Combining HIE, social services data to cut ED visits proves difficult

Emergency room sign

Photo credit: Getty/Nils Versemann

A project to coordinate services to reduce emergency department visits by homeless “super users” in Humboldt County, California, has run into thorny data governance and interoperability issues.

The project, to reduce ER visits by 15 percent among this population, is part of the Community Health Peer Learning Program, funded through a $2.2 million award from the Office of the National Coordinator for Health IT, reports Healthcare Informatics.

It involves care coordination through the North Coast Health Improvement and Information Network (NCHIIN), a nonprofit HIE that connects data from area hospitals, doctor’s offices and labs and social service work by the Humboldt County Department of Health and Human Services.

Nine months into the project’s 18-month timeline, the interface connecting the two agencies has gone live.

Yet, while the Homeless Management Information System that the U.S. Department of Housing and Urban Development requires across the U.S. has been useful in bringing county information into the project, the inflexibility of the old “big iron” system made it difficult for the HIE to send data back to it. And case managers didn’t use it on a day-to-day basis anyway.

Instead, a new cloud-based care-coordination system is being implemented for case workers to understand clients’ healthcare encounters and how to follow up, according to Healthcare Informatics.

Another big challenge has been obtaining and tracking patient consent forms allowing data to be shared among services and providers. Project leaders are trying to understand data governance in systems containing both protected health information (PHI) and non-PHI. That might require regulatory guidance at the federal level, they say.

And they’ve been trying to understand all the various players and where overlaps occur when non-governmental organizations contract with the county to perform some services. Meanwhile, project leaders remain optimistic about their chances of success, according to the article.