SYNCRONYS December 2021 eNewsletter

Converting individual healthcare data into meaningful insights to treat your patients.  SYNCRONYS has built a longitudinal clinical record and partnered with leading health IT organizations to leverage the power of data.  Learn how the Hep-C Use Case, developed with Rhodes, the Diagnostic Images Use Case, developed with eHealth Technology, the Advance Directive and MOST Forms Use Case developed with Vynca, and our Coordinate Use Case developed with Orion, will improve the care you provide to your patients.

Use Cases

Hepatitis-C

SYNCRONYS’ Hepatitis C Tool: By the Numbers

Figure 1. Number of new HCV diagnoses identified per month.

In October 2021, SYNCRONYS released a valuable tool to help New Mexico clinicians understand and treat individuals with Hepatitis C.  This tool, developed by New Mexico’s Rhodes Group (Rhodes), aggregates, and analyzes all of SYNCRONYS’ laboratory tests pertaining to Hepatitis C and presents them to users in an up-to-date, easy-to-read summary document.  The tool is displayed along the left-hand side of the screen when reviewing a patient’s record.  If the patient has testing indicative of an infection, it will display “Hepatitis C Summary.”  The Hepatitis C Summary will display all the patient’s most recent Hepatitis C Laboratory testing and risk factors.  The tool will automatically calculate APRI and FIB scores (if possible) enabling users to quickly ascertain what the patient may need prior to, or during, management.  This Summary document is to help users complete New Mexico Health and Human Services Department’s HCV Checklist.

Another valuable feature this tool will provide New Mexico healthcare is aggregate statistics so leaders throughout the state can understand the status of Hepatitis C from an epidemiological perspective.  For example, SYNCRONYS and Rhodes can now identify the number of patients with new infections (Figure 1) as well as the number of patients who have achieved a sustained viral load (Figure 2).  Through this new feature, SYNCRONYS and Rhodes intend to further the understanding and management of Hepatitis C in New Mexico.

Figure 2. The number of patients who have achieved a sustained viral load as identified through lab data.

To learn more about the HEP-C Use Case reach out to us at info@syncronys.org.

 

 

This Photo by Unknown Author is licensed under CC BY

Diagnostic Images

Medical imaging is a vital and yet costly component of healthcare.  Medical imaging is one of the most important tools in the diagnoses and treatment of many conditions such as cancer, heart disease and stroke.  At SYNCRONYS our tagline is Better Data, Better Health, and imaging is key to achieving better health, however, the question often is at what cost.  Our collaboration with eHealth technologies and their eHealth Connect Image exchange allows quality, diagnostic images to be accessed and displayed in our portal for our subscribers.  Access to this important information enables faster, more efficient, and effective care delivered by healthcare providers and controls cost by eliminating duplicative or unnecessary imaging.

Advance Directive and MOST (Medical Orders for Scope of Treatment) Forms

The MOST program protects and promotes patient autonomy in several important ways by addressing physical, mental, spiritual, and social needs to improve the patient’s quality of life.  A few highlights of this program are below –

• The MOST is created in conjunction with a healthcare provider and addresses a patient’s current situation
• The MOST is very visible and is transferable to other care settings
• The MOST captures a patient’s preference regarding resuscitation
• The MOST allows a patient to define the level of care that is consistent with their care preferences
• The MOST is signed by a physician, APC, or PA allowing for greater compliance by other providers

Through our partnership with Vynca, and their serious illness management platform, completed MOST forms are accessible in the SYNCRONYS portal.  Patients who do not currently have a MOST form outlining their advance directive can create one within the portal in just a few minutes.  When the patient’s wishes are documented, families can focus on their loved one.

Coordinate                              

Our partnership with Orion Health has led to a remarkable option for our subscribers, Coordinate.  The Coordinate solution provides fundamental models of care aligned to an array of treatment best practice guidelines. Coordinate can be seamlessly implemented throughout the healthcare system, within a hospital, ambulatory settings and across an entire community. Coordinate supports a wide range of task demands, from simple risk assessments to highly sophisticated predictive workflows that can follow individual patients through their care programs.  The benefits are many but include:

• Organizations can design and manage care delivery models
• Bring the care team together and support multidisciplinary care models
• Standardize policy, procedures, and processes within the organization
• Leverage and contribute to integrated care records
• Reduce hospital admissions, readmissions and missed appointments
• Treat patients at the right place and the right time

In addition to the above, tasks can be assigned and creating smart and flexible forms, that work for your organization, enable fast and accurate entry of information.  As you can see, Coordinate may be a valuable solution for you.

 

SYNCRONYS provides the following Use Cases along with our valued partners.  If you need more information about these or any of our other solutions, contact us at info@syncronys.org.

Substance Use Disorder	Collective Medical
Emergency Department Optimization	Collective Medical
Transitions of Care Management	Collective Medical
Collaboration and Coordination of Mental Health	Collective Medical
Conditions of Participation	Collective Medical
HCV	Rhodes
Diagnostic Images	eHealth Technology
Advance Directive and MOST Forms	Vynca
Coordinate	Orion

 

 As we look at healthcare news around the nation, we found the following from the AMA. 

 

What is information blocking?

The 21st Century Cures Act (Cures Act) was signed into law on Dec. 13, 2016. Included within the law are provisions related to “information blocking.”

The law outlines the four types of “Actors” for whom information blocking provisions are applicable and for whom enforcement actions apply:

• Providers
• Health information technology (health IT) developers
• Health information networks (HINs)
• Health information exchanges (HIEs)

 

Physicians, health IT developers of certified health IT (e.g., EHR vendors), HIEs and HINs will be subject to information blocking requirements as it relates to the sharing of electronic health information (EHI) data starting April 5, 2021.

Currently, only a subset of the patient’s entire electronic medical record is considered EHI. This subset is called the U.S. Core Data for Interoperability (USCDI). Many EHRs can already support most of what is outlined in the USCDI, but those that cannot are being updated to support of all data elements in the USCDI. This will take time and, for some smaller EHR vendors, may take several months. Make sure to check with your EHR vendor on their progress and ask about their efforts to help you comply with the information blocking rule. After October 6, 2022, all physicians must make all of their patients’ ePHI (not just the ePHI in the USCDI) available for access, exchange, and use.

While the Cures Act specifies penalties for health IT developers, HINs and HIEs, Congress left it up to the Department of Health and Human Services (HHS) to issue regulations on “disincentives” and enforcement policies for physicians. At this time, HHS has not yet released information on physician penalties.

Information blocking practices can be an Actor’s acts or omissions—essentially anything that interferes with the access, exchange or use of EHI. However, just because an action interferes with the access, exchange or use of EHI does not mean the practice is automatically considered an information blocking violation—facts and circumstances unique to each action should be considered. For instance, physician Actors must have the required knowledge and intent to interfere with access, exchange or use of EHI. Information blocking practices may include but are not limited to:

• Limiting or restricting the interoperability of health IT;
• Implementing health IT in ways that are likely to restrict the access, exchange or use of EHI;
• Acts that lead to fraud, waste or abuse or impede care delivery enabled by health IT (for example, modifying EHR data reported to federal payment programs such as MIPS) and
• Having the capability to provide same-day access to EHI in a form and format requested by a patient or a patient’s health care provider but taking several days to respond.

 

Physicians may implicate the information blocking rule if they knowingly take actions that interfere with exchange, access, and use of EHI, even if no harm materializes.

For nearly all EHI requests, physicians must respond and release patients’ medical records unless an appropriate exception can be identified and used. ONC has identified in regulation “reasonable and necessary” activities that are not information blocking (i.e., information blocking exceptions). For instance, medical practices may need to restrict access to patient records in their EHR due to data privacy or security reasons—such as when a patient’s consent is required but not documented or in instances of cybersecurity threats. Individuals or other entities may also request medical records from a physician’s office in a manner not supported by their EHR—such as requesting documents over application programing interfaces (APIs) when APIs are not supported by the practice’s EHR. There are eight information blocking exceptions (PDF), spanning across two categories:

• Not fulfilling requests to access, exchange or use EHI
  • Preventing harm exception
  • Privacy exception
  • Security exception
  • Infeasibility exception
  • Health IT performance exception
• Procedures for fulfilling requests to access, exchange or use EHI
  • Content and manner exception
  • Fees exception
  • Licensing exception

ONC makes clear that an Actor’s failure to meet an exception does not automatically mean that the Actor has engaged in information blocking. Just because there is no relevant exception or a physician fails to meet all requirements of an applicable exception, does not mean that the physician will necessarily be found to have engaged in information blocking. The federal body tasked with enforcement and investigations—the Office of the Inspector General (OIG)—must still determine that the action taken by the physician meets the definition of information blocking.

Where to start?

Physicians should start by identifying whether their organization already has a compliance program, even if it has not yet begun to work on information blocking compliance. This is important because your existing compliance program will have structure, policies, procedures, and resources that will lay the foundation for information blocking compliance. Info blocking regulations and requirements are new for everyone; do not be surprised if your organization’s compliance professionals are not knowledgeable about the information blocking rule. If your organization does not have a compliance program, then it is important to stand one up—both for information blocking compliance and for compliance with laws like HIPAA.

You should consider starting with your organization’s policies that currently address requests for access, exchange, or use of patient medical information. This is particularly important for situations where patients or their non-clinical caregivers are requesting electronic information. Medical practices are urged to review all policies related to their responses to information requests and update their policies and procedures as needed. This should include both HIPAA policies and those governing confidential or sensitive patient information, including information related to adolescent health. Your policies must address each of the information blocking exceptions prior to the exception’s use. You should detail how each exception can be met to ensure that the exception is applied as narrowly as possible and in a non-discriminatory manner.

The AMA has created a two-part educational resource to help physicians and their medical practices understand the requirements and develop an information blocking compliance program. Part 1 outlines what information blocking is, key terms to know, examples of information blocking practices and a summary of exceptions for when physicians may restrict access, exchange, and use of EHI. Part 2 helps physicians start down the path of compliance, including questions to consider, considerations for maintaining a compliance program and next steps. AMA is also offering an online Continuing Medical Education resource to help physicians learn while receiving CME credit. Additional information can be found at infoblockingcenter.org.

As we end 2021, the SYNCRONYS Team would like to thank you for your support and business, and we wish you a peaceful holiday season and a prosperous new year.  If you would like more information about our Use Cases, or any other solution SYNCRONYS provides, please contact us at info@syncronys.org, and our website is always open at syncronys.org.