New Jersey-based Osler Health is a clinically integrated network of physicians who work collaboratively to deliver quality care for 86,000 lives in value-based contracts. The network transformed into an accountable care organization from an independent physician association in 2017. It has a panel of 350,000 patients with more than 200 providers and more than 40 different practice locations.

THE PROBLEM

Osler Health was facing a set of difficult challenges. One was data integration – for a seamless data exchange, the ACO was looking to connect 14 disparate electronic health record systems with 17 different versions and 27 disconnected practice sites. Another was establishing interoperability among platforms – to enable real-time health data exchange, data needed to be ingested for a panel of 350,000 lives.

A third challenge was transforming raw data into actionable insights – to understand utilization and enhance reporting on quality measures, abundant raw data had to be processed for generating actionable value.

PROPOSAL

To overcome these challenges, Osler Health deployed an integration platform called InData from vendor Innovaccer.

MARKETPLACE

There are a variety of integration platforms on the market today. Vendors include Built.io, Celigo, Flowgear, Scribe Software and Workato.

MEETING THE CHALLENGE

"As one of the first accountable care organizations to employ sophisticated analytics, our challenge was harvesting clinical data from EHR systems from the beginning," said James Doulgeris, CEO of Osler Health. "A private/academic partnership pioneered pulling clinical data from disparate EHRs and other relevant sources was not adequate, so, we evaluated eleven of the top commercial providers of the time. None offered any meaningful improvement until Innovaccer approached us."

Doulgeris, who will be speaking October 22 at the HIMSS Big Data and Healthcare Analytics Forum in Boston, said he was impressed by Innnovaccer's background in data capture and normalizing and populating analytics systems. He explained that Osler Health took a calculated risk at the time and has never looked back.

"Today we have deployed Innovaccer's healthcare data platform, InData, across 27 of our practice sites," he said. "The transitional process took about three months. With patient data distributed across the network, the amount of data available to us delivers accurate and reliable analytics, a foundational factor in making us one of the top performers in commercial and Medicare accountable care."

InData was able to connect with 14 different brands of EHRs and their different versions using its pre-built connectors and configurations. Using interfaces to extract data, InData set up extract/transform/load pipelines to enable data transformation and mapping in a secure and compliant manner.

"The visual pipelines gave us, as users, considerable flexibility, and control over the data transformation process," he explained. "The entire patient data was mapped to a standard schema to maintain uniformity across different formats and was run through InData's enterprise master patient index module to make sure there were no duplicate records or invalid values."

Once the patient data was cleansed and standardized, the technology helped Osler Health store it in a longitudinal form where staff could see all the details associated with a patient – their primary care physician, their visit history, diagnoses, episodes, and more – in one place.

"This allows us to equip, enable and empower our physician partners to sustainably perform at superior levels to their peers, setting us on a trajectory to full risk in 2020."

James Doulgeris, Osler Health

The aforementioned second challenge was establishing interoperability among platforms.

"The data we needed was distributed across multiple avenues and more than that, most of the data we acquired was not received in time," Doulgeris said. "We needed to enhance how information was being accessed and leveraged in real time."

Using the integration platform, Osler Health was able to establish data exchange mechanisms that are robust, secure and incorporate updates in near real time, he said.

"Since the platform is source and format agnostic, InData was able to normalize these disparate data sources and put it together in a standardized format," he explained. "Most important, we could export and share critical data and insights all over the network via a secure data exchange. InData supports necessary industry standards and protocols which simplify how data is exchanged."

As for Osler's third challenge,  transforming raw data into actionable insights, Doulgeris noted that "bad, incomplete or spotty data generates misleading analysis. The key step for any organization stepping into data-driven care is having integrated and standardized data. With InData, we were able to achieve that near-perfect quality of integrated data to power analytics on our Optum platform."

It is mission-critical for Osler Health to have error-free data, he explained. The integration platform conducts more than 65 data quality checks to ensure its integrity before and after transformation and checks for invalid values, null values and weeds out duplicate records. The technology does the heavy lifting to process data, put it together in longitudinal records and make it analytics-ready, he added.

RESULTS

Osler Health has achieved enhanced quality reporting on all commercial payer and MSSP contracts at Level 3, resulting in enhanced and across-the-board shared savings for the provider organization, Doulgeris reported.

"InData is essential to identify gaps, both in care and data, for five different value-based agreements and related programs, each with a different set of quality measures over 86,000 attributed patients," he explained. "What used to be a mad, fourth-quarter, all-hands-on-deck rush to validate that tracked patients received required diagnostics or visits has become an uneventful reporting requirement because we can manage the process throughout the year with the platform."

And Osler Health has the highest quality reporting data for shared savings program in the state of New Jersey, Doulgeris added.

"We receive de-identified quality rankings from our payer partners each year, which is important for several reasons," he said. "Primary among them is that it is important for us to be an asset to our patients and to our payer partners. Assets are supported. Second, there is a direct link between quality and cost of care, particularly in improving health status among our population – real population health – which is essential to sustained success in value-based care."

Today, Osler Health's model is completely data-powered.

"This allows us to equip, enable and empower our physician partners to sustainably perform at superior levels to their peers, setting us on a trajectory to full risk in 2020," said Doulgeris.

ADVICE FOR OTHERS

"Those who recognize analytics as a tool have taken the first key step to using it to reach their goals," Doulgeris said. "The next step is to learn how to use it to transform data into consumable, actionable information that is compatible with workflows. Lastly, understanding that the analytics tools you use to create actionable information are only as good as the data they are built upon is the key to success."

Twitter: @SiwickiHealthIT
Email the writer: bill.siwicki@himssmedia.com