NC HIEA February 2023 Update

2022 Participant Survey reveals insights into participant needs and use of NC HealthConnex. The Stroke Registry Dashboard, a new public health tool launches for NC HealthConnex.

NC HealthConnex Participant Survey Reveals Insights into Participant Use, Needs

In mid-December, the NC HIEA sent a survey to Clinical Portal Users and Participant Account Administrators to gauge usage and needs of participants in NC HealthConnex, the state-designated health information exchange.

The NC HIEA received just over 500 responses, of which 424 or 83.61% had a Full Participation Agreement and 82 or 16.4% had a Submission-Only Participation Agreement.

Both groups were presented with questions regarding onboarding and interest in value-added services either currently provided by NC HealthConnex or potential future services. Those who had a Full Participation Agreement were also asked questions regarding training, use of the exchange, and data quality and usefulness.

Key Insights:

Additional Insights:

  • Respondents primarily indicated that NC HealthConnex best meet their needs by providing a more complete picture of a patient’s health information or by filling in missing data.
  • Participants in the survey said that the data they find most important to know are clinical notes, encounter/discharge summaries, medication histories, and lab results.


A Bar Graph showing how the data in NC HealthConnex meets your patient care needs. Data is in article

                                                   Note: These questions allowed participants to select more than one answer. Values will not add to 100%.

A Bar Graph showing which patient data is most important to you. Data is in article.

Having access to the data in NC HealthConnex can help reduce duplicative testing, avoid unnecessary tests, reduce errors in medications, and reduce staff time spent faxing information to other providers.

Participant Feedback:

Many respondents indicated that they were waiting for a live connection before they began training. It’s important to note that training is available to providers who have signed a participation agreement, regardless of connection status. Providers can receive immediate value from the features and services available through NC HealthConnex, even before the connection is complete to allow submission of their own data to the HIE (known as going live).

Enrollment in value-added services is available to health care providers with an executed Full Participation Agreement. This means that your practice can view data, receive ADT alerts through NC*Notify, and enroll in additional services before the submission of data to the HIE goes live.

Also of note, respondents to the survey raised concerns about the cost to connect to the state-designated HIE Network. The NC HIEA remains committed to its mission to securely connect providers to help improve the quality of care provided to patients. The NC HIEA does not charge fees to connect to NC HealthConnex or for its current value-added services but does not have control over fees charged by EHR vendors which vary widely across the industry. The legislature currently requires any provider who receives state funds for the provision of health care services to submit data to the HIE. The NC HIEA’s Advisory Board is actively involved in making recommendations to the legislature on policy and enforcement of the Statewide HIE Act.


Stroke Registry Dashboard, a New Public Health Tool Launches for NC HealthConnex

On February 15, 2023, the N.C. Health Information Exchange Authority launched the North Carolina Stroke Registry, a population health tool that supports the N.C. Division of Public Health (DPH). The dashboard leverages demographic and clinical data on stroke patients that is received by NC HealthConnex to improve the stroke care continuum.

In 2021, DPH and the N.C. Stroke Advisory Council led the efforts to secure a grant from the Paul Coverdell National Acute Stroke Program that funded the development of the Registry. Anna Bess Brown, Executive Director of the Justus-Warren Heart Disease and Stroke Prevention Task Force and the Stroke Advisory Council said she is excited to see those efforts paying off.

“Having this registry is providing us with data and with opportunity to provide state-of-the-art care no matter where you live and to explore areas of need in our state and to identify gaps in care so that we can address these issues through the training of providers, providing resources for hospitals, and so that we can seek funding to improve our statewide system of care,” said Brown.

The N.C. Stroke Advisory Council, the N.C. Department of Health and Human Services, and members of the health care community were present to view the demonstration of the Stroke Registry dashboard on the campus of the NC HIEA’s technical partner, SAS.

The registry uses existing data for its dashboards from more than 9,000 facilities connected to NC HealthConnex at this time. The dashboard gives a visualization of the prevalence of stroke by county and by zip code, tracks analysis on comorbidities, and identifies trends based on demographics such as race and age. Data regarding stroke patients from emergency medical services connected to the HIE is planned to be included in a future enhancement in cooperation with the Office of Emergency Medical Services.

The Stroke Registry project aims to improve the system of care for stroke patients in North Carolina; identify areas in the stroke care continuum where interventions may be needed, whether that involves stroke prevention or post-stroke care measures; and address disparities in care.

“Stroke is the fourth leading cause of death in our state, and in the U.S., it’s the fifth, so we really do have a problem with stroke,” said Brown. “For many people, once it hits their family, they become aware of the problems with it. A lot of people can’t go back to work, or they’re really limited in their speech or in their mobility.”

A study led by Duke University recently revealed that the algorithms used to identify stroke risks perform worse for black individuals. Better data collection could help improve that disparity.

There is also a need for identifying stroke risks and outcomes in communities where there may not be larger hospitals or health systems. Brown explained that although many hospitals in North Carolina are stroke-certified, the stroke registry will provide information on stroke in all areas of the state, including those with fewer resources.

“We’re not just capturing those hospitals that are very well-resourced, but everybody across the state, so we’re getting a more complete picture of stroke in our state. We’ll get a certain level of data from the population level from the HIE; there’s no other device that can do that,” said Brown.

The data in the dashboard is aggregated at the population level, meaning that it is not possible to identify specific patients by using the dashboard. Data is suppressed for small populations where identification is more possible. The Stroke Registry dashboard is currently only accessible by a handful of state employees in the Division of Public Health who have both an NCID and authorization to access the dashboards.

Teams at both the NC HIEA and SAS are working on new developments for the project and are already gathering requirements for new phases. Future versions of the registry may include granting access to the aggregated data to health care providers so they can work with DPH to improve the standard of care.

Brown said the overall goal is to ensure that all North Carolinians receive the best standard of care, regardless of race, ethnicity or geographic distance, “We want you to be taken care of in the best way possible anywhere you have a stroke in NC. If you live an hour away from a hospital, that is significant; and if that hospital closes or is so small that they have to transfer you to another hospital, that takes time, and time is brain.”


Employee Spotlight: Jenell Stewart

Jenell Stewart began working at the NC HIEA in 2019 and was recently promoted to Assistant Director, Health Analytics and External Services. Her new role includes establishing the strategic direction for the NC HIEA analytics program, managing the analytics team, and working closely with health care leaders across the state of North Carolina. She will be working closely with leadership, technology partners and other key stakeholders to drive adoption of good data management practice across the enterprise.

Jenell earned her Doctorate in Business Administration specializing in Management of Engineering and Technology from Northcentral University. She has over 18 years of NC State Government experience with the last 11 years working for the NC DIT Data Division where the HIE is housed.



“NC*Notify is critical as is the portal, and in this specific example, when a dialysis patient is out of area, and is hospitalized, or seeks treatment with another provider or facility, the NC*Notify notification for this panel comes directly into the practice’s EHR, …and is immediately notifying the practice. These notifications are monitored daily by staff. The practice can reach out quickly to the rendering provider out of the region and assist with the care of the patient allowing a continuity of care without additional testing labs or other services that the patient may not need while coordinating care upon the patient's discharge. When you’re ’in a downside risk model and you have very acute patients this process is absolutely critical to the successful healthcare improvement, or management, of these acutely ill patients and their outcomes. It's improving performance all around and giving our patients just a better care experience.” - Terri Roberts - Senior Practice Consultant/Statewide Quality Improvement Manager, NC AHEC

Ms. Roberts was a panelist at our recent Teletown Hall: Firsthand User Experiences, where we heard from specialists and providers on the benefits of using NC*Notify and the Clinical Portal in their everyday workflow. A recording of this presentation is available online.


Upcoming Events:

Advisory Board Meeting – Thursday, March 2, 2023 – 2 p.m. to 5 p.m. Save this link to join the meeting.

How to Connect Call – Monday, March 27, 2023 – 12 p.m. to 1 p.m. Click here to register.

How to Connect Call – Monday, April 22, 2023 – 12 p.m. to 1 p.m. Click here to register.


In the News:

N.C. Collaborative Launches with Focus on Equity, Aligned Quality Measures - North Carolina is one of four states taking part in the State Transformation Collaborative to accelerate the movement toward advanced payment models.

eHealth Exchange Approved as Qualified Health Information Network (QHIN) Candidate - Health and Human Services Secretary Xavier Becerra recognized eHealth Exchange today as an approved QHIN candidate and as an organization that has agreed to meet the stringent TEFCA eligibility requirements.

How An HIE Approaches Continuous Patient Data Quality Improvement - Consistency, completeness, and accuracy are key characteristics of health data quality. However, achieving quality patient data is easier said than done.

Our own Data Quality Lead, Michelle Hunt, joins us in our March edition to explain how she and her team ensure data quality in NC HealthConnex.