Rush Health embarks on ambitious HIE project

Rush Health in Chicago has gone live with a private health information exchange to share data with three of its hospitals and 800 physician providers.

The HIE platform from InterSystems will support the collection, use, sharing and analysis of financial, clinical and resource utilization data, as well as care coordination, the patient experience and provider engagement as the industry moves away from fee-for-service and into value-based care.

Rush Health is a clinically integrated network of four hospitals and 1,400 providers who in total use up to 15 different electronic health record systems, which is part of the reason that a private HIE was desired. Rush Health does not own these entities but negotiates and manages all the payer contracts.

The HIE is part of an interoperability strategy to support standard transition of care workflows across the delivery system’s network, says CIO Julie Bonello, and to define the best inoperability tools and standards to support the different types of providers and their EHRs.

The HIE also triggers admission and discharge notifications for care managers to follow up with patient, and over time will link to other exchanges and networks to give physicians a longitudinal view of patients’ medical histories.

“As more contracts shift to value-based care, it is important for our providers and care team to have easy access to correct clinical data along with actionable clinical notifications integrated within their EHR,” Bonello explains. “Our goal is to ensure interoperability tools support our new care delivery workflows that connect the entire care team.”

By using the HIE, clinicians will be able to view their aggregated patient data within their own HER, even when the data comes from a different EHR. This will spare physicians the need to alter their clinical workflows or sign on to an additional application. The HIE also will support real-time alerts and notifications.

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To support providers moving to value-based care, Rush Health will help them negotiate payer contracts and manage performance such as clinical metrics, utilization, patient satisfaction, care coordination patient experience and costs.

“As a private HIE, we want to use all the data to tell us how patients are doing,” Bonello explains. “We will use HIE as an intelligence hub building rules to monitor quality and resources. We can use analytics to identify patients at risk and trigger events in the HIE to notify providers and care management teams for follow-up. We’re using our HIE to support our performance across the network.”

For now, however, the HIE is in an early stage, and a clinically driven governance structure is being developed to guide the project and learn from lessons experienced. Early pilots are examining use of the emerging FHIR interoperability standard and application programming interfaces.

There will be a lot of trial and error as processes and tools are not yet mature, Bonello says. “We’re talking about data, quality and metric standards that remain relatively new so this is very much an innovative journey.”