Posted on: May 9, 2018

In mid-April, I had the great pleasure of meeting with students in the Introduction to Healthcare Management class at Siena College. It’s an event I’ve looked forward to each spring since I received my first invitation a few years ago.

The instructor, David G. Kruczlnicki, is the president and CEO of High Peaks Strategic Business Advisors. His name may be more familiar to many in the healthcare community as the former president of Glens Falls Hospital or from his other leadership positions in the industry.

The chance to sit with more than 30 students—most all upperclassmen and nearly all majoring in business or management—and answer their questions about Hixny, healthcare information technology and the state of the industry always gets me thinking.

I thought you might find it interesting to know what kinds of questions were on their minds and how I tried to answer.

What is the effect of cloud technologies on healthcare?

Cloud technologies have begun to revolutionize all types of businesses—including healthcare—by creating central sources of information that eliminate inefficiency and duplication. By this definition, Hixny can be viewed as the “cloud” for all of the healthcare providers in the region. The concept of Hixny is that all of the data from different electronic health records (EHR) systems is in one place and it’s accessible from nearly any other place—that’s what makes it so valuable today. It’s like when you take a picture with your phone and it gets saved to iCloud and then you can view it on a “Smart TV” or pull it up on your computer to edit and print it.

Technology is also beginning to play a bigger role in who will share patient information in the future. Apple Health, for example, is expanding the ability for you to download your own data onto your phone. They’re betting that you want to control your own data. But there are limitations to that model. I’ve seen articles recently that show something like 1 in 8 people deliberately leave information out when they talk to their doctors. Doing that forces doctors to treat you without knowing everything that matters. That creates different problems. The idea with a health information exchange (HIE) is to make all of the information available to the doctor so he or she can make the best decisions for your health.

And let’s think for a minute about your phone. What happens if you lose it or your battery is dead? How will you share information in those situations?

  1. What is Hixny’s role in the opioid crisis?
    We have lots of ways to support treatment and recovery. In some cases, that’s making information and alerts available. In other cases, it’s more about population health, or addressing conditions across an entire community by bringing people together—beyond physicians—who need the data to make broader plans. For example, a sudden increase of overdoses in one community might indicate that there’s a need for public health intervention, drug education or law enforcement support.Hixny could help identify “hot spots” so that organizations know where to focus their resources. It puts all of the information, from overdose deaths to types of emergency department (ED) admissions to the administration of Naloxone, in one place. Health information exchanges like Hixny are weapons in the battle against opioid abuse. Just in the last few weeks, we’ve been discussing with our counterparts across New York on how the HIEs connected through the Statewide Health Information Network of New York (SHIN-NY) can be even more useful in this field.
  2. Does Hixny have plans to expand beyond our region?
    Because Hixny and our counterparts across the state are all connected through the SHIN-NY, there’s no reason to expand in a traditional sense. For us, expansion is about broadening the type of clinical data we get from providers, the type of claims data we get from payers and even the social determinants of health that organizations may provide.Imagine a patient keeps going to the ED with acute asthma attacks, but all of the clinical history indicates their asthma treatment is appropriate for their condition and they’re following their doctors’ orders. The ED doctor wouldn’t know about the house full of mold or the busy, exhaust-filled road outside, both of which could be affecting the patient’s health. We’re looking at how to bring together population health data and value-based care efforts that will really improve the health of our communities.
  3. What will Hixny look like in five to seven years?
    I think about this every day. Technology doesn’t move as fast as people think—just look at self-driving cars. I’ve been hearing about how they’re going to take over for years now, but it will probably be a while before they chauffeur me to and from work every day. I see more and more information becoming available. I see fewer problems with interoperability between HIEs and EHRs. Hixny’s role will be to evaluate data quality and completeness and then to link together the right people with that data to provide care. In that asthma example above, we envision being able to bring together individuals who can impact the patient’s housing environment along with those providing value-based care. We’ll be looking at what outcomes really matter, what workflows really make a difference and what people ultimately need to be involved to make changes.That said, the environment these students are entering is very different from the one I navigated during college. I took a typewriter with me my freshman year and graduated writing papers on a computer with WordPerfect. Right now, providers are still calling and faxing one another for data, or relying on patients to relay information. So a lot could happen in five to seven years.
  4. What advice can you share as we start our career?
    You need to love what you do. Your career is a marathon, not a sprint, so be willing to learn from your experiences and be prepared to try new things over the course of time. I started as a science major, but now the only science I use is classifying animals I spot from the car. I took the opportunity to learn about data and analysis and then how to use computers to analyze data and it turns out that’s what I love. Learn from all the people you work with—I learned some of the best professional lessons in the least likely places.I learn something from these questions every year, so I hope I’ll be invited back to Siena again next year. In the meantime, I wish those seniors graduating this year great success in whatever lies ahead in their careers.