The Paso del Norte Health Information Exchange enables data sharing between 11 regional hospitals and more than 40 outpatient clinics, local primary care practices, laboratories, imaging centers, home health and more in the El Paso, Texas, border region. 

The hyperlocal HIE has built a clinical viewer that enables primary care physicians and doctors to access patient medical records from the community. It has reduced hospital readmissions and visits to the emergency department, according to Emily Hartmann, PHIX executive director, and Juan Nanez, PHIX director of programs, presenting today at HIMSS23.

Anecdotally, the ability to gain access to records has enabled local doctors to intervene and improve patient outcomes – even make lifesaving referrals.

"Not because the data does anything its own, but because it allows [doctors] to make actionable choices," said Nanez.

Hartmann and Nanez said they learned through their validation study, made possible through an effort with Dr. Chantel Sloan-Aagard at Brigham Young University, that their approach justifies the need to create regional health data exchange with small healthcare practices and other community providers.

PHIX collects the data from multiple locations, standardizes it and allows partnering clinicians to access patient data through any modality.

Analyzing HIE value

The depth of PHIX's data brings value, Nanez explained. 

Available from the clinical viewer, which Hartmann said is supported by Medicity, HIE partners can view diagnoses, imaging, medications, clinician reports and more.

PHIX began more than six years ago as a three-person operation and now has 13 staff members, Hartmann said, noting that they provide 24/7 support. After hours, it's Hartmann's and Nanez's cell phones that ring.

Their study looking at the efficacy of access to patient records and the ability to reduce hospitalizations and ER visits between January 1 and November 30, 2021 was narrowed down to a cohort of 8,216 patients over age 18.

"The journey of value" grew when PHIX's physician committee asked them to look further into whether HIE access by clinicians improved patient care transitions, explained Hartmann.

Their analytical approach found that patients in the study cohort were 61% less likely to be rehospitalized if doctors could access their medical records.

Methods of stakeholder engagement

Hartmann said that validation is the key to improving and growing PHIX in the border region on two levels – with new providers and by increasing utilization with their current partners.

"Working with smaller stakeholders, it takes a lot of relationship building," Nanez said in response to an attendee's question. "We have to really build trust."

PHIX informaticists go out to the practices to work directly with them, explained. One of the barriers is IT knowledge as many small providers outsource their IT.

A second method PHIX uses for engaging new providers is the HIE's various committees, which all stakeholders are invited to be part of.

Hartmann said in response to a question that a regular concern for new practices PHIX engages with is data privacy. The committees, like PHIX's privacy and security committee, help to foment success in onboarding new providers.

"Having the compliance and legal folks from all of our major partner organizations, the hospitals participating in that, and helping to drive the policies and create the organization really helped build trust," Hartmann said. 

From there it's a "domino effect."

Once the first few who are willing take a chance and join, "their friends" follow, she said. For example, practice office managers hear that PHIX helps their peers get records without having to call the hospitals and wait for faxes.

The goal to grow PHIX is not just in reaching new partners that want to participate, but "helping our current partners better understand different ways that they can use the data and how can it help and really going back to folks and making sure that the resources we already have in the community are being used really effectively to benefit our community," Hartmann said.

Andrea Fox is senior editor of Healthcare IT News.
Email: afox@himss.org
Healthcare IT News is a HIMSS Media publication.