Over the last few weeks, alongside the rest of the world, our staff has been adjusting to the circumstances presented by COVID-19. During that time, it’s been our privilege to collaborate with peers statewide to support the critical work of state and local public health officials.
From its inception, the Statewide Health Information Network for New York (SHIN-NY)—of which Hixny is a part—recognized the importance of supporting public health and included public health as a core service. The needs envisioned for public health access to data included tracking infectious disease outbreaks as well as providing resources for emergency response. While parts of the system have been pressed into service at different times, today’s extraordinary circumstances show us just how important it is. It’s one of the reasons that the state has invested in the SHIN-NY as a public utility—and we’re pleased to play our part.
Here is what we are doing, alongside our counterparts across the state.
In early March, Hixny began working with New York State Department of Health (DOH) to modify Hixny’s flu surveillance capabilities to track early COVID-19 cases in the region. Because the virus was so new and the need for testing outpaced supplies, providers were using very general codes to describe their findings. Working with our partners, Hixny reviewed the incoming data to understand how each facility was identifying patients with COVID-19. Rather than a diagnosis code specific to the new virus, providers were using general codes for things like upper respiratory infection or other infectious diseases, like SARS. When we started to see clusters of those codes in an individual patient record or a geographic area, we had to question whether it was related to COVID-19 or other viruses or conditions.
As testing became available, we were able to identify these lab codes in the data. DOH used Hixny as a sounding board in developing the data requirements and used this as the basis in working with our peers statewide to do the same. To supplement Hixny’s ability to identify the necessary data and patients, DOH began providing COVID-19 testing results from all New York State labs.
The state’s main interest in working with Hixny and our counterpart qualified entities (QEs) isn’t in monitoring the rates of infection or testing—which DOH already knows. Instead, it’s learning what the severity of the illness looks like in those who’ve tested positive and then how quickly they recover.
By identifying the advancement of the virus in different types of patients—such as those with underlying conditions like smoking, pregnancy, hypertension, COPD and diabetes—DOH can forecast how overwhelmed hospitals may become. For example, the data can help predict answers to questions like how many beds may be needed as the rate of infection increases, how many ventilators may be required and how many intensive care unit (ICU) admissions can be expected.
This is the type of data that is being analyzed and applied when you hear, for example, Governor Cuomo explain that within six weeks, it’s expected the state will require 110,000 beds—with up to 30,000 of them in ICUs. Armed with that knowledge, the state can move forward rapidly to create more spaces for treatment and attempt to meet the anticipated demand given the state currently only has 50,000 beds, of which only 3,000 are in ICUs.
Last week, I sent an email to our users informing them of our work with DOH and our contingency plans for routine functioning during this time of uncertainty. I got a response from an executive at one of our local hospital systems, who wrote, “The community of hospital systems in the Capital Region are working closely with each other on a daily basis, and plan to continue. Knowing that Hixny is working alongside us is reassuring.”
This is the value that HIEs and the SHIN-NY provide, showing massive return on a relatively small investment of state funds.