Arkansas Blue Cross and Blue Shield recently awarded $250,000 to the Arkansas Rural Health Partnership (ARHP) to expand its health information exchange (HIE). The rural partnership is made up of 14 hospitals, two federally qualified health centers, as well as 108 affiliated clinics in southern Arkansas. This organization also collaborates with the prominent academic medical center University of Arkansas (UAMS). Critical for connecting communities and supporting patient health record availability, rural HIEs often can find it more difficult in rural areas to involve hospitals and provider participation. The payer covered the original initial grant totaling $817,000 to AHRP earlier in the year. The movement intensifies for interoperability across the nation. This will help this group working to ensure access to quality and localized healthcare throughout this rural Southern state.
Surveys Reveal Rural Challenges
Moreover as recently covered by Arkansas-based Camden News https://www.camdenarknews.com/news/2021/jan/07/arkansas-blue-cross-gives-additional-funding-ocmc-/a recent survey https://strategichie.com/2019/08/19/first-survey-of-the-strategic-health-information-exchange-collaborative-shiec-shows-health-information-exchanges-hies-provide-critical-national-infrastructure/conducted by Strategic Health Information Exchange Collaborative https://strategichie.com/ (SHEIEC) 92% of the U.S. population already is somehow covered by HIEs but the most recent ONC data (2018) reveal that small and rural hospitals don’t participate nearly as much. In fact according to that survey only 62% of small hospitals engage sustainably in such exchanges.
Growing Rural Participation but Ways to Go
Hence the importance of this recent grant to support smaller rural hospitals in Arkansas to participate in the state’s HIE known as State Health Alliance for Records Exchange (SHARE), https://www.sharearkansas.com/ overseen by the state’s Office of Health Information Technology. https://www.healthit.gov/ With a vision to improve the healthcare system so that caregivers and patients both have real-time digital access to more complete records, all in the health ecosystem will be able to make better, more informed decisions thanks to this unfolding situation.
Once hooked up to SHARE providers will be in a position to transmit and exchange patient information from clinical care summaries and vital signs, medications, allergies, continuity of care documents (CCDs), transitions of care documents, immunization records, lab results, radiology report transcriptions, discharge summaries and more. SHARE users get a daily report of a 24-hour snapshot of critical events from emergency room visits to inpatient discharges.
But traditionally statewide HIEs are not necessarily affordable for all, at least not for small or rural hospitals and clinics. Sometimes it’s difficult to sustain a full membership. The grant offers participants more comprehensive participation in SHARE which is a win for all.
Readying for Rules Changes
In one of their recent newsletters, SHARE discusses its specific readiness https://www.sharearkansas.com/sites/default/files/SHARE%20Fall%202020%20Newsletter.pdf to meet rules promulgated for activation by May 2021. The Centers for Medicare & Medicaid Services (CMS) and the Office of the National coordinator for Health Information Technology (ONC) are moving to a requirement that that hospitals must send admission, discharge, and transfer (ADT) alerts to community providers when patients are seen in the emergency department or admitted to, discharged and / or transferred from the hospital to another community provider or practitioner. The imminent yet to be published rules can be viewed here. https://www.cms.gov/files/document/121020-reducing-provider-and-patient-burden-cms-9123-p.pdf
Important to Engage and Integrate the Rural
Rural hospitals and clinics can benefit from participation in statewide exchanges such as SHARE. For example although rural providers (hospitals, clinics, and small practices) participate less the population faces more risks in the form of chronic conditions as compared to bigger cities and suburbs suggests the data. Hence the importance of purpose-designed, streamlined solutions that support expedited onboarding to digital health networks.
Social Determinants of Health
Health care involves far more than visits to primary and even specialists and involves a myriad of other considerations. As HIEs support access by first responders, substance abuse disorder (SUD) treatment centers, schools and others to connect, engage and even share relevant information the social determinants of health (SDoH) becomes an ever more important topic associated with emerging value-based care models.
Some Participating Hospitals in Arkansas
Some of the hospitals that are receiving funding include Ashley County Medical Center, Baptist Health, Dallas County Medical Center, Magnolia Regional Medical Center, Medical Center of South Arkansas, and Ouachita County Medical Center.
CrossTx: Focusing on Rural Health Networks
Bozeman-based CrossTx www.crosstx.com knows something about rural networks. Actively growing in Montana, Wyoming, Colorado, Texas and elsewhere, the health network technology platform, partnered with Amazon, supports these important networks defined as a group of three or more rural health providers and/or other stakeholders that combine to take on collective needs in the community.
CrossTx works with a number of different types of rural health networks and collaborative groups supporting a number of important health and social aims. These networks come together at times for various reasons; all strive to make a real difference for their respective communities.
Whether for establishing a safety net baseline set of health and human services to “cross-sector collaborations taking on multiple goals to specialized networks, such as behavioral health, the Bozeman-based venture invests continuously to support the health and human care infrastructure working with clinics, regional health centers and hospitals to large health systems as well as specialized nonprofit and for-profit providers.
By providing a turnkey, scalable, extensible, and flexible network health platform, CrossTx supports rural health network referral management, closed-loop referral and care coordination, Medicare-compliant Chronic Care Management services as well as support for medication reconciliation and seamless interfaces for telehealth and remote patient monitoring initiatives. Importantly, the company fully embraces concepts of interoperability, embracing standards such as FHIR.
Chief Business Officer