How HINs Work: Webinar Q&A with Troy

Can you talk a little about ECQM’s – Electronic Quality Measures, and the opportunities there are for data scientists and synthetic records?

Quality Reporting is a huge opportunity that National Networks have not yet supported. These organizations typically use fax, state HIEs or literally picking up the phone to make calls in order to gather the data required to create quality reports today.

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What do you think the role will be for regional HIEs in this larger interoperability framework?

Regional HIEs will have a place in the world as they offer more customized solutioning for their local community of providers. Sometimes this could be contracted research, it could be custom operational evaluations, etc. Having a strong local HIE creates bubbles of high quality data that can feed into the larger HIN and QHIN ecosystem.

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What does success rate / hit rate mean in your slides - is that the percentage of time you’re able to find the specific document, such as a discharge summary, that your client is looking for?

This is the most basic metric we can measure, essentially defined as 1 = we found at least one record and 0 = we found nothing. We can go a layer deeper, however, every Particle partner has a different datapoint they find most crucial. In our presentation, we measured A1c, GFR and BUN for ESRD partners where our ‘hit rate’ = 95% and of those records found, 98% had those key metrics.

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Will the ban on info-blocking allow patient access to billing/payment data?

They should be able to today via payor portals. Companies like Flexpa are working on this. Billing/payment data should also begin appearing in EMR data as well, this will depend on the USCDI expansion timelines.

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What is your view on the exchanging of Images?

DICOM will be really difficult because the file sizes are very large & will likely need a different type of network build for this. Simplified images, like JPEG, do flow through the national networks today. There is actually a live working group trying to roll this out today.

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Where might Particle be headed to help reduce the # of charts where providers do not find patient data to be actionable / relevant? (Especially for high-complexity patients, who are likely to return far more results)

This is what our FOCUS product is meant for!

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Hey Troy ... can you please comment on how Particle responds to queries? do you furnish an aggregated record?

Particle will receive an incoming query, match against our MPI and send back all the data we have on the patient. We have several options (FHIR, CCD, etc.) and adhere to each networks rules accordingly.

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Even though they have the same or similar names, not all lab values are directly comparable e.g., because they are done on different machines with different reference ranges. It has been demonstrated that some labs put LOINC codes on incorrectly, so you can’t just match LOINC codes. Can you address how you handle this issue?

There are some things we can account for and some things we cannot. In your example, you say some machines have different reference ranges - this is not something we can account for. The best we can do is consolidate, flag and serve data up using the information we have at hand. All data has provenance back to its origin systems, making it easy to reference where it came from.

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Which healthcare segment has the biggest gap in data availability? Behavioral health given that they primarily rely on siloed homegrown EMR’s and paper records? How do you think info blocking will affect this segment?

Hard to say, but this is indeed a long-tail of small specialty EMRs that have not come up the interop curve quite yet. You can probably think of this similarly to the HITECH Act that required providers move from paper to electronic… it took awhile, but today almost every provider in the US is on an EMR.

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Similar to the question about Surescripts, how do quest and labcorp fit into these networks?

Quest, LabCorp and other labs send data back-and-forth from the EMR. Orders are sent, and results are received. Particle can pull all that data from the EMRs we’re connected into.

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Does particle health integrate with EHRs?

Yes! That is what we do :)

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For what you've seen with FHIR early adopters...have you identified any common characteristics, maybe among the types of organizations, regions, use cases, etc., where data is exchanged in FHIR instead of C-CDA?

There are 3 buckets of healthcare orgs out there: (1) those not on FHIR - this is the most common, (2) those making the transition to FHIR - second most common, (3) those fully up-and-running on FHIR - this is the least common. Particle can ‘speak’ CCDA and FHIR interchangeably so it doesn't really matter where your org is today.

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Given PoU requirements, would Particle allow a provider enabling care delivery platform to use its HIE connecting API? To be clear, this platform wouldn't initiate a record request, a provider using the platform would make a patient record request.

With this limited amount of info, this seems like it would likely fit the Treatment PoU, but there are a few other qualifying questions we’d need to understand.

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What purpose of use are you using to access data?

Treatment mostly today.

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Does Particle provide access to data for large cohorts for research purposes?

No, we do not today. Perhaps as the interoperability rules mature, this could be a reality.

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Sorry I joined late, will you share the recording later?

Yes! If you missed our webinar Interop 101: How HINs Work, reach out to us at go@particlehealth.com!

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Interested in learning more about healthcare interoperability?
Stay tuned for an exclusive course we're hosting with Out-of-Pocket's Nikhil Krishnan in September 2023.

More details to come: https://www.outofpocket.health/course-library