Connecting to Data in Primary Care

featuring Jonathan Bush, CEO of Zus Health

June is going to be hot at XPC. Here’s why 1) Primary Care 101 course 2) XPC Hackathon

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Onboarding a new patient in a primary care office is a crucial but painful process. Currently it involves a combination of patient self-reported conditions on a clipboard and record retrieval by the primary care physician (PCP) office from wherever the patient was previously seen, assuming they can remember all the locations. The clipboard process is repetitive and often redundant, and the records retrieval process can be arduous.

Currently, the records process goes through these steps:

1. Patient fills out “authorization to release records” form or forms.

2. PCP office faxes the forms to the respective specialist or previous PCP offices.

3. PCP offices tracks whether or not the outside offices have responded to the request and follows up on those who don’t send records.

4. When records do come, they arrive as a packet of mostly useless and repetitive information. Most will arrive electronically by e-fax, but some come by physical paper fax or even regular post office mail.

5. Received records are scanned into patient chart.

6. PCP skims through pages of useless noise to try and find meaningful information about their new patient.

Fortunately, the world of interoperability has advanced significantly and has the potential to simplify this process.

Most patient data currently sits in three large Health Information Networks - Carequality (Epic focused), CommonWell Health Alliance, and eHealth Exchange (mostly government affiliated data, e.g., the VA). While some EMRs, such as Epic have access to these networks, allowing users to see data from outside their office immediately, most EMRs do not. Connecting to the Networks requires technical skill, understanding of regulation, and time, which most clinics, startup companies, and smaller EMR companies do not have to undergo the endeavor themselves. Catalyzed by the 21st Century Cures Act, companies have emerged to simplify the process by building connections to the HINs and then linking those via API to end users who want access to the networks.

Zus Health has focused on EMR integration, partnering with Healthie, Canvas, and Elation. Particle Health focuses more on data analytics for end user companies such as Oak Street and One Medical (initially as part of Iora, and now part of Amazon). Health Gorilla has completed the regulatory process to become one of the first Qualified Health Information Networks (QHIN). For a great intro to interoperability, check out Particle Health’s white paper.

Making care more interoperable is a game changer for PCPs. Better information at point of care allows for delivery of higher quality of care. Moving patient data across a multitude of healthcare silos is a huge challenge, and we’re rooting for everyone tackling it.