Integrating clinical, claims data key in one Delaware organization's response to COVID-19

Dr. Jan Lee, CEO of the Delaware Health Information Network, speaks Wednesday at the HIMSS21 conference in Las Vegas.

Photo: Jeff Lagasse/Healthcare Finance News

LAS VEGAS – Early in the summer of 2020, to combat the spread of COVID-19, the state of Delaware implemented a testing program at several Walgreens locations throughout the state. With many employers requiring printed proof of negative status before allowing a return to work, the state's epidemiologists found themselves spending inordinate amounts of time drafting and mailing letters to patients.

In July 2020, the Delaware Division of Public Health approached the Delaware Health Information Network, or DHIN, to leverage its personal health record, Health Check Connect, for consumers to both see and print their COVID-19 results. DHIN's personal health record service, while several years old, had little mainstream adoption and comparatively few active users.

Would an underutilized and subsequently underfunded service meet the challenge for thousands of new users in the course of several days?

That was what Dr. Jan Lee addressed in her HIMSS21 session, "Putting a Personal Health Record to the Pandemic Test," here on Wednesday.

Lee is DHIN's CEO, and it's been her organization's mission to integrate clinical and claims data in ways that make best use of both data sets. Health Check Connect was created before the pandemic, initially conceived as a tool for small practices to meet their meaningful use patient engagement requirements.

"We were expecting this to be sort of the poor man's sharing portal," said Lee. "In Delaware, 7% of practices are five providers or less, and independent of any hospital or health system affiliation. That was kind of our vision for that."

The initial use case got very little traction. Some people signed on, but for the most part it never took off the way DHIN had envisioned.

Then came the pandemic.

"With COVID testing occurring in great numbers, our delivery of lab results almost doubled our pre-pandemic levels," said Lee. "We, of course, populated the community health record with the test results we received, and that was something the healthcare community really valued. Sometimes you get a bit ahead of your headlights. The state was having testing all over the state and not getting that info into the community health record."

DHIN offered the same services, but now they were becoming much more sought-after. The state's Public Health office then sought out DHIN for information regarding health disparities in communities of color, and while the data wasn't 100% complete (due to patients not being required to disclose such data), the organization was able to dramatically improve Public Health's ability to answer questions about how the pandemic was impacting specific population groups within the state.

"We provided de-identified data to Public Health to allow them to answer questions from governmental authorities to identify risk factors for those who died of COVID," said Lee.

With information blocking rules in place, information was available to patients and providers at the same time. But public awareness was still a barrier to adoption. To address that, DHIN dragged its technology into the future; whereas previously its portal was only available in a browser format, it found a partner to help develop an app that people could use on their connected devices.

That increased awareness, but Health Check Connect is still a loss leader for DHIN. It has been aided by funding through the Coronavirus Relief fund, but DHIN is currently mulling options for better monetizing the platform post-pandemic.

A potential ongoing partnership with the Delaware Division of Public Health is in the cards, as is possible collaboration with the state's EMA.

"We'll be a meaningful platform for engagement," said Lee. "We don't want to get between a patient and their healthcare provider. That is a sacred relationship. So we are wading very carefully in discussions with our stakeholders in the medical community to ensure our efforts add to theirs."