Outgoing NC HIEA Board Chair Anticipates More Data-Driven, Proactive Health Care
The N.C. Health Information Exchange Authority's Advisory Board outgoing chair reflects on growing North Carolina's state-designated HIE into a data-driven organization that he expects will drive more proactive population-level health care.
Dr. Jeffrey Ferranti, chief information officer and vice president for medical informatics at Duke Health, stepped down as Advisory Board chair at the end of a five-year term. He is succeeded by Dr. William Way, director of diagnostic imaging at Wake Radiology.
"It's been an interesting journey," Ferranti said, "but one that has been successful because of the incredibly hard work of [NC HIEA Executive Director] Christie Burris and the team and the dedication of our board, who are really a multidisciplinary group of very talented people who openly share their insights."
From the start, the NC HIEA board and staff had a clear vision for NC HealthConnex, the state-designated HIE, he said.
"The goal is simple. It's just to make health care in North Carolina easier to deliver because there are no barriers to information exchange," he said.
Initially, the NC HIEA encountered technical and regulatory deadline challenges to onboard as many organizations as possible to NC HealthConnex within aggressive timeframes. To that end, the team has worked diligently to help smaller, independent providers with fewer technological resources overcome technical hurdles to onboard with their electronic health records (EHR) vendors.
The benefits of NC HealthConnex soon became clear, Ferranti said. Patients no longer have to recall all their medical history, facilitating "a much more comfortable conversation during what could be a stressful time."
After five years of aggressive onboarding within North Carolina and expanding data exchange across state lines, participating providers can now see a much more complete medical record on their patients — whether they choose to log in to a web-based clinical portal or to build out bi-directional exchange back to their native EHR. "It's important when you're seeing patients in the clinic to have a full understanding of all of their care, regardless of where it's delivered, regardless of which organization around the state or around the country," he said.
Ferranti said the health care and IT leaders on the Advisory Board urged a data-driven approach to improve and expand NC HealthConnex.
"Looking at our own data and going out and seeking input from others who've gone before us is the spirit of what we're trying to do. Probably what I'm most proud of is that we've created an engine to do that," he said. "Our HIE is now one of the leading HIEs, and people come to us and ask us how we did things."
The board's advice has resulted in results, Ferranti said, because it has built trust through an open dialog on challenging issues with the NC HIEA staff.
"It's been a great, transparent relationship. HIEs are most successful when there's trust," he said. "I appreciate this group and their engagement, answering hard questions that I've had along the way, openly considering new ways of doing things, and ultimately expanding the HIE in in a way that will serve the state."
NC HealthConnex's large database has served as a critical information resource, particularly during the COVID-19 pandemic.
"As you get a critical mass of institutions on the HIE, you can suddenly start thinking about populations of patients and how the HIE can be leveraged to improve the health of citizens in the state," he said. "As we moved into this COVID era, it suddenly became really essential to understand the health of patients across North Carolina."
Ferranti believes that NC HealthConnex can use that data to transform patient care.
"Where I think we have some untapped potential in the HIE is to start thinking about it less as a patient-by-patient data resource and more as a population resource to identify patients who most need our help and then proactively intervene to partner with them in health," he said.
The state HIE's "robust, real-time data" on those at high risk of chronic diseases such as hypertension and diabetes, for example, could prompt more timely interventions, reducing morbidity and costs, he said.
"We are shifting from the mindset of a patient self-declares, shows up at a doctor, gets treated — to a mindset of let's look at a population, identify people who are high risk, and more proactively try to help them," he said. "That may seem like a subtle difference, but that's actually a world of difference in how you care for patients."
Ferranti expects that Dr. Way, the incoming Advisory Board chair, will lead greater use of that data.
"[He's] willing to challenge our thinking and push us to do better and continue to have the open conversations that have gotten us as far as we are today," Ferranti said.
Ferranti urged Advisory Board members to keep up their engagement and speak up to achieve more in collaboration with the NC HIEA team.
"We have only scratched the surface of what we can accomplish, and we're in a really good place," he said. "We need creative ideas on how we can now use this data to improve the health of North Carolinians."
Health Care Faces Evolving Cybersecurity Threats
Cybersecurity is increasingly critical to the health care industry. Cyber threats require that providers and organizations understand the potential risks and take proactive steps to protect data and privacy.
A common attack is phishing. Cyber criminals use fake emails, texts or social media to trick employees into giving them access to their organization's IT systems. Phishing attacks can open the doors to ransomware attacks. Hackers use malware to encrypt systems and files and demand that organizations pay them to get back access.
The Enterprise Security Risk Management Office (ESRMO), with the N.C. Department of Information Technology, offers cybersecurity resources.
- Dissect the anatomy of a phishing email in ESRMO's October newsletter.
- Get tips to avoid phishing attacks.
- See N.C. Cybersecurity Awareness Symposium videos and materials to learn about the latest cybersecurity threats and ransomware types.
NC HealthConnex, as part of NCDIT, is attuned to mitigating these risks with our technical partners. Learn more about our privacy and security policies.
Enhancements to NC HealthConnex's Clinical Portal Coming Soon
Important updates to the NC HealthConnex web-based clinical portal will be released in November 2021. All NC HealthConnex participants with active clinical portal accounts will see the changes to the clinical viewer used for patient care.
The updates to the provider clinical portal will include the following:
New modern look
- Improved ease of navigation with options to return to a previous section of the provider clinical portal, including the ability to retain patient data when returning to the patient search
- Navigation optimized for mobile users
- Changes to patient search/patient record:
- Improved patient search by local medical record number (search box instead of scrolling selection)
- New sorting functionality available throughout the clinical record; for example, users may now sort encounters by date or type of encounter
Improved data display
- Documents section now includes U.S. Core Data for Interoperability (USCDI) V1 Clinical Notes
- Users no longer need to click to refresh eHealth Exchange feeds
Security enhancements
- Users will now be required to choose from a prepopulated list for challenge questions to ensure account security
Look in early November for updated user documentation for the provider clinical portal, and register for the Nov. 17 Teletown Hall to see a demo of the new provider clinical portal.
If you have questions about these features or need assistance, please contact the NC HealthConnex team at HIEA@nc.gov or 919-754-6912.
NC*Notify Enhancements Release Notes and Specifications Available
The NC*Notify team is working to release the latest version of NC*Notify, the patient notification service for NC HealthConnex, in the coming weeks.
A detailed breakdown of NC*Notify 4.5 is available in the release notes and specification on the NC HealthConnex website. Highlights of the new NC*Notify enhancements include new event triggers, reports on patient panel loading, additional required fields in panels, EHR integration for the plus service tier and CMS Conditions of Participation fields.
If you have specific questions about these upcoming changes to NC*Notify and how to prepare for them, contact us at HIESupport@sas.com.
NC’s State-Designated HIE Supports Improving Bi-directional Health Information Exchange
NC HealthConnex is helping providers attest to compliance with the Centers for Medicare and Medicaid's (CMS) Merit-Based Incentive Payment System (MIPS) measures.
NC HealthConnex participants may complete the NC HealthConnex Bidirectional Interface Confirmation Form, and the N.C. Health Information Exchange Authority will help confirm whether they have bidirectional exchange with NC HealthConnex.
A bi-directional interface with NC HealthConnex, which supports transition of care, fulfills the HIE Bi-directional Exchange measure within the Promoting Interoperability measures. Eligible clinicians and groups are required to attest they are capable of establishing the technical capacity and workflows for bi-directional exchange through a HIE for all patients they see and for all patient records in their electronic health record (EHR). This measure can replace the MIPS Electronic Referral and Send and Receive measures for 2021 reporting and provides 40 points for MIPS scoring.
Bi-directional EHRs
The following EHRs have built out the capability to pull electronic health information back to the practice’s EHR. NC HIEA will work with additional EHRs to add this functionality.
- Allscripts
- Athena
- Cerner
- eClinicalWorks
- Epic
- HIS-Netsmart
- Meditech
- NextGen Thrive by Evident
For questions about bidirectional capabilities, contact the NC HIEA team at hiea@nc.gov.
Upcoming Events
- Teletown Hall: New Look for the NC HealthConnex Clinical Portal — Wednesday, Nov. 17, 2021, at 12 p.m.
Learn about new enhancements to the clinical viewer portal, and see a demonstration of the new features. Bring your questions on how to improve care coordination with NC HealthConnex. Register here. - NC HIEA Advisory Board Meeting — Wednesday, Dec. 15, 2021, at 2 p.m. to 5 p.m.
- Quarterly User Audit — Friday, Dec. 31
NC HealthConnex Participant Account Administrators contacted by email should complete their user audits. See the Quarterly Audit Quick Reference Guide, or for assistance, contact the NC HealthConnex Help Desk Team at hiesupport@sas.com or 919-531-2700.
In the News
NRHI, SHIEC Partner to Support HIEs, Interoperability Infrastructure — The Network for Regional Healthcare Improvement and the Strategic Health Information Exchange Collaborative have partnered to form Civitas Networks for Health, which aims to support local health information exchanges and collaboratives to strengthen the national interoperability infrastructure. Ehrintelligence.com
Greater Houston Healthconnect Uses InterSystems HealthShare® to Create Largest Known COVID-19 Outcomes Study — The Greater Houston Healthconnect HIE and InterSystems, a data technology provider, have assembled a cohort of more than 1 million COVID-19 positive cases with all associated medical histories for outcomes analysis. Businesswire.com
Assessing the Future of Public Health Data Exchange, Interoperability — Micky Tripathi, ONC national coordinator for health IT, noted that the ONC is working with CDC to improve public health data exchange. Ehrintelligence.com
API EHR Integrations Grow, But FHIR Data Exchange Adoption Trails — While the number of application programming interfaces (API) EHR integrations increased from 2019 to 2020, the proportion of APIs that support the FHIR data exchange standard remained relatively the same, according to a study published in JAMIA. Ehrintelligence.com