Once an underdog, Connecticut’s HIE network gains traction
While Connecticut was one of the last states to launch a statewide health data exchange, the HIE network has grown rapidly, adding 1,078 new locations over a 12-month period.
When it comes to health information exchange (HIE), Connecticut has long been an underdog. After a decade of false starts, the state launched its statewide HIE network, Connie, in 2021, making it one of the last states to create an HIE.
However, according to Jenn Searls, executive director of Connie, the network is making up for lost time.
"I think Connecticut's come from behind in a lot of ways," said Searls. "We were maybe one of the last states to get an HIE up and running, but we really have, I think, skyrocketed."
According to Searls, several failed attempts at launching a statewide HIE in Connecticut had created "legacy trepidation" about this kind of network.
However, when the COVID-19 pandemic exposed critical data exchange challenges, Connecticut pushed forward its HIE plans.
"It sort of was this realization of, 'We still have pockets of providers and patients and organizations that maybe aren't as interoperable as we thought,'" Searls said. "I think there was sort of this perfect storm of, 'Now is the right time, let's make it work,' which I give a ton of credit to the legislature in our state, the stakeholders who helped set up Connie and all the partner organizations."
State legislature drives HIE growth
Connecticut law required all licensed healthcare providers with an EHR system to begin the process of connecting to and participating in Connie by May 3, 2023.
For a long time, it sort of felt like we were the little engine that could. Now we're getting up to that top point where there's just so much engagement from large health systems and the provider organizations that work with them, so we're really excited about that.
Jenn Searls, executive director, Connie
"It's a pretty broad mandate," said Searls. "The cool thing about that is that it stops us all from looking and hoping someone else is going to go first. I think it was the right move."
Not only is Connie steadily growing -- adding 1,078 new locations over a 12-month period ending in September 2024 -- but it has also seen an influx of repeat users. From January to October 2024, the number of repeat users on Connie's website portal or app increased by more than 200%.
"For a long time, it sort of felt like we were the little engine that could," said Searls. "Now we're getting up to that top point where there's just so much engagement from large health systems and the provider organizations that work with them, so we're really excited about that."
Improving provider workflows
As a network, Connie aims to streamline clinical workflows through access to updated patient health data. For instance, the HIE's medication management tool parses continuity of care documents (CCDs) from across a patient's care team to create a deduplicated medication list.
"As a patient, I might have three or four or five different providers, and I give them the same med list every time, so there's all these episodes of care," said Searls.
Now, instead of opening each of those CCDs to compile a medication list, providers can use the HIE tool, which automatically creates a deduplicated list of medications.
The HIE also supports image exchange, which is helping providers across the state diagnose and treat patients more efficiently.
"We had this really heartwarming email from a pediatric provider," Searls noted. "They ended up diagnosing a child with bone cancer much sooner than they might have because they had access to X-rays that they didn't have in their system, which meant that they could start discussing treatment options and get the patient in treatment much faster."
Enhancing public health reporting
In addition to the network's benefits for clinical workflows and patient care, Connie is working with the Department of Public Health to streamline public health reporting.
State government initiatives and private sector input have driven this effort. Searls noted that health system leaders, including a former CIO at Yale Health, have voiced concerns about the burden of setting up multiple data feeds for reporting to different state agencies.
Connie is stepping in as a conduit to consolidate data exchange and reduce redundant processes through an electronic interface for tests, orders and results.
Searls said that Connie hopes to bring the interface live this year to help ease reporting burdens on public health labs and healthcare organizations.
"If we already have the pipes, let's not rebuild them," Searls emphasized. "That's taxpayer dollars. That's a ton of work and money for each of the private organizations. Just use our highways, our pipes and tunnels to get data back and forth to you."
Connecting state agencies
Notably, Connie's growing HIE footprint doesn't just include healthcare providers. As the network has expanded, state agencies have joined Connie to drive data exchange efficiency. Take Poison Control, for example.
With access to Connie's clinical portal, Poison Control can easily pull up patient health records to inform poison cases. For instance, a patient's health information may reveal risk factors for the ingestion of certain substances.
"They're able to really provide better, more targeted assistance to patients that call in, but also to emergency rooms that call in and say, 'I've got a patient here who's presenting with X,'" said Searls. "They're able to pull up that patient's chart and say, 'Here are the three or four things you need to consider.'"
"It's been this absolute boon to help them as they manage poison cases in the state, as well as figuring out their reporting on the number of substances that are being ingested accidentally or otherwise," she added.
The Office of the Chief Medical Examiner is also connected to Connie, which has drastically cut down on the amount of time it takes to complete a death investigation, Searls said.
Instead of calling or driving to a provider's office to gather patient data, the agency can pull up patient records in Connie to inform death investigations.
"There are all of these use cases where previously the agencies or public health utilities in the state have had to run around and either get faxes or go to doctor's offices to get information, and through Connie, they can really do the job they're supposed to do that we're paying for as taxpayers," Searls emphasized.
Hannah Nelson has been covering news related to health information technology and health data interoperability since 2020.
