published on January 25, 2022 - 2:30 PM
Written by Gabriel Dillard

The Fresno County Public Health and Behavioral Health departments are making strides to bring improved access to health records among Central Valley hospitals.

Joe Prado, interim assistant director for public health, said this project has been in the works since before the pandemic. Recently, it was approved by the Fresno County Board of Supervisors for the county to partner with Central Valley Health Information Exchange and Manifest MedEx to execute the electronic health system.

The county can officially view records within the next three months, and community data monitoring can happen within six months to a year.

Central Valley Health Information Exchange works to provide physicians and hospitals with access to an electronic health records network. It focuses on developing networks for Fresno, Kings, Tulare and Madera counties. MedEx is a health information network that works to organize data and make it more efficient for providers to access. The Central Valley Health Information Exchange acts as the member arm, while Manifest MedEx acts as the technology and information sharing arm.

“So if you show up in an emergency room in Central California, whether you’re in a hospital in Madera but you’re a Kings County resident, that Madera hospital can actually look at your medical records,” Prado said.

Tuberculosis and mental health patients will benefit significantly from this new system, but it also has the potential to impact more people in the future.

In addition to the individual patient, the county can monitor population health – what diseases are circulating in the community and in what zip code. Prado says this is information the county doesn’t have today, and that includes chronic diseases like diabetes and asthma. Eventually the county would like to inform the community about its data. Prado said that organizations can also use it for community outreach.

“It really is a flip of a switch now,” Prado said. “That’s the benefit now versus having to wait for a fax, having to wait for a phone call back. It is very instantly available.”

The county’s Emergency Medical Systems has been trialing the technology for more than a year now. Before, the medical team had to manually enter information about a patient in transport once it arrived at the hospital. Now it can feed information into the system remotely.

Prior to the Central Valley Health Information Exchange agreement, the way the health department accessed hospital records was disjointed, but the county got a taste of what it could look like to have more seamless access to data.

The department accesses hospital records for communicable disease purposes, which helps the county know which zip codes are most affected by certain diseases.

“Covid is a great example of what that looks like,” said Prado.

According to the board of supervisors’ staff report the cost of the five-year term agreement is not to exceed $88,130.

“That is a significant asset that’s been in the community before the county signed on. So that is an improvement of care coordination here amongst the hospitals and amongst the clinics,” Prado said.

Covid case monitoring taught the county that with measuring data, it can help the community by giving more attention to underserved zip codes with the knowledge it obtains.

Cybersecurity is also monitored. Only those legally able to access the health records can see them.

Jason Buckner, chief information officer for Emeryville-based Manifest MedEx, said that information security is a continuous journey, not a goal to be achieved. The company has earned a certification for cybersecurity from HITRUST, an information security certification that is very health care specific.

“It is a very, very rigorous and tough goal to achieve that certification. We are one of the first health information exchanges in the country to achieve that certification,” Buckner said.

The certification is valid for two years, and Manifest MedEx has just received it for the second time, marking year three of being HITRUST certified. Buckner described it as the gold standard of health care data privacy and security.

Manifest MedEx partners with both Central Valley Health Information Exchange and San Joaquin Community Health Information Exchange. Manifest MedEx provides the technical infrastructure and data services, and the health information exchange partners work with the community so that at a local level, they understand what the participants need.

Mimi Hall, vice president of public health innovation for Manifest MedEx, said the benefits span over the entire population in California – not just the medical field.

Manifest MedEx has already been partnering with these health information exchanges since before 2017. Hall says the company has always been poised to work with public health to provide information about what’s impacting the population of a given community, said Hall.

During the pandemic specifically, it has helped identify which communities are high-risk for severe Covid-19 outcomes.

Buckner said the health plans, ambulatory providers and hospitals provide both administrative and clinical data to MedEx on all their patients.

“The first step that we use to begin to make sense of that data is we run it through what is called the enterprise master patient index,” Buckner said. “It creates a unified, longitudinal patient record.”

Once it’s unified and specific to the individual, it provides that information to a clinic or hospital within the Health Insurance Portability and Accountability Act (HIPAA). Health teams that log in to the system can access the patient’s record across different care settings.

He said that often there are gaps in this data because clinics or hospitals don’t have data from everywhere that the patient has visited.

“Access to data means that we’re eliminating the amount of time it takes to chase down information about the people that we serve. And time wasted means that we’re losing lives,” Hall said. “When you have this kind of data, it’s really, really valuable in increasing efficiency to whoever has the ability to tap into it. At the end of the day, it results in healthier people.”


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