Washington takes the pain out of health data exchange
- By Amanda Ziadeh
- Aug 30, 2016
If there’s one field truly burdened with paperwork, it’s health care. If there’s another, it’s government. For the claim managers who oversee benefits for ill or injured workers at the Washington state Department of Labor and Industries, that combination was slowing injured workers’ return to work and making it difficult for health providers to do business with the state.
Washington’s healthcare providers were faxing or mailing more than 7.4 million pages of medical information related to workers’ injuries or illness to the state's Department of Labor and Industries. Besides the inevitable issue of the same information needing to be filled out on multiple forms and entered into different systems, paper forms also increased the chances for inaccuracy, because of illegibility or incomplete information. And once the forms were in the hands of agency, they were converted to images, making it impossible to automate extracting data from them. At times, the storing, interpreting and correcting of the documents delayed medical decision making and the employee’s ability to return to work.
The department wanted to streamline the communication of data on injured workers with a system in which the state and health providers could seamlessly and securely share clinical data about injured and ill workers with the state. “We really are trying to create transactions where we can automate that data,” the department’s business lead, Noha Gindy, told GCN. She knew an online exchange would reduce the number of paper forms, speed up the claims decision process and provide system-to-system security.
Leveraging OneHealthPort, Washington’s statewide secure health-information exchange, the department implemented an HIE so that healthcare organizations and the state could share clinical data. Piggybacking on OneHealthPort eliminated the need to for the department to build its own secure exchange from scratch.
The data exchange was piloted with two partner health organizations, MultiCare Health System and Proliance Surgeons, that helped test the exchange of data on the commonly used Activity Prescription Form. The Labor and Industries gave its partners implementation guides outlining how they should register with OneHealthPort and prepare XML-formatted data to be read and transmitted by the HIE.
According to Gindy, it took about six months for the department to set up the transaction for the Activity Prescription Form, then two to three months for each partner organization to embed the form into their electronic medical record systems. When implemented, treating providers can input data into their systems, and it will automatically populate the statewide HIE and alert claim managers.
The project team also worked with internal technology teams to scale the HIE for enterprise-level adoption and expansion. It created centralized data repositories and business rules for future data sharing and enabled statewide care coordinators and claim managers to access the data for their own business needs.
“Everybody has a slightly different need for the data, and having it at an enterprisewide level and not siloed in a particular business area helps us accomplish that,” Gindy said.
The Labor and Industries Department now collaborates with four healthcare organizations through the HIE, some representing hundreds of providers treating injured workers. “We receive on average about 25 percent of our Activity Prescription Forms through the HIE annually,” Gindy said, and the department has plans to add transactions for more medical claims forms in the future.
The system also improves the process for providers using FileFast, a direct entry claim-filing system the department launched in 2011. The HIE eliminates the need for providers to rekey information to FileFast by allowing them to configure their electronic medical record systems to send information directly to the department. Gindy said the Labor and Industries Department will continue to support all current methods of information delivery from providers, including paper forms.
Through with the HIE, the department projects saving $4.1 million during the first four years. “We’re hoping to see claim resolution rates go up and the timed claim resolutions go down. Overall that’s always an important measure for us,” Gindy said. The department wants to introduce this technology to as many healthcare organizations as possible and explore the benefits of having this data available statewide.
Amanda Ziadeh is a former reporter/producer for GCN.