In early 2019, the American Hospital Association released its "Sharing Data, Savings Lives: The Hospital Agenda for Interoperability" report, examining America's state of healthcare interoperability, characterized as a "patchwork system" at best.

AHA also identified "connecting beyond electronic health records" as one of six pathway goals to accelerate interoperability.

At LANES, the Los Angeles Network for Enhanced Services, our mission is exactly that: Connecting beyond EHRs. It's time to aggregate medical records and put them to good use for the LA providers and our patient community.

Our healthcare ecosystem is littered with fragmented patient encounter data. LANES connects local providers across the care continuum to the most up-to-date patient data when needed from various sources.

In 2018, L.A. Care, the nation's largest publicly operated health plan, teamed up with LANES to help further its mission to provide coordinated healthcare.

More recently, Health Net of California, UCLA Health, Emanate Health and Beverly Hospital have partnered with LANES, making robust clinical data available to our HIE provider participants.

One of the nation's largest counties, LA County has nearly 10 million residents who account for approximately 27 percent of California's diverse and highly complex population. In this geographic area of Southern California, healthcare is delivered locally as most patients typically seek care within their metro area.

Patients visit health facilities where data omissions could extend to duplicate, incomplete or inconsistent records missing recent medical encounters and demographics data such as lab or other diagnostic tests, medications, allergies and family medical histories.

Our lack of quality, relevant and reliable patient data and the inability to share it poses a significant challenge for providers as patients transpose across care settings. At LANES, I am passionate that we work diligently using interoperability and aggregated data to assist participants in improving care management, outcomes and operations.

As CEO of LANES since 2018, I'm laser focused on encouraging hospitals, health systems, clinics and specialists to take advantage of the 2019 California Health Information Exchange Onboarding Program (Cal-HOP) funding to access and use our HIE to improve the quality and effectiveness of coordinated patient care.

Within a few years, we've built a solid technology infrastructure, agile processes and a team of experts passionately committed to the LANES mission. We've also developed a comprehensive security and privacy program safeguarding the exchange of our patient health information.

New initiatives for 2020 and beyond

The healthcare industry has spent the last two decades digitizing medical records to the point of generating substantial volumes of disconnected data. LANES can help achieve seamless care coordination closing care gaps when providers are able to access data, at the point of care, using a central interoperable platform.

Moreover, we are exploring new types of data and innovative ways of collecting and sharing it. We're looking at, for instance, advanced work flow products and services at the point of care as well as population health workflow products and services including smart alerts, gaps in care reporting and risk stratification.

Social determinants of health integration

In 2020, LANES is rolling out SDoH integration as an important data set augmenting the Whole Person Care – Los Angeles program.

Hence, as providers partner with payers on risk-sharing contracts, both parties must seamlessly access and exchange data to inform business decisions. Since risk-sharing contracts incorporate population data, providers will need access to data collected outside of hospital and clinic walls.

Other national initiatives that align with our agenda include the CMS Interoperability and Patient Access Proposed Rule, which introduces new policies to expand access to and exchange of health information to enable better care coordination.

Predictive analytics for population health

I consider ADT notifications to be a core HIE requirement. However, the future is in the functionality that facilitates true population health management: predictive analysis. Our goal is to offer providers targeted data to better identify and care for their 5% to 10% high-risk and rising-risk patient cohorts  possessing one or more chronic conditions and whose care management warrants the greatest healthcare spend.

Patient access to medical records

Another game changer at LANES is a desire to grant patients access to their full medical records. Patients must be able to transport their data from one healthcare professional to the next.

We are building a solution where patients can carry their personal health data on their smartphones as well as assist their provider in joining LANES to look up their data via our platform. In fact, LANES is working towards making data accessibility available and securely to LA residents in the coming years.

Strengthened MPI

Patient-centered care requires a holistic view into an individual's complete health record, giving access to the whole picture of health that includes both provider-generated and patient-generated data.

To support this longitudinal view, we've implemented new technology to improve the functionality of our enterprise master patient index. The resulting enhanced patient matching ensures our providers have the right individual identification in helping that patient receive the right care at the right time.  

Support for emergency medical services

With the California grant focused on integrating EMS agencies (i.e., paramedics) with hospitals and health systems through LANES, those providers offering emergency department services will greatly benefit from our interoperability service.

Paramedics can access patient information using our HIE platform, while hospital EDs will receive notifications and messages when ambulances are en route.

This emergent need was made apparent by California's increasing severity of destructive wildfires and other national disasters. The inclusion of SDoH data and behavioral health knowledge to our platform will also give EMS and state health agencies the ability to see the patient's complete healthcare picture.

The stakes are rising in the pursuit of interoperability and LANES will continue to carry out a value-based approach as we support Los Angeles participants.

We will keep an eye on TEFCA and determine which role best suits our stakeholders as we steadfastly continue to wire that "last mile" of data in curated repositories, ready to be exchanged.

Ali Modaressi is CEO of LANES, a nonprofit organization responsible for operating a community-based health information exchange for hospitals, health systems, clinics, IPAs and health plans that administer care to Los Angeles County residents.

Since 2010, LANES has evolved from a technology tested by a county facility beta site to become a leading HIE for more than 500 hospital and ambulatory care sites using real-time aggregated data sharing to improve care management and clinical outcomes for LA patients.