Texas HIE partnership aims to boost data sharing for critical care

Improving critical care transitions with a bidirectional data connection

Bamboo and THSA stressed that the partnership moves healthcare interoperability beyond just sharing data to ensuring that it is shared when providers must make critical decisions. Real-time event notifications across Texas could allow healthcare organizations to improve care transitions from one type of care to another and enhance follow-up after a patient is discharged.

Healthcare organizations already connected to THSA's HIE can now connect to Bamboo to receive ADT notifications. Providers or payers can access data in their EHR or population health platform through Bamboo's interface using Secure File Transfer Protocol or HL7, according to Kapur.

For instance, if a patient at a Texas clinic that's connected to HIETexas traveled to an emergency department outside the state, the ED could notify the clinic using Bamboo Health's network, according to Bamboo. Similarly, a health plan connected to Bamboo may have members being discharged from a Texas hospital on the HIETexas network. The plan's care team can now receive notifications through Bamboo, enabling quicker follow-up.

This data access will simplify patient discharge planning, which can involve complicated information sharing around scheduling and follow-ups, Kapur said.

Friction also occurs between providers and patients due to inadequate communication and data sharing, she suggested.

"[We] leverage ADT data to help automate some of those workflows to really help ease that process, not just for the scheduling functions and the case management functions within a healthcare setting but also for individuals who are struggling to navigate that system," she said.

Data from the partnership could help an elderly patient being discharged from the hospital get matched with physical therapy or occupational therapy closer to home, for example.

"When an elderly patient is discharged from the hospital, the care team can be notified in real time of the hospital visit through Bamboo Health," Beckett said. "This will allow them to help coordinate care for the patient, assist with additional referrals and appointment scheduling, and help determine the level of care and access they need."  

Connecting data networks reduces complexity

Typically, healthcare organizations access data from multiple sources, which is "expensive and inefficient," according to Beckett.

In fact, depending on the EHR vendor, data interfaces could cost $20,000 in addition to roughly $5,000 per year in maintenance, he said. Providers face difficult decisions in determining whether the data interface would be too costly, even with the benefits of care coordination, Beckett explained

Due to this cost, providers may opt not to share data, Kapur noted.

"They just don't participate, and we know that happens today, and we want to reduce the barriers for sharing," she said.

The partnership  aims to help providers avoid the separate integration fees of multiple systems by using a single connection that Bamboo and HIETexas provide, according to Kapur.

The ability to expand the reach of event notifications  will also improve care in rural and underserved communities, where patients often must travel hours or cross state lines for a doctor's appointment. Because of these long distances, providers may not find out for days or weeks when patients are discharged or transferred between facilities, Kapur explained.

Further, the partnership allows patients to continue care with their local providers within their communities by enabling real-time visibility of data. That allows patients to receive timely follow-up care or medication and enables treatment coordination, she said.

If a patient is traveling from San Antonio to Dallas and then gets hospitalized in Dallas, the provider in San Antonio may not know that the patient was admitted in Dallas, Kapur explained.

"That's a problem because a PCP in San Antonio can't really manage care effectively because they don't know that I was just admitted in Dallas," Kapur explained.

But the partnership would allow the PCP in San Antonio to access the patient's data from the hospital in Dallas through a bidirectional interface, enabling coordination of care.

However, despite the apparent benefits, she noted that some providers in Texas still do not share vital data.

"We hope that this might be a clarion call for them to participate," Kapur said.

She would like to see this partnership inspire other HIEs in the United States to form similar public-private alliances involving bidirectional data sharing.  

Beckett noted that building these types of data-sharing partnerships will involve building trust.

"Data sharing occurs at the speed of trust," he said. "So organizations have got to trust each other and build a relationship, and I feel that we've done that here."

That interoperability will benefit patient care coordination is well-documented. And, as data-sharing efforts advance, restricting data sharing is tantamount to squeezing sand, according to Beckett.  

"If you try to hold on to it, it runs out," he said. "But if you open and [are] willing to share, as we are, that opens up a lot more opportunities. It's for the benefit of patients, and, in Texas' case, for all Texans."

Brian T. Horowitz started covering health IT news in 2010 and the tech beat overall in 1996.