Community Record of Care for Accountable Communities of Health

September 28, 2015

MIN-NS Health Information Sharing

Written by Duncan West

Language and names are funny things. The word “Exchange,” in “Health Information Exchange (HIE)” has become a noun, a description of the software and processes which move patient care documents from provider to provider. The term arose from the statewide initiatives fostered and funded by the ARRA Hitech Act. A recent Robert Wood Johnson Foundation assessment of the various “ObamaCare,” Healthcare Information Technology initiatives gives a mixed grade to those statewide HIE initiatives, noting a number of barriers to their ongoing success.

The statewide HIEs grew from an earlier concept, the RHIO or Regional Health Information Organization. That older (as in early 2000’s) model is what MIN-NS has become. MIN-NS continues to serve our customers with the community records of care for individual patients. In addition, MIN-NS now alerts providers and case managers of care visits and follow up needs of ‘their’ patients and clients. This is accomplished using patient and client registries shared securely with MIN-NS.

We serve providers and patients in all corners of our region-from islands in the Sound into the Cascade Mountains.  Like other non-metropolitan areas of the state the MIN-NS community population is aging. As they age, their need for specialty care increases and spreads organizationally and geographically. MIN-NS’ data shows rates of patients sharing across providers 30% to over 100% higher between the under and over 65 population. Patients in the more rural and remote counties in the market are 20% more likely to be shared among providers than those in Skagit County.

Figure 1 Percentage of patients shared between two or more MIN-NS' customers.

Younger and working well patients receive most of their care from ambulatory providers within their community. However, the location of younger patients in Island and San Juan Counties means that when they need intensive care they 2/3rds more likely to get care from multiple organizations than their mainland peers. Forty three percent of the patients seen during a recent month were share across organizations at a hospital and clinics at the pivot point of the region

After several years of building the community record of care MIN-NS has built base of community records30% of the patients seen for the first time in August at our customers already had records in the HIE. that for patients seen for the first time at our customer site in August of this year , 30% had records of care available in the HIE. Of the 9 thousand plus patients seen for the first time by our customers, 2700 already had records in the MIN-NS HIE. The other 6400 brought our total unique patient count to over 287 thousand..

Healthcare reform is demanding better care coordination across these care settings and political boundaries. MIN-NS understands and has adapted to meet the needs of the providers for these active, mobile patients. We have grown and delivered solutions that support care of individual patients. We are evolving to support population health management initiatives of our subscribers to ensure that patients who need care are identified and brought to the attention of their providers when the visit the Emergency Department. As part of this growth and change at MIN-NS has updated our web site design to reflect our more mobile population and our emerging population health focus.