Chief Among Friends: North Dakota Health Information Network

In his podcast series titled ‘Chief Among Friends’, Orion Health Chief Medical Officer Dr Chris Hobson discusses topics ranging from technology priorities to new innovations in integrated and coordinated care to healthcare sustainability.

In the September 2020 edition of the Chief Among Friends podcast, Chris had a virtual chat with North Dakota Health Information Technology Director Shila Blend about the advances in Health Information Exchanges (HIEs), in particular statewide HIEs, and the strategic direction of their evolution.

Shila and Chris discuss the effect of COVID-19 on the current and future direction of HIEs, the role of HIEs in promoting justice and equity for minorities in healthcare, and the 21st Century Cures Act and new CMS and ONC rules. The following is a summary of the full podcast, found here.

The NDHIN expansion project

Following a strategic review several years ago, North Dakota Health Information Network (NDHIN) has embraced advanced, interoperable technology to exchange information in service of care coordination, analytics, and population health management. 

In 2019, NDHIN introduced Orion Health’s Amadeus platform to meet its data management needs. Shila describes their journey to interoperability across the state as a continuous process of adding functionality and new forms of data to encourage communication and collaboration among facilities.

Streamlining the response to COVID-19

Shila discusses how, throughout the pandemic, NDHIN has been working with the Department of Health and other organizations to modernize systems and processes for COVID-19 testing to be paperless. This was mandated by the sheer overwhelming number of people needing to be tested and has helped streamline the process, allowing for higher volumes of testing.

Collecting and utilizing data during the pandemic has also been crucial as it has enabled the modelling to understand rolling average case numbers which has contributed towards making decisions such as travel restrictions and mask mandates. 

Being able to integrate HIE and clinical data with public health data has meant that in North Dakota, they’re able to manage cases and contract trace more easily. Clinicians can receive notifications when a person they are monitoring has tested positive for COVID-19. The HIE also provides the ability to view patient lab results, in the future allowing clinicians to see whether a patient has been tested for the virus in the past and their results.

Ensuring minorities aren’t left behind

Making sure that minority and indigenous populations in North Dakota have their needs met is a priority for NDHIN, especially during the pandemic, Shila noted. The HIE can aid by bringing together various elements to help determine which populations need assistance and where the points of focus need to be. These focuses could be in providing food, shelter, or other necessities as per the social determinants of health. Shila highlighted that HIEs with quality data are great for helping understand and address problems, when the systems are used appropriately.

Improving data sharing with legislation

The new CMS and ONC Rules, especially on information blocking, will prove to be a benefit for the NDHIN. These regulations will limit data gaps and provide a richer source of information to clinicians, streamlining communication and collaboration. The HIE helps by creating the structure, and with improved data sharing, overall, Shila believes the new rules will benefit patients and the care they receive.

In the full podcast, Chris and Shila discuss these topics in more detail plus touch on benefits the Patient Centered Data Home can bring to HIEs and the role of HIEs in assisting payers to meet the new patient access and interoperability obligations.