Recap of the September HL7 Da Vinci Project Community Roundtable
Exchanging information is much like a dancing competition – it takes partners who are willing to work hard to coordinate their actions.
Multicare Connected Care and Regence Blue Pilot Medication Reconciliation Project
That was a bedrock of the initiative that paired MultiCare Connected Care and Regence Blue Shield, now bearing results in enabling better medication reconciliation between the healthcare organizations.
The partners described their journey to implement a use case from the HL7 Da Vinci Project in September’s Community Roundtable, noting that they are achieving substantial results in improving data exchange efforts, reducing manual work for the two organizations and enabling them to redirect resources to other projects that benefit both patients and the organizations.
The effort has paid off – MultiCare has achieved dramatic improvements in its compliance with medication reconciliation requirements, while reducing the amount of manual intervention by both organizations, said Anna Taylor, director of operations for population health at MultiCare for its an accountable care organization.
Using standardized interoperability, in the form of a use case for coding from HL7’s Fast Healthcare Interoperability Resources (FHIR®) standard, helps to reduce the burden “on us as providers and as an ACO,” Taylor said. “Success in value-based care models requires data and information from partnering entities; we’re able to use this data and information to make sure that those that are the most sick and need the most care navigation get what they need to stay healthy.”Taylor also noted that using standardized coding offers the potential to reduce challenges in information exchange with all MultiCare’s payers as it works with 26 payers and has multiple contracts with each of them. Tracking compliance is difficult and expensive, she asserted.
MultiCare together with Regence zeroed in on medication reconciliation as a pilot project. They expected to gain benefits from improving the process, and MultiCare saw opportunities to enhance medication reconciliation.
Payers and providers need common transport tools to share the data required to complete medication reconciliation at all transitions of care, for care management plans, and during medication changes. Providers and care coordinators face the challenge of collecting accurate and complete patient medication records across care settings. Also, proof of 30-day medication reconciliation post-discharge is increasingly required for value-based care incentives.
The organizations sought to use the FHIR use cases for Data Exchange for Quality Measures (DEQM): Medication Reconciliation Post-Discharge (MRP), said Dave DeGandi, senior interoperability strategist for Regence, which is also working with other provider organizations to test various use cases.
Implementing the use cases for medication reconciliation required regular meetings between staff of the two organizations. Additionally, it’s crucial to gain support from leadership in both organizations for the time and effort that the work requires. Finally, the support of front-line providers was vital, and they needed assurances that improving medication reconciliation would not require extra work or changes in their workflows.
But all the hard work has paid off. Before implementing the FHIR use case, MultiCare achieved successful medication reconciliation on only 24 percent of all cases linked to Regence. Now, that percentage of all cases has risen to 62 to 66 percent, with the potential for even more improvement in the future.
For MultiCare’s part, pulling information automatically from patients’ records reduces the time that staff have to chase charts, resulting in saving five to 10 minutes per patient. Regence receives the information in a form that can be integrated into its systems, not via a spreadsheet that requires manual intervention on its end.
The early success of the medication reconciliation project has spawned additional discussions at MultiCare about other potential uses for FHIR. “We’re talking about how to restructure our data architecture to support this and whether a FHIR server can do more than we think it can. This proof of concept has been the seed. It has lit a fire under the need to move to the next level for how our data is structured,” Taylor concluded.
Providence St. Joseph Health Looking to Expand Impact of HL7 FHIR Use Cases
Expanding the impact of FHIR use cases is also on the minds of those at Providence St. Joseph Health, which is investigating how best to expand information exchange standards so they can be used to assist in supporting more than 130 value-based care contracts covering more than 1.5 million lives, said Tammy Banks, vice president of Medicare strategy for value-based care. The organization is committed to deepening engagement in value-based care (VBC) contracts with shared accountability goals over the next several years. However, it will be difficult because of variability in value-based care contracts, which often impose significant administrative burden and impede scalability of solutions.
The challenge is that most of the population health data encountered by Providence St. Joseph Health comes in non-standard, non-machine readable formats. It’s particularly a struggle when it comes to taking in data on member rosters, member claim-line detail and contract performance summaries; these challenges make it difficult to ingest data into its data warehouse.
“The current process is not scalable. When a new contract or cohort is added, our data engineers need to write, test and implement everything from scratch,” said Semira Singh, product manager for population health for the organization. “Our process is also very brittle; if anything changes in a file, our process breaks. And then lastly, our process is just extremely slow.”
Da Vinci use cases offer hope, particularly for identifying which members will be part of a value-based care contract and sharing necessary clinical data to coordinate care for these individuals. The organization now is looking to build partnerships to facilitate the exchange of information with payers around population health.
The organization is proposing work on a use case on a value-based care cost performance report, asking the Da Vinci community to come together to work on a use case that would give participants the ability to receive accurate and timely performance reports. Such a use case can support the exchange of timely and accurate information within the performance period and in a standardized FHIR format.
Recording Now Available
Want more information? Access the live recording and slides here.
To learn more about the HL7 Da Vinci Project and to join the community, visit hl7.me/davincinews.
About the Community Roundtable
The goal of the Da Vinci Project’s community roundtables is to increase public awareness among payers, providers and vendors of the resources and progress coming out of Da Vinci’s efforts. These 90-minute virtual sessions are open to Da Vinci members and the public and highlight how members leverage the Da Vinci use cases and implementation guides (IGs) in action in workflow.
Typically, two or three organizations showcase their work and answer audience questions, allowing for a vibrant discussion and fostering industry understanding of the Da Vinci work products and resulting market solutions. Sessions are recorded and available online after the event.
Join the Community
To learn more and join the community, visit hl7.me/davincinews.