Saturday, November 25, 2017

HIE future is Bright -- Notification and Alerting

At the WISHIN conference this discussion would have interested me most. I might then have become distracted. By the title, and given my background, I would have thought that this was a mechanism to inform the Patient of when their data was used. A really important Privacy Principle. However I think that it is more a growth of a very interesting use-case that drove the very early HIE within Wisconsin, well before the push in the last decade.

Wisconsin, as I understand, had a network among the large hospital systems in the South-West (Milwaukee, Racine, Kenosha). This was Pre-ObamaCare. This was Pre-HITSP. I think this was back in the 90s. The network was created to help detect malicious patients that would go to various Emergency Room sites seeking dispensing of narcotic drugs. The network would be used in the Emergency Room to detect these patterns, and stop them. Two benefits: A bit of paternalism effort to cut down on drug use, but the main benefit is that any drugs dispensed would not be reimbursed and thus these hospital systems were loosing money. Thus, follow the money...

WISHIN started in 2009, and leveraged this network. Given the slide decks given a the WISHIN conference, it seems that this concept is going state wide. Not only that but they are finding that this kind of a system might be useful for other administrative things.

I don't have the background to better explain this "future". The Patient Activity Notification Report is described. I do see enough "value-add" described to understand why it is being worked on, and why it would be a selling point for the WISHIN service. This gets to the very fact that a HIE is a very useful thing, but it costs money to build, run, manage, and support. This money needs to come from somewhere, so it is a common discussion within HIE organizations on how they can build value that can provide income to support the network.

The potential link to Patient Care is through notification of the Providers when their Patients receive treatment elsewhere. This seems to be being developed. It is not a core function of a Query model network like XCA. I suspect a more robust mechanism should be developed, especially as it supports CarePlans and CareTeams; the last improvement on the WISHIN list.


It would be so much better if these HIE networks cost nothing, but the reality is that they cost something and thus need to be supported.

If you have a different idea, please comment.