NPO is a large physician organization that provides a variety of services, such as legal and IT to its 540 members who are primarily independent physicians from practices of all sizes and specialties. It also provides the infrastructure for two other NPO-owned organizations— Northern Michigan Health Network and Trillium Health, contracting entities that are engaged in value-based care. Ed Worthington is the IT Director at NPO and supports the Health Information Exchange (HIE) that NPO owns and also the technical side of analytics systems provided to analysts and staff that work with the practices for quality improvement or analysis.
What was the Challenge?
NPO has a vast membership, most of which are remote and independent. Since their network of physicians use a number of different Electronic Health Records (EHRs) and varying workflows, the consequences of poor communications between providers during care transitions can be severe, both in terms of risk to the patient and unnecessary costs. Medication errors, duplicative diagnostic tests, unnecessary emergency room visits, and preventable hospital admissions and readmissions are some of the potentially fragmented care results when access to necessary information is lacking.
While NPO’s biggest challenge is aggregating and normalizing large amounts of data into consistent formats and sending it to receiving systems, it’s by no means the only challenge they face. Rural, independent communities are not only very diverse, they may not necessarily have the staff in-house to do the work they need. Traditionally there’s also less capital available and they don’t have the infrastructure to support a larger enterprise EHR like more populated areas can.
“Better coordination of care services between our physicians and other providers is central to our goal of helping our members achieve the Triple Aim objective of improving the patient experience of care (both quality and satisfaction), improving the health of populations, and reducing the cost of care.”
— Dr. Peter Sneed,NPO Board of Directors
Why Use Iguana to Solve It?
It wasn’t only the need to manage a multitude of EMRs and the corresponding differences in data formats, but a limited amount of internal IT resources that played a big role in compelling NPO to search for an interoperability partner. NPO chose to collaborate with iNTERFACEWARE to deploy its Iguana® integration engine. Worthington had already worked with Iguana® and found it to be more reliable, easier to use, and that it required less “babysitting” than previous integration engines. “Iguana® works like a utility. It runs well in the background and we haven’t had to think about it too much,” says Worthington.
Since NPO works with such a large number of systems that aren’t always well normalized, using Iguana® was a huge advantage because their professional development services were able to have the interface developed and get the system up and running on its own. NPO didn’t need to expend a lot of staff or resources or hire in-house developers in order to facilitate faster, more effective communication among providers that enabled the transfer of electronic patient information from physician practices and skilled nursing facilities to Michigan Health Information Network Shared Services (MiHIN).
What is Iguana’s Role in NPOs Processes?
NPO provides a lot of infrastructure, whether it’s legal assistance, workflow assistance like lean training, assistance with obtaining data from patients, or providing that data to the practices so they can navigate through the contract requirements more efficiently. This is in addition to traditional IT services like integrations and health information exchanges.
The role Iguana® plays is getting the data to where it needs to be. But it’s not just providing large amounts of data for analytics, it’s also about providing that information to the person at the point of care when it’s needed. For example, skilled nursing facilities can send data to a health information exchange state wide when that patient is admitted or discharged and being able to send that data quickly to the provider immediately improves patient care. Having the ability to provide updates and receive notifications about their patients also enables NPO’s member organizations to help its providers enhance quality of care delivery and qualify for financial incentive rewards through Blue Cross Blue Shield of Michigan’s Physician Group incentive program.
How Would You Characterize the Results?
“Really helpful, providing a lot of information and knowledge about where we see the industry going and being really transparent about the future of the product. Really helpful in combining professional services and product so NPO didn’t have to license Iguana then go out and find Iguana developers,” says Worthington. “Everything was available in one spot with people who understood the whole sales cycle they went though. They had one account person they worked with and providing that nice transparent streamlined relationship makes moving projects along easy with no gaps in communication. It’s been a helpful partnership.”