Op-Ed: California’s need for a statewide Health Information Exchange Network from a population health perspective


Soraya Marashi


The challenges of practicing medicine in a rapidly changing complex healthcare environment must not be underestimated. From a population health perspective, the unprecedented COVID-19 National Health Emergency (NHE) triggered a heightened awareness of the need for sharing accurate, timely, comprehensive patient information through a secure statewide health information exchange network.

As the Chief Population Health and Quality Officer for the Inland Empire Foundation for Medical Care (IEFMC), it became readily apparent early in the pandemic that understanding and addressing the needs of our communities was essential for reducing healthcare disparities and ensuring the best possible care for those who entrust their lives to us.

From a critical decision-making perspective, real-time access to each patient’s health information is essential. During the initial phase of the NHE, we fully recognized the need to reach out to our patients, especially the frail elderly. Our objectives were to mitigate their risks and to create an awareness of presenting symptoms as well as treatment recommendations.

Utilizing state-of-the-art data analytics software, our team developed a comprehensive risk stratification COVID model that included over 80 diagnoses for identifying at-risk individuals in our Foundation Accountable Care Network (FACN), a Medicare Accountable Care Organization. Accessing key demographic information for these patients was facilitated through a synergistic strategy [YM3] with the Manifest MedEx Health Information Exchange (HIE) that enabled our team of volunteers to contact each identified patient for the purpose of extending a lifeline to those in need. While the number of lives saved to date is unknown, addressing the needs of our patients during this critical period certainly had a wide-ranging impact.

Our utilization of a health information exchange network clearly demonstrates that the practice of medicine today can no longer be confined within the four walls of hospitals, clinics, or medical offices. Data-driven decision-making is of the utmost importance in caring for our patients — especially for those who do not necessarily or routinely show up on the doctor’s radar.

Also, with U.S. healthcare spending reaching an astounding 19.7% of GDP in 2020 , we can no longer afford to treat patients without real-time information pertaining to hospitalizations, emergency room [WJ7] and clinic visits, test results, and vaccination status. Through comprehensive information-sharing, we can more effectively advance our healthcare system in a manner that reduces waste, redundancy, and cost while ensuring the right care at the right time and in the right place.

In the process of training newly-minted and seasoned physicians, I strongly emphasize the need for sharing information as a necessary element for effective patient care.  Whether it be though directly accessing an HIE or fully integrating/ingesting HIE information into state-of-the-art Electronic Health Records (EHRs), providers must build data-driven workflows into their daily routines to more effectively address their patients’ needs.

As our healthcare system advances, the availability of shared patient information is clearly the key foundational element for effectively and efficiently treating our patients. It is also rapidly becoming the catalyst for developing novel artificial intelligence algorithms that can accurately predict disease exacerbations.

In closing, it’s obvious that we cannot build a high quality outcomes-driven healthcare system that eliminates disparities and optimizes patient outcomes without a statewide health information exchange network. The time has come for each of us to recognize that the system can only be effective with the full participation of our providers who are committed to sharing information and working together for the common good.

Dr. Bittman is a neurologist, author, international speaker, researcher and population health innovator who presently serves as a national healthcare consultant.