The New York City Health and Hospitals Corporation (HHC) has embarked on a two- year, $22 million community health information technology exchange program to improve health outcomes and help reduce costs associated with providing care for persons diagnosed with schizophrenia who often suffer from multiple chronic illnesses, have frequent contacts with healthcare organizations and have a shorter life expectancy.

Under the new “InTouch” partnership, five HHC hospitals and a number of community health providers will begin to share patient information electronically to closely track and improve the coordination of medical and mental health care for 2,500 patients who have received primary care from HHC and are residents of a “care coordination” zone in Queens, North Brooklyn and Lower Manhattan. This partnership will operate under the principles of a patient-centered primary care model, and with the help of technology will ensure the hospitals and community providers that care for the same patients can now talk to each other.

“People with schizophrenia are at higher risk of suicide, are more likely to smoke, have drug and alcohol dependency, and often depend on anti-psychotic medications which can result in drastic weight gain that contributes to obesity and heart disease. Yet the healthcare services they receive are too often episodic and lack the integration among all the healthcare providers to effectively manage both their physical and mental health needs,” said HHC President Alan D. Aviles.

With the help of a $9 million New York State Health Care Affordability and Efficiency Law (HEAL) grant and $13 million in matching funds from all the program participants, the program will support the expansion of care coordination through the use of interoperable health IT. The funds will be used for the technology, equipment, training and technical assistance needed to create interconnectivity through the Interboro Regional Health Information Organization (RHIO), which already allows the electronic exchange of clinical information among providers of healthcare in New York City.

The InTouch health information exchange link is scheduled to go live by early 2012 and will allow the participating healthcare providers to share medication lists, known allergies, laboratory and test results, as well as care and discharge plans for all the patients. The electronic link will also feature “care alerts” that can be sent to case managers and caregivers with real-time information to indicate if the patient has entered an emergency department, has been admitted to the hospital and when the patient has been discharged.

“Armed with this clinical information and interconnectivity, we can begin to transform the way we provide care to New Yorkers with mental illness, improve their quality of life, support their recovery, and help them live healthier and longer,” Aviles added.

Other features of the InTouch health information technology exchange will also include:

• adoption of clinical best practices among all providers, including regular physical exams and assessments for diabetes, hypertension and obesity;
• routine monitoring of risk behaviors such as smoking, substance abuse, poor nutrition and non-adherence to medication;
• monitoring of population outcomes through a comprehensive disease registry;
• use of the HHC Advantage online link which allows all the providers to electronically refer patients to HHC’s hospital-based specialty services;
• medication management “decision –support” application to ensure all providers are following best practices in the medication treatment guidelines for schizophrenia; and
• a governance structure to ensure health records for patients with mental health are appropriately protected by privacy and confidentiality laws.

“It is not uncommon for individuals with mental illness to touch several different hospitals, different emergency departments and various community-based psychiatrists or psychologists," said Rosa M. Gil, President and CEO of Comunilife, one of the member agencies of the Urban Institute for Behavioral Health. "By partnering through technology and sharing vital patient information with these providers, we will be able to track patients in real time and quickly and effectively mobilize resources to facilitate the patient’s safe return to the community.”

The InTouch partners from HHC include: Elmhurst, Queens, and Woodhull Hospitals, the Cumberland and Gouverneur diagnostic and treatment centers, HHC Health and Home Care, and HHC’s MetroPlus Health Plan. The community based participants are: Urban Institute for Behavioral Health, Creedmoor Psychiatric Center, the NYC Department of Health and Mental Hygiene, and the Interboro RHIO.

November 2011