Posted on: March 28, 2018

Over the course of the year, we ask our users a lot of questions about a lot of subjects. As we learned from the participants in our recent value-based care meeting, there are still many things even our most frequent users don’t know about Hixny.

In response to the types of questions we heard at that meeting, we’ve created a very simple At A Glance page on our website. I’ve also offered my thoughts in this post about five of the main topics that seem to generate the most questions, all year ‘round. I hope you’ll find them helpful.

Patient Consent

User: “It would be better if people had to opt out instead of opting in to the service …”

Mark: It’s true that the catch-all of an opt-out system instead of an opt-in system simplifies the consent-gathering process. However, consent is a complex issue. For many reasons—such as state and federal laws, as well as patient privacy—New York adopted our current model over the “opt-out” model used in some other states.

I encourage you to read through our comprehensive article, “Why Your Practice Can’t Use Consent Forms Collected by Other Providers,” to learn the details about why Hixny requires an individual opt-in from every patient for every provider they see.

Even within that consent, a patient may choose to prevent sharing of some of their health records through the health information exchange (HIE). “SAMHSA Requirements and Consent” outlines the mental and behavioral health data that a patient may decline to share, while “What You Should Know About Consent for Your Minor Patients” describes the data that minors may choose to hold back if they seek care without their parents present.

Provider/Hospital Participation

User: “I use Hixny quite often. However, sometimes I’m not successful at obtaining the information I’m looking for because it’s not there. I also wish more organizations were part of Hixny.”

Mark: The good news is that more than 60 percent of Hixny users have told us they always or usually find what they are seeking through the HIE. Also, 100 percent of hospitals and more than 75 percent of providers in our region participate with Hixny, exceeding the state benchmarks at this point in time. (You can download an updated list of Data Contributors at any time.)

The difficult news is that we need the help of Hixny users like you to encourage your peers to participate and to contribute all of the data they or other providers may need in the future. This is the reason why New York State has established the common clinical dataset. It defines the minimum information all providers should be collecting and contributing to the HIE.

Hixny is also starting to expand our reporting about what type of data is available from different organizations. So, for example, if you’re looking for something like a progress note from a specific primary care physician, you’ll soon be able to check our list of data contributors to see if the doctor is a Hixny participant and if he or she contributes progress notes.

User Workflow

User: “Hixny is one more resource for us to use, but most days, we hardly have time to do all that we do, let alone fine tune our patient care by accessing Hixny.”

Mark: We understand that hospitals and practices are busy places and that getting the most from Hixny may require altering certain workflows. We’ve seen, though, that organizations that shift HIE access to the beginning of their workflow see significant time savings. I wrote a little about this workflow change in a recent post.

Many providers can retrieve HIE records directly through their electronic health records (EHR) system. Some have automated a pull of all records for patients who are scheduled to visit on a given day. In one case, we’ve even helped implement context-specific interaction, which automatically pulls up the Hixny data for the patient whose record is being viewed in the EHR.

For users of the Hixny online portal, we know that some tech issues made the experience cumbersome—and we are working to address them with an easier and more secure login process. We’re also actively working to help several organizations implement single sign-on solutions that integrate the Hixny portal into their existing automated workflows.

At the same time, we continue to refine and improve our Individual Care Manager (ICM) tools, including the online portal and the mobile and specialty apps that put customizable alerts about patient health events at providers’ fingertips. We know those tools may work better in some workflows than other—for example, in an emergency department or a specialist’s office. Making them available advances our goal to offer a broad set of tools that fit within the myriad different workflows across practices and hospitals.

We’ve been asked to make more alerts available to notify providers of patients’ specific lab results. Throughout 2017, we did exactly that—you can learn more from our annual report article, “Ready for Take-Off.” You can expect to see alerts evolve further this year, too.

Data Quality

User: “The quality of the data, such as medication lists and problem lists, needs to be improved. Amended reports need to be sent. Ways to amend erroneous data that was sent needs to be implemented.”

Mark: Our primary focus in 2017 was improving the quality and completeness of the data available through Hixny. (Take a look at our annual report article, “Raising the Bar”–  to see the great strides made last year.)

One of the ways we approached this was by implementing Logical Observation Identifiers Names and Codes (LOINC) to ensure that users contributing lab data and users searching lab data were using the same language, making the data itself more accessible and usable. We also performed extensive work to de-duplicate the information that appears when a user conducts a search—and to ensure that going forward, users can find more information while sifting through fewer data entries.

We know there’s more to do, and last year’s efforts gave us a solid start. We’re now connected to all of our regional counterparts through the Statewide Health Information Network of New York (SHIN-NY). So our next task is to comb through the data that’s being shared—with the SHIN-NY guidelines in mind—and to help our participants ensure they are contributing the common clinical dataset. We’re also working to ensure that users have the training they need to know how to indicate corrected data.

System Value

User: “I think this should be a nationwide resource!”

Mark: You’re not the only one! In fact, Hixny is involved in the Strategic Health Information Exchange Collaborative (SHIEC), which just announced an initiative to exchange data among HIEs nationally. While we are not yet connected to HIEs around the country, that effort is an example of how we are already involved in considering how to accomplish this valuable aim.

In the same vein, we’ve also heard from users that Hixny:

  • “… has helped our office obtain documentation needed for patient care.”
  • “… helps me [work] with individuals who are not local to our organization and who have trouble identifying their providers and their access to follow-up.”
  • “… [when used] to find lab or other test results … has helped regarding safe treatment of our patients.”

We’re always glad to know that Hixny is serving its purpose. That said, the HIE is only as valuable as the information it contains—and that information requires a three-way partnership between Hixny, our participants and the informed, consenting patients throughout our region.