Health IT and Public Policy

* Article from the VITL 2016 Annual Report

Data Capture Analysis

In October 2016 VITL unveiled a new quantitative model to the Green Mountain Care Board (GMCB) that showed the Vermont Health Information Exchange (VHIE) is collecting about 61 percent of the available health care data for Vermont patients.

The model is indexed to the Vermont Health Care Expenditure Analysis which is published each April by the GMCB. This analysis is important because it provides insight into two key factors related to health information exchange, namely the relative weighting of health care segments, and the challenges of achieving a fully connected health care system.

The analysis shows how VITL has prioritized its work such that clinical data is captured for the largest portions of health care expenditures. VITL captures 87 percent of hospital data, the largest component of health care related expenditures. VITL is receiving encounter data, lab results, immunization reports, and transcribed reports from all of the hospitals as well as Continuity of Care Documents (CCD)—documents used for care transitions that are rich with patient data— from three hospitals. Work is underway with the remaining hospitals to collect CCDs from them as well, closing the gap on remaining hospital data.

Physicians—whether hospital employed or independently employed—together make up the next largest component of health care expenditures. The VHIE receives clinical data from 61 percent of the known hospital physicians and 14 percent of the known independent physicians. VITL works with OneCare Vermont and the Blueprint for Health to prioritize continued connectivity for physician practices.

Percentage of clinical data captured in the VHIE

Measuring VHIE Effectiveness

VITL has embarked upon two research studies to demonstrate the impact of the VHIE on health care delivery in Vermont.

The first study demonstrated the efficiency brought to organizations that moved to direct, electronic delivery of laboratory results through the VHIE. Prior to electronic delivery, staff at health care organizations would manually transcribe printed or faxed results into their EHR systems. Through an in-depth survey of organizations equipped to directly receive results and examination of internal VITL data, the study concluded that repurposing of staff to more productive clinical tasks could be valued at $342,594/year.

A second study underway is seeking to relate an organization’s technical maturity with its per- patient expenditures, and emergency department outpatient utilization. Patient-Centered Medical Homes (PCMH) in Vermont were assigned maturity scores based on several types of interventions completed by VITL. The analysis indicates that PCMHs that have a higher technical degree of maturity also have lower expenditures per person ($134), and were associated with fewer emergency department outpatient visits (nine visits/1000 patients).

The impact of the maturity score on cost savings cannot be completely isolated as a single independent variable. Work is underway to further isolate maturity from the other factors that effect a change in medical expenditures per capita, and inpatient and outpatient measures of utilization. VITL anticipates publishing these research studies in 2017.