Brooklyn HIE leverages infrastructure to advance value-add services

The Brooklyn Health Information Exchange (BHIX), incorporated in mid-2007 and operational since mid-2009, continues to add new stakeholders and data, gaining momentum and reaching critical mass. But 2011 will see the veteran HIE going beyond basic data exchange to create value-added services for its stakeholders.

BHIX has been collaborating with providers who jointly take care of mental health patients to deliver continuity of care and wraparound services – including medical, mental, housing, transportation and therapy – in New York City. "We're trying to build technical services that will help coordinate the care of that population," said Irene Koch, executive director since 2007.

The mental health community project is benefitting from the HIE's scalable and continuously enhanced infrastructure. Users can access data through BHIX, but they can also leverage the secure platform to send clinical messages and referrals to relevant healthcare providers, and to receive event notifications, or proactive alerts – for example, to inform them that a patient from their patient-centered medical home (PCMH) has been admitted to an emergency department or other facility.

BHIX also contributed to an R&D effort, which included the Indiana HIE and CareSpark, for the Center for Medicare & Medicaid Services' Physician Quality Reporting Initiative (PQRI). As a result of its participation, BHIX enables reporting of the Quality Reporting Document Architecture through its HIE infrastructure and NHIN Gateway, which is an advancement over the traditional methods of getting the PQRI report into a registry or downloading reports from a healthcare provider's electronic medical record (EMR).

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Healthcare providers have been able to send messages and quality reports to CMS for the program in the past, but the bidirectional capability from the R&D project will allow healthcare providers to receive feedback from CMS. The feedback, which had been a missing critical component of the program's quality improvement goals, will now give healthcare providers a more reliable and timely way to adjust care treatment plans and improve patient care.

In April, BHIX anticipates going live with advanced clinical decision support (CDS) and care management functionalities in support of deeper advanced PCMH projects. Offering CDS and analytics through the HIE instead of through one EMR leverages the power of aggregated data across the community, Koch said. BHIX's infrastructure will also support patients' personal health record portal.

These services were built to support the goals of patient-focused grants and to meet the needs of its various stakeholders, which include nursing homes, home care, in-patient and out-patient facilities, and so on, said Koch.

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