Author: Jessica Hagins
Executive Director Sam Thompson Reflects on His First Three Months at the N.C. Health Information Exchange Authority
Sam Thompson, executive director of the NC HIEA, began his role the first week of March 2024 after serving as the deputy director of program evaluation at the N.C. Medicaid. He has had a busy 80-some days in office, learning everything about the workings of the NC HIEA, meeting with staff and partners, and forming goals to further mature the state-designated health information exchange, NC HealthConnex.
Q. How do you feel your time in program evaluation at the N.C. Department of Health and Human Services prepared you for what you’ve encountered at the NC HIEA?
Working in program evaluation helped me understand health data, how they are used for treatment, payment and analytics, and the key systems involved. I have been infatuated with NC HealthConnex since I first heard about it - the idea that there was a system that collected and exchanged clinical data from providers all over North Carolina was really exciting. When I was at the N.C. Division of Public Health, NC HealthConnex was integral to evaluating diabetes prevention and management interventions by providing data on patients at practices where we were implementing and allowing us to compare it to data on similar patients at practices at which we were not working. When I moved to Medicaid I realized that, in addition to internal analysis, we could use NC HealthConnex for exchanging data with providers. Over time, in partnership with the NC HIEA team and key payer and provider stakeholders, we developed and received support from the Center for Medicaid and Medicare Services (CMS) for work related to:
- Producing near-real-time digital quality measures in NC HealthConnex
- Supporting the exchange of Health-Related Resource Needs screening data
- Simplifying and strengthening the exchange of data for care management
Q. What plans/vision/goals have you identified for your first 90 days or for further growth of programs or participation?
I have mostly been in learning mode – there are a lot of sharp, dedicated people that have been working at the NC HIEA for longer than I have, and I want to understand their perspective, challenges and opportunities. I am at about the 90-day point right now and the top priorities I’ve identified are:
- Enhancing our operational metrics so we can know, at a provider level, how the data are flowing, the quality of the data being submitted, which and how much HIE services are being used, etc.
- Improving our provider connections process and increasing throughput
- Increasing and supporting our internal project management resources
Q. What are some of the key challenges you’ve experienced in your new role?
Coming in I knew a lot about the policies that govern NC HealthConnex, the purpose it serves and the data it collects. I have had a steep learning curve related to the technology that makes it work, the teams that oversee that technology and the funding that makes it all possible.
Q. What are some of the best new things you’ve discovered about the NC HIEA, your role or any aspect of the job?
The people that work at the NC HIEA, my new teammates, are wonderful!
Seamless and Integrated Data Sharing Can Improve the System of Care for Oral Health, Improving Health Outcomes in Other Areas
The North Carolina Institute of Medicine Oral Health Transformation Task Force recently released a report on transforming oral health care in North Carolina. The task force met several times between August 2022 and August 2023 to discuss creating a patient-centered future of oral health care in the state. Christie Burris, former executive director of the N.C. Health Information Exchange Authority and current State Chief Data Officer, was a member of the task force.
The report details the task force’s findings, goals and recommendations for improving multiple aspects of oral health care in the state, including creating a system of care in which oral health is seamlessly integrated with overall health care.
Dental and oral health providers are currently required to connect to the state-designated health information exchange, NC HealthConnex, if they receive state funds for the provision of health care services. The integration of dental health data into whole person care could pave the way for better insights into a patient’s complete health.
Studies show that having oral health problems is associated with an increased risk of serious health conditions, such as stroke1, heart disease2, diabetes3 and even chronic pulmonary disease2. In turn, having diabetes, Alzheimer’s or using certain medications are risk factors for developing oral diseases. Those with disabilities and who struggle with social needs are also at a high risk of developing oral health issues.2
Oral health is also an important part of prenatal care. Pregnancy may cause a pregnant adult to be more prone to gum disease and cavities. An estimated 60%–75% of pregnant people have gingivitis, the early stages of gum disease.4
The task force identified the need for integration of oral health information into whole person care and called out the data exchange work already being done with NC HealthConnex. They recommend that the NC HIEA, NC Medicaid, the North Carolina Medical Society, the North Carolina Dental Society and others continue to collaborate to improve coordination and data sharing.
By exchanging information with electronic dental records (EDRs) and electronic health records (EHRs), health information exchanges like NC HealthConnex can facilitate faster and easier sharing of patient information across multiple specialists and primary care providers.
NC HealthConnex breaks down information silos between these disparate systems, allowing for a holistic view of patients’ records, including dental care. This integration of care services can lead to better health outcomes through early detection and addressing of behavioral and social factors.5
With NC HealthConnex, primary care, ED, behavioral health, pediatric and residential care providers can all have access to a patient’s complete health record, including dental visits and diagnoses.
Benefits of bridging the divide between dental and medical care include improvement of the patient experience through the incorporation of oral health in routine medical evaluations, integrated management of chronic conditions and streamlined electronic health record systems to allow the sharing of health information.6
The report also explained the barriers to accessing oral and dental care for North Carolina residents. The primary barrier for most patients was affordability. Dental coverage is usually lacking compared to other forms of health care coverage by payers, including Medicaid. More than 1 in 4 adults lack dental insurance. Low-income residents have trouble affording what are often out-of-pocket expenses for care that goes beyond periodic cleanings. Other barriers to accessing dental and oral care include the limited access to dental care in underserved communities. Five counties in North Carolina do not have a dentist office at all.
You can learn more by reading the report by the Oral Health Transformation Task Force.
1 Periodontal Disease, Regular Dental Care Use, and Incident Ischemic Stroke
2 Oral health: A window to your overall health
Reminder: NC HealthConnex Upgrade Planned for August 2024
The North Carolina Health Information Exchange Authority (NC HIEA), and its partner SAS Institute, are pleased to announce that an upgrade is coming to the NC HealthConnex platform in August 2024.
Why are we doing this upgrade?
The goal is to modernize the NC HealthConnex infrastructure to current health information exchange standards, which will result in improved system performance and a better user experience for those participants utilizing exchange services including, but not limited to, the NC HealthConnex Clinical Portal.
Some new benefits Clinical Portal users may see include an improved Clinical Summary section allowing data to be viewed in two columns, the ability to do a text search within individual chartbook pages and additional clinical sections within the patient record.
What will this mean for my practice?
This upgrade may have different considerations for your practice depending on where you are in the connection process.
- In order to focus fully on this upgrade, we are working diligently to complete data connections for NC HIEA participants whose data connection project is currently in progress. We appreciate your full cooperation during this time to move your connection project forward.
- Onboarding activities for NC HealthConnex data exchange services will be subject to a planned change freeze starting on Monday, June 24, 2024, through August 2024. This means that planned data integrations not completed by Friday, June 14, 2024*, will be temporarily put on hold until later in the year.
*Please note: This is an updated, earlier date from the last communication.
- If your connection project has not yet started, you will remain in our onboarding queue until after the upgrade is complete.
- If you are already live, meaning your practice is already submitting data to NC HealthConnex, there is no action you need to take at this time.
Please note: This upgrade process and any subsequent downtime will not impact your compliance with the HIE Act. If you have a signed and executed Participation Agreement, there is nothing more you need to do at this time.
What are the next steps?
This upgrade is scheduled to occur over a weekend in August, during which we expect downtime and delays in NC HealthConnex data exchange services. Estimated timeframes for downtime and go-live details for the upgrade will be communicated as more information becomes available. You can check on the progress of this update on our Notices page.
If you have additional questions, please contact the NC HealthConnex Provider Relations team at (919) 754-6912.
Employee Spotlight
Therese Palkovic
Data Quality Analyst
Therese has worked for the NC HIEA for three years, originally as a contractor and then as a full-time employee beginning in 2023. Therese is a key member of the Data Quality Team. She works with NC HealthConnex participants and our technical partner, SAS Institute, to support electronic health record (EHR) integrations. As part of her work with data integrations, Therese is heavily involved in ensuring data quality standards are met and supported through User Acceptance Testing (UAT) and ongoing participant feedback.
Therese has over 14 years of experience in health IT, originally building and developing content for EHRs. She started her health care career as a consultant doing end-user training and application support, as well as custom content development. She was a subject matter expert in Centricity Practice Solutions (now Athena). She also has a background in Quality Assurance, directing a team of medical transcriptionists and is a medical language specialist.
Connex Kudos:
“The ability of this work [by NC HealthConnex] to reduce the duplication of testing (blood tests and radiology). The cost savings component of this could be in the hundreds of thousands of dollars just in the obstetrical work.”
– County Health Department