Program Spotlight: AL HIE Program

We met with Ragan Sappington, Healthcare Interoperability Practice Director to learn how we are improving the delivery of healthcare in the state of Alabama.

1. Can you tell us a little more about our Alabama Health Information Exchange (HIE) Program?

Alabama One Health Record® (ALOHR) is the HIE serving the state of Alabama. The mission of ALOHR is to improve the quality and efficiency of healthcare delivery in the state. Ultimately, it provides consumers access to their own health information and helps them make more informed health care decisions.
ALOHR is an interoperable, two-way data exchange platform for providers, hospitals, and other trading partners within Alabama and across the nation. It provides a secure network to facilitate data exchange that supports patient-centered healthcare and continuous improvements in access, quality, outcomes, and efficiency.
Under the guidance of the Alabama Health Information Commission and with our support, ALOHR has emerged as an interoperable, comprehensive solution needed to transform statewide health care for all Alabamians. To-date, ALOHR maintains a Master Provider Index (MPI) representing more than 3.5 million covered lives. Over the past four years, we have connected more than 5,500 points of care locations, allowing the secure exchange of clinically relevant data between various data trading partners, including:

• 32 hospitals
• 290 ambulatory clinics
• 6 Accountable Care Organizations
• 7 Alabama Coordinated Health Networks (ACHN)
• 23 HIEs participating in Patient-Centered Data Homes initiative
• 1,255 Veterans Health Administration (VHA) hospitals and clinics in the state and across the country
• The Department of Defense
• eHealth Exchange
• 3 additional state HIEs
• The Social Security Administration
• 2 state agencies, including Alabama Medicaid and Alabama Public Health (representing 64 county health departments)

2. What are the top three things employees should know about the AL HIE Program?

1. The Cognosante Team manages and oversees the core ALOHR HIE technical infrastructure that is hosted in the Amazon web-services cloud and comprises of state-of-the-art technologies that delivers the following solutions:
   • Clinical portal – a web-based application allowing providers to access comprehensive patient records
   • Query exchange – enabling providers to query ALOHR for patient records from their native health information system
   • Master Patient Index – providing management, matching, and reconciliation of patient records from multiple data sources
   • Direct Secure Messaging – providing a HIPPA-compliant secure messaging platform between trusted healthcare entities
   • Healthcare Analytics – providing real-time analytics, data analysis and reporting capabilities to drive adoption, utilization, and provide care management solutions
   • Single Sign-On Provider Portal – providing a fully unified one-stop landing page for products and services available to authorized end-users
   • Clinical Alert Notifications – providing real-time notifications to end-users (i.e. healthcare providers, care managers, Accountable Care Organizations, emergency management) of admission, discharge, and transfer on patients
2. Our team works with local, state, federal, and national trading partners and their vendor(s) to provide solutions to many of the healthcare interoperability barriers (i.e. technical, financial, trust, administrative, reporting, and usability). We bring a human element alongside our technology offerings to drive interoperability forward while still fostering a client connection. We are transparent and listen to the needs of every client to fully understand their information sharing objectives, workflows, and technology limitations before we design an interoperable connection solution. We collaborate with each client to help iterate, anticipate, and manage changes to their implementation.
3. Since Cognosante was awarded this contract in 2016, the ALOHR set a goal to achieve critical mass by connecting 45% of its eligible Medicaid hospitals. To-date, ALOHR has connected 32 eligible Medicaid hospitals representing 36% and is on-track to exceed critical mass projections by April 2021. Our passionate and mighty team of 15 comprises Cognosante, Ready Computing, and Inpriva staff. Together, we manage between 20 to 30 client implementations in parallel and support ongoing maintenance and operations of the ALOHR 24X7.

3. How have we provided value to the Alabama Medicaid Agency with this project?

The tangible results are seen daily with the increased number of points-of-care locations that are sharing critical health information for patients in real-time through direct connections and inter-connections to other Exchanges on the state and national levels.

As of July 1, 2020, ALOHR has successfully connected to over 5,500+ points of care locations. Over 4.2 million registered clinical documents are available for query and retrieved through the ALOHR Exchange. Clinical Alert subscribers have received 119,000+ Admission, Discharge, and Transfer alert notifications. In addition, 64,100+ alerts have been delivered via ALOHR Direct Secure Messaging mailboxes to Alabama’s Coordinated Health Network, and 49,300+ alerts distributed to six Alabama Accountable Care Organizations.

Our team is proud to support Alabama during state and national public crises:

• March-July 2020, Alabama’s Governor Ivy declares a state of emergency due to COVID-19. We connected 12 facilities (6 hospitals, 5 accountable care organizations, and 64 Alabama Public Health County Health Departments) to ALOHR, enabled the HIE HealthShare analytics platform to support near real-time analytics and migrated 1.6 TB of data, and continued implementations and technical solution designs for 20+ new clients.
• September 2019, Alabama Medicaid went live with a statewide Coordinated Health Network servicing seven regions and incentivizing eligible providers to improve the quality of care for an estimated 850,000 eligible Medicaid recipients—specifically in the areas of childhood obesity, infant mortality rates, and substance abuse disorder. We built a custom ACHN alert notification subscription solution designed to trigger real-time Admission, Discharge, and Transfer events on eligible Medicaid patients. The messages are batched nightly and distributed to the seven ACHN regions where they are reviewed by providers and care managers. More here.
• October 2018, ALOHR connects to the Georgia Health Information Network and Georgia Regional Academic Community Health Information Exchange during hurricane Michael within a 24-hour period. An estimated 800 high-risk Floridian evacuees were unable to be located. Using the ALOHR HIE, providers were able to locate 32 high-risk Floridians who were then relocated to various Alabama hospitals. More here.

4. What are you looking forward to most because of this project?

This project improves the quality and safety of patient care by delivering real-time critical health information to care providers and patients. The ALOHR HIE is in a position with its robust technology platform to evolve over the years to support critical initiatives that stimulate consumer education and patient’s involvement in their own health care. The ALOHR HIE delivers on its mission of ‘No Provider Left Behind’ and provides Alabamians an opportunity to have access to their comprehensive medical record.