While the COVID-19 pandemic has shown us all the fragility of life, the disease has also undisputedly exposed shortcomings in our health system in the United States. Although our frontline healthcare providers, although they are exceptional evidence of resilience, they urgently need a better and more streamlined health information technology infrastructure to care for all patients, today and tomorrow.
In this spirit, the new year tilts the exchange of health information in exciting directions, as caregivers move from practicing isolated symptomatic care to taking into account the full range of patient needs.
As part of this transformation, the accelerated population health capabilities now provided by many HIEs enable service providers to identify patients at risk and high-risk groups, where care management resources are most urgently needed.
HIE data also reports on patients who frequently use unnecessary healthcare resources. When the problem is handled appropriately, expenses are reduced and the doctor’s time allocated properly.
To help innovative service providers advance in population health, the Los Angeles Network for Enhanced Services, or LANES, provides insights into clinical data – medical, behavioral, social, and economic – to bridge data gaps and better inform decision-making.
In essence, this data enrichment service translates into critical 24/7 access to structured, high-quality, and complete patient information in real time. Our regional HIE creates actionable information in a dashboard view, with navigation to identify gaps in the fragmented healthcare system.
Built on a robust technical infrastructure, LANES is making giant leaps in 2021 to streamline healthcare delivery across the care chain in Los Angeles County. We see a path towards a better future, made possible by the involvement of the federal and state government to drive interoperability. The widespread use of HIE technology is proven to have the cost while improving the quality of care.
LANES is increasingly associated with the LA provider community
LANES commends its dedicated network of service providers, treating 7.7 million unique patients across 32 hospitals and health systems and 500 community clinics and medical practices.
Our vision is to form partnerships with healthcare organizations that support the Los Angeles communities we serve. We are grateful to the many service providers who contribute health data to LANES HIE, who are using this data at the point of care to improve patient outcomes. Our Clinical Data Repository has recorded 56 million prescriptions, 200 million clinical results, and 51 million patient interviews.
Understanding the value of relevant patient data, the Los Angeles medical community’s demand for data sharing is a powerful driver to further our initiatives. Encouraged by the active participation of the provider, LANES is continually investing in tools to generate data insights across the community within a patient’s longitudinal record.
Health care workers are champions
Never before did I remember our nation coming together to give such generous praise to healthcare professionals. They deserve the utmost gratitude and appreciation for their courage, perseverance and sacrifice in caring for patients suffering from COVID-19. Despite the difficulties and health risks, millions of essential workers appear on the front lines every day to do their jobs. They are the true heroes of this health crisis.
The severity of this horrific disease has particularly affected California. Los Angeles – America’s most populous province, with a population of over 10.4 million representing more than 140 cultures, 224 languages, and huge income disparities – continues to dominate the headlines as a national hotspot.
With 80% of LANES ‘clinical data originating from the Los Angeles safety net, our participants have access to toolkits to leverage our data assets to manage those populations most vulnerable to the coronavirus pandemic.
Against this backdrop of the challenges of COVID-19, we are proud to play a role in helping our primary care providers deploy new solutions to care for patients who comply with social distancing. In March 2020, LANES co-CSC Health implemented our HIE platform together with Telehealth Technology.
Previously, CSC Health relied on a “horse and carriage delivery system” to obtain paper medical records of patients from local hospitals and physicians’ offices. The request process involved old communication methods – mail, fax, and phone calls – that were sometimes repeated multiple times.
Federally Qualified Health Center implemented LANES at the start of the pandemic, dramatically improving timely access by 75% in online recoveries of the hospital’s emergency room and hospital records from participating service providers.
“Rapid access to patient records during the COVID-19 pandemic has become more valuable, medically necessary and urgent,” said Dr. Felix Aguilar, Chief Medical Officer at CSC Health. “The LANES platform provides quick access to community medical records, including a comprehensive medical history. The clinical portal is well-designed and easy to use, which is important in times of national crisis, when clinicians need tools that allow us immediate access to real-time patient data.” .
To further support frontline health care workers, LANES is collaborating with state and county public health agencies and laboratory companies to collect and share laboratory test results for COVID-19, and immunization information soon.
LANES will focus on three main areas in 2021
Although healthcare has traditionally lagged behind other industries in digital adoption, we have observed that the pandemic has forced many service delivery participants to quickly switch to remote services and empower population health. With this in mind, the following is the 2021 Health Information Sharing Strategic Roadmap that is anchored in three main areas:
1. Get data assets
Rich clinical data and population health data have the potential to help transform our regional healthcare system.
For LANES, obtaining our high-quality HIE data depends on the availability and sharing of patient information from our valued public and private healthcare delivery partners. This year, as part of our vision, we will continue to build new partnerships with participants to leverage our clinical data assets. Participants have access to our dynamic data and service technology that supports the flow of patient information across the Los Angeles healthcare chain.
LANES Clinical Data Assets provides 360-degree insights into patients’ personal health information to help service providers make informed decisions about actionable care, treatments and interventions. Studies have demonstrated that the power of clinical information gathered about a patient’s medical history, along with behavioral and social determinants of health factors, can predict or diagnose diseases in order to better manage case outcomes.
The gathering, normalization and provision of high-quality data at the regional level has been the hallmark of the LANES technology infrastructure, given that the majority of healthcare is provided and consumed locally. We see this as a clear advantage over national HIEs such as CommonWell and Carequality.
Los Angeles’ severely fragmented healthcare system requires a proven data aggregation solution to solve inequalities and disruptions in care. Establishing a coordinated and connected care system via the value of HIE accumulated information and leveraging its potential can be one answer.
2. Privacy and security
LANES is committed to a strong and secure HIE organization and has implemented policies, procedures and practices over the past few years to support this commitment. Protecting sensitive patient information is a top priority amid growing data threats.
HITRUST CSF Certified, the world’s gold standard for information security – or as our Chief Information Security Officer likes to describe the approved framework: “HITRUST is HIPAA over steroids.”
LANES works diligently to examine and support the complexities of patient consent through continuous consultation with HIPAA’s legal experts and our community privacy and security experts working on the LANES Privacy and Security Advisory Council. Permissible use of data is guaranteed by robust data sharing agreements with our participants.
We have earned participants’ trust and confidence in our commitment to excellence in customer service and responsible data management.
3. Clinical use cases
Our clinical implementation team will work closely with leading clinicians, care coordinators, and other medical professionals to develop results-based use cases.
We will measure the application of participants providing our HIE technology services to solve complex interoperability challenges according to the first requirements of the CMS Interoperability and Patient Access final rulebook starting January 2021. Our tools and services, using FHIR standards and APIs, support our service provider meeting new CMS rules.
The team will consider measured improvements gained in health outcomes and key performance indicators that track clinical, operational and business performance. We also learn about several cases where LANES played a significant role in minimizing the benefit of unnecessary emergency department visits and hospital readmissions.
We can all agree on evidence-based HIE use case studies that support the idea that health information technology can improve the quality, safety and efficiency of care delivery and contribute positively to enhancing the patient’s care experience.
LANES use cases will range from transmission of care to referral management and effective care coordination. We are proud of the many multi-care facility providers in Los Angeles in hospitals and clinics participating, collaboratively, in this important endeavor.
In conclusion, our three priorities for 2021 are in line with the full integration of the IHI triple goal of simultaneously improving population health, improving the patient’s experience of care and reducing cost.
Ali Modrisi is the CEO of LANES, a non-profit organization responsible for managing community health information sharing for hospitals, health systems, clinics, investment promotion agencies, and health plans that provide care to residents of Los Angeles County.