New ACO Gateway Developed for Community Health Accountable Care

VITL completed a project in December with Community Health Accountable Care, LLC (CHAC) that will provide clinical patient data for their attributed patients. The CHAC Gateway Project put in place the capability to identify and route CHAC patient data coming into the Vermont Health Information Exchange (VHIE). Once identified, the patient data will be made available to CHAC for use in managing the health of their patients from participating network providers.

CHAC is an accountable care organization (ACO) that participates in the Medicaid shared savings program, and coordinates care among its participating providers to meet the medical and social needs of each patient. Carefully coordinated care improves the patient experience by potentially eliminating redundant tests. CHAC providers share in the cost savings associated with participating in an ACO.

The VHIE is a network managed by VITL that collects patient information from hospitals, Federally Qualified Health Centers (FQHCs), primary and specialty care providers, home health care providers, and commercial labs from across Vermont and adjacent states. This patient information is then made available to any provider in a treating relationship with a patient. The patient data can also be used by accountable care organizations for population health analytics. By analyzing data from their entire patient population, an ACO can determine if they are meeting wellness objectives for their patients.

Each month, CHAC provides a list of its consenting patients to VITL for use in the CHAC gateway, so that the clinical data associated with these patients can be identified from all the data flowing in the VHIE. This list is used to route admit, discharge and transfer data, lab results, care summaries and immunization records for CHAC patients. In technical terms, routing CHAC patient information in the VHIE network is done by isolating their patient data and adding an identifier field to inbound messages that are formatted with the HL7 (Health Language 7) standards.

Data sent to the VHIE is stored in a data warehouse which organizes the information so it can be used for analysis. CHAC patient data will eventually reside its own subset of the warehouse called a data mart (or dataset), for analysis by the ACO. Each month, the list of attributed patients from CHAC is updated and processed through the gateway.

The project team at VITL that worked on the CHAC gateway was led by Program Manager Carolyn Corbato-Stone, and included the Application Systems Analyst Team of Jennifer Starling, Regi Wahl, Craig Hill, Mary Donati and Suzanne Garrow, along with Mark Daly, programmer/analyst, Stuart Lopez, database analyst, Kenan Nurkanovic, systems engineer, and the Technical Support Specialist Team of Dana Clark, Angela Shaheen and Whye Yap. The CHAC team included Kate Simmons, Heather Skeels & Lauri Scharf.

This is the second ACO gateway project that VITL has completed. Corbato-Stone noted that “Time management is always a challenge for large projects, and at the end of last year there were many projects competing for resources. We had to work as an efficient team, and incorporate the lessons learned from the first gateway project to complete this project on schedule.”

The CHAC Gateway began operating on February 1, 2016, and VITL is currently working with CHAC to scope out the details of their data mart project.