How the Constantly Changing Technology Landscape is Helping Improve Patient Care - Part 1

Podcast Transcript:

Integrated Healthcare Executive: Hi Integrated Healthcare Executive listeners. My name is Julie Gould, associate digital editor. During this podcast series we will hear from John D’Amore of Diameter Health. In Part 1 you will learn a little about John and Diameter Health. He will also provide an overview of how health organizations are currently using health information exchanges.

In episodes 2 through 8, John will discuss how technology and data integration use in practice impacts health care and patient outcomes.

Stay tuned for each episode – they will be posted weekly. Enjoy Part 1!

Integrated Healthcare Executive:  Can you first tell us a little bit about yourself, your background, and Diameter Health?

Mr D'Amore:  Sure. Thanks so much, Julie, for having me here today. My background is I worked first in healthcare consulting, then in a large healthcare system. Went over to work at a large EHR company.

Became involved with both the regulations around information interoperability, how information is recorded and transmitted between providers. Got involved with HL7 and then eventually was the founder of Diameter Health. I've been across the whole spectrum of being at an industry level, being at a provider level, being at a vendor level.

Diameter Health fits a lot of that convergence of being able to take data from virtually any clinical source system and be able to normalize that, deduplicate it, enrich it, organize it in the appropriate way so that that information is ready and available for both clinical analytics and reporting, but also for clinical care at the bedside.

Integrated Healthcare Executive:  How does Diameter Health work with and improve health information exchanges?

Mr D'Amore:  One of our primary client bases is health information exchanges. As you may know, health information exchanges exist on a regional level. They've gone by many names over time.

Previously, they were called RHIOs, Regional Health Information Organizations, CHINs, Community Health Information Networks for it. Now, more recently being called HIEs, or Health Information Exchanges.

Some of them are on a regional level. The New York Metro region has one. Philadelphia has one. Some of them are state-wide which, essentially, they'll serve the whole state of Colorado, or Kansas, or Arizona for us.

We work with HIEs both at a regional and a state level. They've been receiving data that's been recorded in EHRs now for the past several years, coming out of the HITECH Act for meaningful use.

What we do is we sit there. After they receive that information we're able to parse, to extract clinical information, to normalize that information, be able to put it into ways that they can understand it. They can, effectively, deduplicate it and also organize that information. Then their use case for that is twofold.

One is that when you go and ask a health information exchange for information on a patient and, presumably, for a lot of the patients that you're interested in, they're generally patients who have been sicker, they may have been to 5, or 7, or 10, or 15 providers over the course of the past year.

You don't want that health information exchange to respond with 15 disparate sets of information on a patient. As a provider, either clinician or a doctor receiving that information, you don't want to look at 15 problem lists, 15 med lists, 15 allergy lists and have to reconcile all that information recorded at different EHRs at different points in time.

It's much more in the workflow of clinicians to be able to receive one longitudinal, complete, and deduplicated summary of that patient information. That's a fundamental value proposition that we serve to the HIE market. The other one, which is very core and valuable, is to be able to use that data for analytics and quality reporting purposes.

When they collect all that information on patients, they can calculate care measures or quality measures for that, ECQMs, Electronic Clinical Quality Measures. Be able to use that information both for reporting to value-based care programs and ACOs as well as, also, to be able to send that information along to payers so that they can use it in their reporting programs.

Fundamentally, those are the two arms that we serve for the health information exchange market. One, being on the provision of information for clinical care and two, being on the provision of that data in a normalized format for analytics, population health, quality measurement, and downstream uses.

Integrated Healthcare Executive:  How are health organizations using health information exchanges to improve quality measures and care management?

Mr D'Amore:  That's a great question, Julie. In terms of when you think about ambulatory care quality measures, the things that are important and that are being required to be measured both by the federal government but also by private payers and state payers for this, you think about things like, is a patient over a certain age getting the right preventative screening?

If you're over 50, did you get your colorectal cancer screening which might be a colonoscopy or some other diagnostics, or things that are specific to a disease? Being able to say, is your diabetic patient getting their glucose managed in a way that's going to help them have a good outcome, reduce their chance of heart attack, stroke, other micro-vascular retinopathy, and other diseases for this?

What you want to do when you're looking at quality measurement is you want to have a full picture of that patient. You want to be able to take data from every provider that they've seen, any source of data, any EHR. You want to be able to bring that data together. Unfortunately, today a lot of quality measurement is done on a very episodic and siloed basis.

As a primary care physician seeing a patient, you might have a good chunk of the data on that patient. If that diabetic patient has been to an endocrinologist or a nephrologist and you don't have the flows of information coming back from that specialist, you're not necessarily going to have the complete and longitudinal record.

When you're doing something like quality measurement, like asking if the glucose has been in good control, having all the information is critically important to being able to have the right quality measurement. It's also really important for care to have that. That's a core component, a core function of HIEs.

It's incredibly enabling and going to be part of their long stay value proposition is being able to bring all that data together, not just to be a middle man, not just to send that data from point A to point B.

To be able to say, "Hey, this patient is getting good care," or, "These patients over here need more attention because right now they're not in compliance with this other quality measures."