Medical organizations in North Carolina are achieving significant cost savings and improving care through the use of NC HealthConnex, the electronic, statewide health information exchange network that facilitates the exchange of health information among providers.
The N.C. Health Information Exchange Authority, within the N.C. Department of Information Technology, has established and maintained NC HealthConnex under the 2015 Statewide Health Information Exchange Act to enhance access to medical information, which helps improves patient care and outcomes and control costs. The act requires all providers of Medicaid and state-funded health care services, with certain exceptions, to connect to NC HealthConnex. The data in NC HealthConnex is also used by public health professionals at the N.C. Department of Health and Human Services.
Cary Medical Management, which manages a patient population of 40,000 individuals across 48 clinics through commercial and government value-based care contracts, is seeing the benefits of being connected to NC HealthConnex. By utilizing the data within NC HealthConnex and near real-time patient alerts, Cary Medical Management has maintained an average cost savings of around 20% of their reimbursements from payors, including Medicare.
Dr. Siu Tong, CEO of Cary Medical Management, credits a significant portion of these savings to its clinics’ use of NC HealthConnex.
Before patient visits, clinicians access NC HealthConnex to fill in critical missing clinical information in their electronic medical records, giving them a more complete knowledge of patients’ medical history, diagnoses and potential risks. Clinicians can also see what medications their patients are taking, which results in fewer mistakes, saves lives and prevents adverse drug interactions. According to the FDA, there are approximately 2 million serious adverse drug events (ADEs) in the U.S every year.
During one pilot test, Dr. Tong studied 769 patients who visited one of their nine clinics. He found that their records flagged only 11 patients for 16 drug-to-drug interactions, but incorporating the data from NC HealthConnex found 143 patients with 357 potential drug-to-drug interactions. This data meant that providers had the potential to not only save a patient a visit to the emergency department, but to also save their life.
“We’ve been treating patients with incomplete information not knowing all the serious diseases and medications which could interact with each other. After we incorporated HIE (NC HealthConnex) data into our care delivery, we were able to see the full problem for the patients,” Dr. Tong said. “We saw a 16% increase in savings from one commercial payor after incorporating HIE data, which is a pretty important value from NC HealthConnex.”
Integration of NC HealthConnex with pharmacy claims systems over the next 12-18 months will also make records on dispensed medications available, which will allow providers to know whether their patients are following recommended treatment.
Dr. Tong also credits NC*Notify, NC HealthConnex’s event notification service, with reducing their readmission rates to emergency departments. NC*Notify sends alerts to a provider when a patient presents at an emergency department or has any other transitional care event. A year after beginning to use NC*Notify alerts, Cary Medical Management had a readmission rate of 8.3% – nearly half the national average of 17% – and had achieved savings for Medicare patients of around $1 million