Interoperability and the 21st Century Cures Act

By Lesley Brown, SVP of Project Management at Halfpenny Technologies

It should go without saying that interoperability has potential to have a tremendous impact on patient care in the U.S and as such is a necessary component of healthcare reform.  The impact of interoperability ranges from expediting access to external sources of patient data (lab results, test data, clinical care plans etc.) to improving gaps in care during healthcare encounters to closing referral loops to enabling patients to access their data (and maybe even exchange their own data from home monitoring or wearables).  Depending upon the stakeholder and the end goal of their data exchange needs interoperability solutions vary widely within healthcare today.   With solutions ranging from basic HL7 interfaces to the use of the consolidated clinical document architecture (C-CDA) to direct messaging or the use of State or private HIEs.  And more recently select adoption of the Fast Healthcare Interoperability Resource or FHIR APIs.

There are three (3) fundamental areas that are important for healthcare interoperability.  Firstly, the business case or need for clinical data, secondly the industry standards required and thirdly the changing culture of healthcare.  This changing culture of healthcare and data sharing is often the missing element in the interoperability puzzle but it could well see a shift forward with the recent passing of the 21st Century Cures Act.

The 21st Century Cures Act, passed into law in December 2016, covers a wide range of healthcare issues from precision medicine to diagnostic tools and disease therapies and includes components that will significantly impact healthcare information technology and interoperability.  The Cures Act aims to encourage interoperability between EHRs (and hence providers) while also providing patient access to that data, reducing clinician documentation burdens (read more time with the patient), the discouragement of information blocking and the development of a reporting system identifying how usable the numerous EHRs in the marketplace really are.   Really?  It would be awesome if electronic health information could be securely exchanged with and used by any EHR system without any special effort needed by the provider or system user, providing of course that the access and exchange is authorize under applicable State or Federal Laws.  And that it does so without constituting information blocking.   This legislation has no doubt caught the attention of healthcare’s information technology stakeholders and those companies providing the necessary technology, many of whom have responded positively to the Cures Act. Several of the EHR system vendors are already participating in one or more data sharing initiatives such as Carequality or Commonwell while providers are realizing the impact and importance of ensuring their EHR product is up to date and leverages the appropriate technologies that will be needed.   In a progression from some of the interoperability solutions used today the Cures Act calls for the use of a national API standard that would cover many facets of data interoperability such as authentication, security and auditability.  In these early days it remains to be seen how impactful the Cures Act will be on healthcare interoperability but it’s a step in the right direction.

Looking for a secure, flexible, vendor agnostic approach to interoperability and clinical data exchange? Halfpenny Technologies has been in the clinical data exchange business for more than 15 years and over that time have built reusable interfaces that connect to 90%+ of the top EHR vendors and LIS/HIS systems.  Halfpenny Technologies comprehensive clinical data exchange platform uses a multi-faceted methodology to obtain clinical record data.  We do not rely solely on the use of just one of the industry standard.  Our vendor agnostic approach allows the receipt of any EHR medical record data format and in return you can receive clinical data in the layout of your choice. Our continued investment in innovative solutions has uniquely positioned the company as a national provider of clinical data exchange solutions to the health care industry.


Challenges in Obtaining Complete Medical Record Data

By Lesley Brown, SVP of Product Management at Halfpenny Technologies

As previously discussed the potential benefits to health plans of compiling a complete picture of their member’s health status are abundant.  The more data and information you have about your members, the better help and guidance you can give them to ensure they receive the most appropriate and best care without redundant replication of services.  And without unnecessary cost!

Being able to obtain a comprehensive medical record for a member from a physician’s practice is one avenue that health plans can take to enrich their member’s health records.  Yet, technical and business challenges aside, being able to gather a comprehensive or full medical record from an EMR can be difficult.  Experience has demonstrated that all too often much of the key clinical information about a patient is missing from the “structured” components of Electronic Health Records.  And this occurs even when data is retrieved using “industry” standard formats such as the HL-7 C-CDA template and document structure.  This missing clinical data ranges from lab result interpretations, medication detail around frequency and dosing, allergy information to physician signatures.  An additional challenge is the inability to distinguish and interpret between actual missing data in a record from “null” data elements such as “no information documented” or “no known information”.  This absent information can be very challenging to find and retrieve from within an EHR system.  Experience has shown that reliance on “industry standards” such as the C-CDA templates isn’t sufficient.  Add in the fact that many different EMR’s are in use today by physician groups and hospitals, and these medical record systems are built in a proprietary way, making the challenge of finding that missing or incorrect information different between EMR systems and hence physician practices.  As a result of these challenges, healthcare providers who would like to gather clinical data in order to compile a more complete picture of their member’s health are faced with a project that is time consuming, extremely expensive, frustrating and can often result in disappointment and incomplete personal health information.

Looking to obtain a complete medical record on your members?  Halfpenny Technologies has been in the clinical data exchange business for more than 15 years and over that time have built reusable interfaces that connect to 90%+ of the top EHR vendors and LIS/HIS systems.  Halfpenny Technologies comprehensive clinical data exchange platform uses a multi-faceted methodology to obtain clinical record data.  We do not rely solely on the use of the C-CDA standard.  Halfpenny Technologies completes a quality assessment at each data retrieval stage identifying how full or complete a medical record is and highlighting missing sections or data elements.  We can then work with our customers to identify ways to ensure that clinical data is being acquired and stored correctly.  Halfpenny Technologies’ vendor agnostic approach allows the receipt of any EHR medical record data format and in return health plans can receive clinical data in the layout of their choice. Our continued investment in innovative solutions has uniquely positioned the company as a national provider of clinical data exchange solutions to the health care industry.


Interoperability and Bi-Directional Health Information Exchange

By Lesley Brown, SVP of Project Management at Halfpenny Technologies

Health information data exchange between healthcare providers and healthcare enterprises is associated with a multitude of wins including improved workflow efficiencies, better quality of care for patients and members, care that is more coordinated, streamlined processes, superior patient safety and cost savings to name just a few.  Add to that the increase importance on quality compliance and value based reimbursement and suddenly there is an accelerated demand for discrete clinical data to be exchanged and aggregated between providers and health plans.  Many would say this is where true interoperability or the bi-directional exchange of data between the multitudes of healthcare players involved in a patients care management and coordination comes into play.

How is bi-directional data exchange different?  Bi-directional data exchange allows for the two-way sharing of PHI data between two healthcare entities involved in the care of a patient. That means retrieving data out of a clinical medical record warehoused in an EMR in a physician’s practice or hospital and then returning or sending data back into that EMR as appropriate and as needed. Data shared can include patient referrals, physical histories, progress notes, care plans and corresponding gaps in care. Rather than just allowing data sharing by passing patient records on to other systems, bi-directional data sharing can truly help support the ecosystem of tools and applications that are available today focused on care coordination and the improvement of clinical outcomes.

In the current changing face of healthcare in the United States, providers and payers alike have powerful incentives to modify the way care is managed and paid for.  Their roles are morphing with payers looking to play a bigger role in the management of their members and providers looking to take on more risk.  Central to this is the ability to access and coordinate the vast amounts of population data that can be derived from the multiple outpatient and inpatient settings.  Technological challenges aside data sharing comes with cultural challenges that need to be addressed, particularly between physicians and payers, where historically data has often been used as a pawn in contract negotiations between the two.  Payers and providers need interoperability now more than ever, allowing them to work together to share data and combine resources and forces. Robust bi-directional data exchange can be a solid foundation for this.

Not sure where to look for assistance in coordinating successful bi-directional clinical data exchange?  Halfpenny Technologies has more than fifteen (15) years of experience with bi-directional clinical data exchange including medical record data obtained from Continuity of Care Documents (CCDs) exchange as the demand has intensified of late.  A recent example includes the near real time bi-directional exchange of clinical care documents between physicians in ambulatory practices and health coaching providers aligned with a health system. This clinical data exchange allows collaboration on clinical guidelines and protocols for the management of chronic conditions outside the typical primary care provider setting.

Halfpenny Technologies’ continued investment in innovative solutions uniquely positions the company as a national provider of clinical data exchange solutions to the health care industry.




Halfpenny Technologies Names Linda Groff as Vice President and General Manager for the Health Plan Market

Halfpenny Technologies, Inc., a leader in clinical data exchange solutions, announced the appointment of Linda Groff, MBA, as the Vice President and General Manager for the Health Plan Market.

“I am pleased to welcome Linda to the Halfpenny Technologies team.  Linda’s extensive experience with the health plan market makes her uniquely qualified to help us expand our already compelling solutions to the market,” said Tim Kowalski, President and CEO of Halfpenny Technologies.

Linda brings 25 years of experience in the healthcare industry to her new role at Halfpenny Technologies. She has built upon her decade of experience in healthcare delivery with positions in both the healthcare payer and healthcare technology sectors of the market.  Recently, she served as Associate Vice President of Consulting Services at McKesson Health Solutions. She previously held executive positions at both Horizon Blue Cross and Blue Shield of New Jersey and Americhoice, a Medicaid subsidiary of the United Healthcare Group.

“I am thrilled to join the Halfpenny team,” said Linda. “I look forward to the opportunity to contribute to the development of products and services that will enable effective operations for the healthcare industry.”

About Halfpenny Technologies

Founded over 15 years ago, Halfpenny Technologies Inc. provides clinical labs, pharma’s, hospitals, ACOs, and health plans with a cloud based, secure, scalable, clinical data exchange platform designed to optimize care coordination, supplement HEDIS reporting, improve STAR ratings and efficiently connect physicians EHR systems.


Halfpenny Technologies Inc.
Emily Pollock, 610-277-9100 X191

The invaluable benefit of finding out in real time when a Member or Patient is in the Hospital

By Lesley Brown, SVP of Project Management at Halfpenny Technologies

Keeping track of when a member is admitted to the hospital is critical for both the patient’s health plan and their physician.


Many health plans receive utilization data from their associated hospitals, but how frequently and how quickly does this occur? And primary care physicians rarely find out their patient has been in the hospital until their next office visit. The result – all too often, your patient has left the hospital before you were informed they were admitted!

Admission, Discharge, and Transfer (ADT) HL7 messages are ubiquitous in hospital information systems and communicate a patient’s state (admitted, discharged etc.) and when their personal or demographic information has changed. Timely notification of an inpatient hospital stay, an emergency room (ER) visit, or transfer to another facility via these apparently simple but ever present messages can be instrumental in supporting care coordination. Assistance with helping to reduce hospital readmissions comes to mind when we talk about hospital events but the near real time tracking of utilization events can have a much broader impact.

Imagine knowing a member has been admitted to the hospital for an exacerbation of a chronic condition such as congestive heart failure or COPD. How impactful would it be to have knowledge of that before the patient is discharged and to visit that member right there in the hospital? Research has shown that patients are more accepting and acquiescent to suggestions and changes to their health when they are in such situations. This time could be invested to review a care management program that would be beneficial for them to enroll in and to help them understand their plan of care. Notably, the time can also be used to improve member’s exposure to their health plan and transition their insurance provider’s image from one centered around billing to one focused on care coordination. For health plans, care managers who are located in hospital locations or patient centered medical homes, real time knowledge of utilization events can drastically improve their effectiveness and impact.

Looking for some assistance in obtaining meaningful clinical data such as ADT HL7 messages so you can be notified immediately of health care encounters? Halfpenny Technologies Hospital Utilization Notification Solution can provide you with real-time, customized information around a member’s hospital events including ER and inpatient admissions, changes in level of care, transfer to another facility and discharge. In the case of a trigger event you can be notified immediately via text or email providing the opportunity for instant contact and communication. Halfpenny Technologies’ continued investment in innovative solutions uniquely positions the company as a national provider of clinical data exchange solutions to the health care industry.

Ivy Creek Healthcare to Expand Physician Outreach Program

Clinical Data Exchange Solutions provided by Halfpenny Technologies solutions to assist in expansion

BLUE BELL, Pa.–(BUSINESS WIRE)–Ivy Creek Healthcare announced today an expansion of their hospital physician outreach capabilities through clinical data exchange solutions provided by Halfpenny Technologies Inc. (“HTI”). The HTI platform will facilitate the exchange of clinical laboratory orders and results to physicians, clinics and long-term care facilities that refer to the Ivy Creek three hospital system.

“Our team is looking forward to helping Ivy Creek expand into their surrounding communities through their clinical outreach initiatives with our clinical data exchange and business intelligence solutions,” Tim Kowalski, President & CEO said. “We have worked with over 95% of the EMR companies so we are uniquely positioned to assist in providing Ivy Creek’s patients with reliable, proven interoperability solutions that we deliver as a fully managed services delivery model. Our latest V7 release of our Web-based Clinical Orders and Results Portal will also be rolled out to assist their clients with a secure, easy to navigate system to create clean requisitions and to view results online.”
Read more here

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