HIEs Carving Out a Role in Community Information Exchange Space

As technology solutions develop to enable data sharing and referrals between health systems and community-based organizations, traditional health information exchanges (HIEs) are starting to play a role in the community information exchange (CIE) space.

The North Coast Health Improvement and Information Network (NCHIIN), a California nonprofit organization providing both health information exchange and health improvement in Humboldt County, is working with a platform called NinePatch to allow it to serve as the CIE in the region.

NinePatch was developed by QS Systems, a partnership between Stella Technology and Quality Health Network of Grand Junction, Colo. They are working in Western Colorado under the name Community Resource Network.

QS Systems recently named Leigh Sterlings its CEO. She had served as CEO of the East Tennessee Health Information Network (etHIN) since 2010.

“QS Systems’ NinePatch platforms helps create cross-community coordination of services, and Leigh's innovative approach uniquely qualifies her to lead QS Systems,” said Dick Thompson, QS co-founder and CEO of Quality Health Network, the HIE serving western Colorado, in a statement. “Leigh brings national leadership and on-the-ground expertise to solve the complex challenge of achieving whole person care for a community.”

“Our partnership with QS Systems and implementation of NinePatch will allow us to execute on our CIE vision,” said Martin Love, NCHIIN CEO, in a statement. “It is a constant challenge for Humboldt County community members to find the services they need to keep themselves and their families healthy. There are many complicated systems to navigate through to have easy and proper access to services.”

NCHIIN sought a solution to the coordinated information sharing and closed-loop referral process across medical, behavioral and social health domains, allowing collaborative organizations to address care and wellness from a whole person perspective.

NinePatch says it builds on the power of HIEs to connect these three fragmented sectors through simple, visual, and powerful tools. “We went through a comprehensive evaluation of the established solutions in the market, and were impressed with the rich set of functionality NinePatch provides to help solve a very challenging problem. It checked all the boxes for us,” Love continued.

NCHIIN has been working on improving interoperability between healthcare and social service agencies for several years. In a 2016 interview with Healthcare Innovation, Love described how the organization was at the center of an effort to reduce emergency department utilization by the indigent, high-need population in Humboldt County by 15 percent over one year. The project involved working through some thorny data governance and interoperability issues.

NCHIIN built an interface between the Humboldt County Department of Health and Human Services Social Service Homeless Management Information System and North Coast’s HIE to share data from electronic health records and public and private records. Social services case managers received alerts about clients’ health center/hospital visits for follow-up care coordination.

The project was part of the Community Health Peer Learning Program, a national peer learning collaborative managed by AcademyHealth through a $2.2 million award from the Office of the National Coordinator for Health Information Technology.

Love said several issues arose as they tried to bring data together from different types of systems. “I think it is fair to say we were naïve when we started the project, and had a sense that the data systems at the county would be like the data systems in healthcare but a slightly different color, but that is not true,” he said. “They are very different. The Homeless Management Information System is HUD-required software used throughout the United States. It is ‘big iron,’ — old and not very flexible. It has a lot of problems.”

Yet another issue for the HIE was trying to understand the organization of all the county programs. There are non-governmental organizations that contract with the county to do some of the work, and there are overlapping programs. “It is interesting to us how many different programs there are, and sometimes it is hard to keep it all straight,” Love said. “But it has been a pleasure working with the county. In some ways, they have been easier to work with than healthcare.”