Data, data, who has the data?

In health insurance and health care, information is captured and stored in many places and the majority of information is duplicative of data stored by other entities. Who has this data, and what are they doing with it? I may have found the answer, at least in the Pacific Northwest!

In the State of Washington, there is a little known entity called the Foundation for Health Care Quality (FHCQ). It is the sponsor for, and the home of, a number of programs which deal with variability, outcomes and quality in various medical and surgical services. In addition, they have been a long time participant in the health care technology arena and sponsor a major statewide patient safety coalition.

FHCQ is a nonprofit organization dedicated to providing a trusted, independent, third party resource to all participants in the health care community – including patients, providers, payers, employers, government agencies and public health professionals.

In January 2011, Washington State began implementing a secure, shared health information technology infrastructure to advance Health Information Exchange (HIE). Secure HIE will help providers improve clinical care and services. It may also prevent duplicate procedures and eliminate prescription mistakes. The State HIE program is funded by the Health Information Technology for Economic and Clinical Health Act (HITECH) provisions of the American Recovery and Reinvestment Act of 2009.

OneHealthPort (OHP), in coordination with the Washington State Health Care Authority, will lead HIE implementation activities. OHP is a private sector health information technology management organization, created in 2002 by local health care organizations to streamline and accelerate the exchange of business and clinical information.

In response to feedback from stakeholder webinars hosted by OHP, a governance model that included HIE Community Oversight was recommended. FHCQ was selected as the Community Oversight Organization.

FHCQ has, and continues, to lead and oversee several key programs for Washington State. Before HIE, there was CHITA. CHITA was born from the CHMIS and CHIN initiatives, funded by the John A. Hartford Foundation and was the next iteration of health information technology as the internet began replacing proprietary private networks. While CHMIS and CHIN were centralized models of information sharing, CHITA was a collaborative model. CHITA helped to bridge the gap between pre‐Internet CHINS/CHMIS era which had focused on building a shared network and the Internet era which brought a greater focus on security, data standards and policies.

The ten founding members included the Washington State Hospital and Medical Associations; all the major health plans in the state—Regence Blue Shield, Premera Blue Cross, Group Health Cooperative—as well as Providence Health System, Swedish Hospital and Medical Center, University of Washington Medical Center, the Washington State Department of Health and Clinitech Information Resources. Their initial focus in 1996 was to address e‐commerce, with a focus on both interoperability and data security. The hope was to have the CIO’s (Chief Information Officers) of these organizations work collaboratively to share information securely, identify the data they could or would share, and create standards needed to enable secured data sharing.

How do I know about FHCQ? Because I was a representative from one of the ten founding members mentioned above that worked to identify key, common data between health plans, physicians, and hospitals so that information could be obtained in a common format and then shared securely to promote reduced costs and increased quality of care.

By sitting at the table with representatives from these entities, it provided me and others the more broad insight and perspective of data complexities and commonalities. We all gained a better understanding of the requirements for each type of entity, and the challenges to maintain, secure, and structure the data elements collected. This knowledge and understanding of opportunities has helped me as I work in Business Intelligence and Reporting and in Business Process Improvement with health care and health insurance companies.

Big data in healthcare? I think the State of Washington and FHCQ could lend some critical, practical insight on this matter.

Citations and information obtained from http://www.qualityhealth.org/downloads/1104_FHCQ_History_Publication.pdf

Margaret Shilling

Senior Manager – Business Consulting, Virtusa. Margaret is a seasoned and experienced Information Services Leader with over 32 years of experience in medical health insurance, business process improvement, and project management. At Virtusa, she is part of the business consulting group, manages HIT integration, health insurance, and healthcare business intelligence projects. Prior to Virtusa, Margaret has worked with leading health organizations such as TriZetto Group, Group Health Cooperative, The Regence Group, etc. She has completed various undergraduate courses in Tacoma Community College.

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