Valley Presbyterian Hospital
Promotes Interoperability Through CommonWell
Patients from across the Los Angeles metropolitan area seek treatment at Valley Presbyterian Hospital, one of the largest acute care facilities in the San Fernando Valley. VPH provides care for virtually every specialty and subspecialty at its facilities, which include a certified Cardiac STEMI Receiving Center and a designated Pediatric Medical Center. Serving a diverse, and often vulnerable, population means VPH clinicians depend on interoperability for a more comprehensive view of their patients’ journeys.
Bridging gaps across care settings
Hospital leadership found that connecting to CommonWell Health Alliance® and its bridge to Carequality offered the most efficient solution to improve the quality of care and acquire points through the Promoting Interoperability Program, which requires healthcare organizations to either connect with other providers through a certified health information exchange or rely on direct messages. The connection enables VPH to exchange information with local hospitals and clinics, each of which has its own EHR. In addition, it expands VPH’s interoperability beyond the capabilities it achieves through its participation in the Los Angeles Network for Enhanced Services, the county’s leading HIE.
“Out of all our interoperability options, CommonWell comes closest to what ONC and CMS envisioned and requires the least development effort,” said Jeff Allport, the CIO and VP at VPH. “It has the potential to make HIE common and straightforward, allowing us to reduce our integration technology footprint.”
Through the CommonWell network and its connection to the Carequality Framework, VPH can limit point-to-point interfaces, which often require adjustments to individual components and can be labor intensive to maintain. Instead of managing single connections, VPH aimed to be as generalized as possible in its approach to sharing data. Using a combination of CommonWell Services, direct messaging, and its county HIE leaves the hospital better positioned to fill gaps in the continuum of care.
VPH went LIVE with CommonWell Services and the Carequality connection in 2019. The connection enables VPH to use a standards-based approach that optimizes and promotes interoperability while removing the burden of identifying the patient’s primary care provider.
Before the initiative, if a patient acknowledged having a primary care provider but couldn’t identify the physician or clinic, VPH would need to first determine which clinic the patient was assigned to before sending a direct message with a discharge summary of care. As part of a healthcare community in which patients frequently move and change health plans, the hospital staff had difficulty identifying the patient’s primary care provider from among the other providers a patient had previously seen. This was especially challenging when caring for the community’s vulnerable population.
Now VPH staff use the CommonWell record locator service to search automatically for patient matches and specify where the patient has received care. The RLS is a sustainable approach, limiting direct messages to only the care organizations that do not use CommonWell or Carequality. In addition, clinicians can quickly and easily identify which facilities need access to their patients’ information.
VPH doesn’t have its own clinics; instead, it partners with many federally qualified health clinics in the San Fernando Valley. Most of these FQHCs use eClinicalWorks or NextGen; the CommonWell and Carequality connection enables the hospital to connect to these EHRs and further reduce the gaps in the care continuum. Through VPH’s partnership with the Community Clinic Association of LA County, staff can access a profile of every hospital and clinic in the county. The profile includes information on how the facilities are exchanging data. It turns out that most of VPH’s partners are already on a roadmap to participate in either the CommonWell network or the Carequality Framework.
Sharing information across networks and EHR vendors
The most useful information VPH receives from CommonWell connections is the patient summaries from practices not associated with the hospital. In addition, VPH has successfully exchanged patient information with several major health systems, including Keck Medical Center of USC, a Cerner customer, and Cedars-Sinai Medical Center, an Epic customer, as well as many other medical facilities throughout Southern California.
With the CommonWell-Carequality connection, VPH registration staff and providers have access to over 40,000 providers nationwide, enabling them to acknowledge patients during enrollment and check-in. The ED benefits from the ability to pull in information from CommonWell and Carequality that pertains to its patients; it averages more than a 75% capture rate when listing the previous day’s missed patients. Some of these missed patients may represent the area’s homeless population, since it is still difficult to capture their information.
California’s HIE patient consent policy is opt-in: Patients must consent to the disclosure of their health information. VPH’s admissions staff are transparent about the potential issues that may occur if patients opt out of CommonWell Services. For instance, they could end up in a clinic or practice and the physician wouldn’t know anything about their health history. So far, patients are on board with the exchange; evidence suggests few, if any, patients have opted out.
VPH’s success with CommonWell is overwhelming. Until the remaining local facilities come on board, VPH’s interoperability strategy will continue to include direct messaging and traditional interfaces through the county HIE.
“I’m thrilled the discussion has transformed from focusing on how to get the information to how to present and manage the information we’re getting,” said Allport.