September 2019 Update

Wednesday, October 2, 2019

NC HIEA Wins National Award

 The North Carolina Health Information Exchange Authority (NC HIEA) was awarded the 2019 Strategic Health Information Exchange Collaborative (SHIEC) Community Partnership Achievement Award on Tuesday, August 20, at the fifth Annual SHIEC Conference in National Harbor, Maryland.

The Community Partnership Achievement Award recognizes outstanding achievement by a Health Information Exchange in responding to a community crisis, meeting a community need, or facilitating community action or collaboration, including Social Determinants of Health.  The NC HIEA was selected for its work to connect to five neighboring state and regional HIEs in the week that led up to Hurricane Florence in 2018.

Hurricane Florence resulted in the evacuation of millions who left their local area where health care records were housed. The North Carolina Department of Information Technology’s Secretary Eric Boyette, whose agency is responsible for the state-designated HIE, explained the agency rapidly worked to allow the exchange of health records across state lines to provide additional support to providers who were treating individuals escaping affected areas.

The effort to create these connections was enormous, so establishing a connection that would normally take weeks or months in less than three days is unheard of in the health care industry, according to SHIEC. NC HealthConnex opened the gateway for bidirectional query and exchange of patient records via the national eHealth Exchange Network, with multiple state and regional HIEs including Coastal Connect HIE (Wilmington, NC), ETHIN (East Tennessee), GRAChiE (Augusta, Ga.), MedVirginia, (Richmond, Va.), SCHIEX (South Carolina). There were existing connections already in place for GaHIN (Georgia’s state-designated HIE) and the VA HIE (Veterans Administration).

“The genesis of HIEs is to enable the secure exchange of healthcare information using technology during emergent situations,” said Christie Burris, executive director of the NC Health Information Exchange Authority. “Use cases for widespread adoption of this type of technology during emergencies continue to emerge.”

NC HIEA Chosen as Finalist in National Association of State CIOs Awards Program

As a part of the 2019 National Association of State CIOs (NASCIO) State IT Recognition Awards program, the NC HIEA was chosen as a finalist in the Government to Business category for its work to connect health care providers to NC HealthConnex to support improved patient care through the secure, electronic exchange of health records.

National Survey Shows Health Information Exchanges Provide Critical National Infrastructure

At the same conference where the NC HIEA was recognized for its work during Hurricane Florence, results of first national survey were released showing how health information exchanges “provide critical national infrastructure.”  Ninety-two percent of the U.S. population is served by a health information exchange (HIE) that is a member of SHIEC, according to a survey results reported at this year’s conference. 

The survey shows not only the growth of HIEs nationally but also the value that is being delivered, said Kelly Thompson, SHIEC CEO. “We’ve believed in the value of HIEs since the early days of SHIEC, but we wanted to measure how HIEs provide critical national infrastructure to improve the way health care is delivered in communities across the nation,” she said.

SHIEC was founded in 2014 and now has 135 organizations which include 76 HIE members, and 59 strategic business and technology (SB&T) members, organizations that sell products and services to HIEs. 

Critical Infrastructure
The survey shows that America’s HIEs are serving 92% of Americans, delivering more than one billion clinical alerts annually. These are real-time notifications of hospital admissions, discharges or transfers (ADTs) delivered to doctors, hospitals and other organizations tasked with coordinating the care and services of high-needs patients. These alerts trigger follow-up and care coordination that reduce hospital readmissions and improve outcomes as demonstrated in HIE case studies available on the SHIEC website.

Real-time Alerts Across the Nation
In 2016, SHIEC member HIEs came together to connect the nation through the Patient Centered Data Home® Model, enabling near-real time alerting about important clinical events across the nation. The survey shows that the PCDH model continues to grow, with participation increasing by 230 percent and the number of alerts delivered increasing by more than 300 percent over the last year. More than 200 million patients are served by HIEs connected to the nationwide PCDH network.

More than Healthcare Data
Survey results show the critical role that HIEs play in connecting communities, from ensuring that patient records are available from all of the top electronic health record systems to community connections with pharmacies, labs, behavioral health, and state and federal agencies. As value-based health care brings more focus to patients’ social needs, HIEs are providing critical infrastructure in connections to organizations such as blood banks, social service agencies, dialysis centers, first responders, state and county correctional health, school nurses and drug & alcohol treatment centers.

Changes to the Health Information Exchange Act Signed into Law June 6

On June 6, Governor Cooper signed into law House Bill 70, now N.C. Session Law 2019-23. The legislation delays the June 1, 2019, deadline until June 1, 2020. 

Additionally, licensed physicians whose primary area of practice is psychiatry now have until June 1, 2021, to connect. Further, SL 2019-23 now exempts certain provider types from the mandatory requirement to connect and send data to the Health Information Exchange network, NC HealthConnex. The following provider types have the option to connect on a voluntary basis, however, they are no longer required to connect:

  • Community-based, long-term services and supports providers, including personal care services, private duty nursing, home health and hospice care providers.
  • Intellectual and developmental disability services and supports providers, such as day supports and supported living providers.
  • Community Alternatives Program waiver services (including CAP/DA, CAP/C and Innovations) providers.
  • Eye and vision services providers.
  • Speech, language, and hearing services providers.
  • Occupational and physical therapy providers.
  • Durable medical equipment providers.
  • Nonemergency medical transportation service providers.
  • Ambulance (emergency medical transportation service) providers.
  • Local education agencies and school-based health providers.

For more information, see FAQs regarding the legislative changes.

The NC HealthConnex Team Answers Your Frequently Asked Questions

The FAQ section of the NC HIEA website contains answers to common questions we are asked. Here are some recently updated answers to a few of the questions we receive the most:

What is the difference between a Submission Only and a Full Participation Agreement?
The Submission Only Participation Agreement does not include a Business Associate Agreement (BAA), and therefore providers are neither able to access the patient longitudinal health record nor can they utilize any services provided by NC HealthConnex. Providers should ensure that their electronic health record software (EHR) has the technical capability to separate out and only send data pertaining to health care services paid for with State funds. This data parsing or filtering may come at a cost to participants. Participants with a Submission Only Agreement should consult with legal counsel before sending data not pertaining to health care services paid for with State funds pursuant to the HIE Act (Medicaid, NC State Health Plan, NC Grant Funding, etc.).

The Full Participation Agreement provides for a Business Associate Relationship between the HIEA and the provider organization. With this agreement, providers may access patients’ longitudinal records, utilize all NC HealthConnex services, and send additional patient data from their EHRs to support whole person care. Note: A bidirectional interface, or the ability to bring NC HealthConnex data back into the Participant EHR, is not required with this type of agreement.

How do Full Participants gain access to the NC HealthConnex Clinical Portal for Health Care Providers?
The Participant Account Administrator (PAA) for your organization is responsible for managing the creation of user accounts. Please contact your PAA to request access to the NC HealthConnex Clinical Portal or a Direct Secure Messaging (DSM) account. If you do not know who your organization’s PAA is, please contact the HIEA Help Desk team at HIESupport@sas.com or (919) 531-2700.

If I am no longer required to connect, may I still choose to participate with NC HealthConnex?
Yes, providers covered by N.C.G.S. § 90-414.4(e) may voluntarily choose to submit data to NC HealthConnex, or may choose to simply receive access to the clinical portal for health care providers and other NC HealthConnex value-added features. Voluntary providers must sign a Full Participation Agreement if they want to participate. Submission Only Agreements do not include a Business Associate Agreement and therefore can only be signed by providers who are required to connect and submit data to NC HealthConnex for the provision of services paid by state funds.

How will data submitted to NC HealthConnex be used?
Patient data will become part of the patient’s longitudinal record for the permitted purposes outlined in the Participation Agreement (governing agreement for data use and sharing) and in applicable law. The NC HIEA takes very seriously the responsibility of protecting the data that is being entrusted to NC HealthConnex for the purposes of health information exchange and as outlined by the General Assembly. As a State entity, health care providers can rest assured that the State is prohibited from using HIE data for commercial purposes. SAS, the State’s technology vendor, is also prohibited from using HIE data for commercial purposes, and can only use, disclose or access the data as directed by the State. Permitted uses of HIE data include only those allowable under HIPAA and applicable law, including patient treatment, payment, health care operations, as well as public health activities, registries and reporting. As an example, a clinical event notification will allow a full participant who shares a patient with another health care organization to know where that patient has touched the system as this supports care coordination. 

Does HB 70 change the deadline to connect for providers not identified above?
Providers who originally had a deadline of June 1, 2019, to connect will now have a new deadline of June 1, 2020. Licensed physicians whose primary area of practice is psychiatry now have until June 1, 2021, to connect.

NC HIEA Calendar of Events

  • Clinical Portal User Audit Kicks Off on October 14, 2019
  • NC Providers Council Conference – Conference Presentation, Tuesday, October 8, 2019, For more information, click here.
  • Local Health Management Association – Conference Presentation, Wednesday, November 6
  • Teletown Hall: Patient Education & PAA User Management (Open to all NC HealthConnex Participant Account Administrators), Wednesday, November 6, 2019, 12:00-1:00 p.m. To register, contact hiea@nc.gov.
  • Teletown Hall: NC HealthConnex Clinical Portal Demonstration (Open to all NC HealthConnex Participant Users), Wednesday, November 13, 2019, 12:00-1:00 p.m. To register, contact hiea@nc.gov.
  • National Association of Social Workers North Carolina Fall Conference – Conference Presenter, Friday, November 22, 2019, For more information, click here.
  • i2i Center for Integrative Health, Sparking Innovations – Conference Presentation, Thursday, December 5, 2019, For more information, click here.

DSM Provider Directory: Updates coming in October! 

If your organization would like a member of the HIEA Outreach Team to present at a meeting or conference, please contact Jessica Brehmer at Jessica.Brehmer@nc.gov.

In Other News

A Closer Look: The N.C. Government Data Analytics Center - As North Carolina emergency officials spent last week pleading with coastal residents to flee from the potential dangers of Hurricane Dorian, a team with the N.C. Government Data Analytics Center (GDAC) worked behind the scenes to make sure vital medical information would be available electronically across state lines for those displaced by the storm.

Free Federal Tools Available to Aid Physicians Treating Chronic Pain - A new tool from the federal Agency for Healthcare Research and Quality can help physicians find pain-related information on a particular patient. The agency says the tool consolidates information scattered in the electronic health record into a single view or dashboard. Healthdatamanagement.com

Machine Learning Identifies Patients for Advanced Depression Care - A new machine learning algorithm is helping to identify primary care patients in need of advanced depression care within existing provider workflows. HealthITanalytics.com

Pop Health IT Helps Partners in Recovery Reduce Psychiatric Hospital Admissions By 50% - Combining psychiatric and primary care data, including social determinants of health, has also helped reduce ER spending from $2,265 per patient per month to just $875. HealthCareITNews.com