: “HITRUST is HIPAA on steroids.”

LANES works diligently to examine and uphold the complexities of patient consent through continual consultation with legal experts in HIPAA and our community privacy and security experts serving on the LANES Privacy & Security Advisory Board. The permissible use of data is ensured by robust data sharing agreements with our participants.

We’ve earned the trust and confidence of our participants in our commitment to customer service excellence and responsible data stewardship.

3. Clinical use cases 

Our clinical implementation team will work closely with physician leaders, care coordinators and other medical professionals to develop outcomes-based use cases.

We’ll measure provider participants’ application of our HIE technology services to solve complex interoperability challenges in accordance with the CMS Interoperability and Patient Access final rule’s first requirements effective January 2021.Our tools and services utilizing FHIR standards and APIs  support our providers meeting the CMS new rules. 

The team will look at measured improvements gained in health outcomes and KPIs tracking clinical, operational and business performance. We’re also learning about the many instances where LANES played a significant role decreasing utilization of unnecessary emergency department visits and hospital readmissions.

We can all agree evidence-based HIE use case studies supporting that health IT can improve the quality, safety and efficiency of care delivery contribute positively to enhancing the patient’s care experience.

LANES use cases will range from transition of care to referral management and care coordination effectiveness. We’re proud of the many L.A. multi-care facility providers in hospital and clinic settings involved cooperatively in this important endeavor.

In conclusion, our three priorities for 2021 are aligned to fully integrate the IHI Triple Aim of simultaneously improving the health of populations, improving the patient experience of care, and reducing cost.

Ali Modaressi is CEO of LANES, a nonprofit organization responsible for operating a community-based health information exchange for hospitals, health systems, clinics, IPAs and health plans that administer care to Los Angeles County residents.

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