Industry Insight

Project Aims to Improve Interoperability of Social Determinants of Health Data

Health Level Seven International (HL7), the global authority for interoperability in HIT, and the American Academy of Family Physicians (AAFP) are pleased to announce that the Gravity Project is now part of the HL7 FHIR Accelerator Program.

The Gravity Project aims to standardize medical codes to facilitate the use of social determinants of health (SDOH)–related data in patient care, care coordination between the health and human services sectors, population health management, value-based payment, and clinical research. SDOH are the conditions in which people are born, grow, work, live, and age, and the wider set of forces and systems shaping the conditions of daily life.

The HL7 FHIR Accelerator Program is designed to assist implementers across the health care spectrum to create HL7 FHIR implementation guides and other products than can facilitate FHIR acceleration and adoption activities. Other projects within the Accelerator Program include Argonaut, Da Vinci, and CARIN Alliance.

Why the Gravity Project? Unmet social needs including limited access to food, transportation, and housing can negatively impact health outcomes. Research has demonstrated that addressing social and medical needs in tandem improves health outcomes and lowers costs.

“Progress in patient care and research has made significant strides with the emergence of the HL7 FHIR Accelerator Program,” says HL7 International CEO Charles Jaffe, MD, PhD. “By incorporating the social determinants of health care into our decision process, the Gravity Project will help to transform care delivery and health analytics.”

In this context of mounting interest around collecting and using SDOH data in health care settings, new challenges have emerged related to the capacity of existing medical terminology standards to effectively capture, use, and exchange the necessary data.

The Social Interventions Research and Evaluation Network (SIREN) at the Center for Health and Community at the University of California, San Francisco (UCSF), was an early catalyst of the Gravity Project, convening a diverse group of stakeholders as early as November 2017 to develop a strategy for achieving consensus-based comprehensive coding standards for SDOH data capture in EHR systems.

“With funding from the Robert Wood Johnson Foundation and in partnership with EMI Advisors LLC, SIREN is pleased to be working with multiple stakeholders to meet the rapidly expanding market needs around SDOH data documentation and interoperability,” says Laura Gottlieb, MD, MPH, SIREN director and a UCSF associate professor of family and community medicine. “Building on work originally supported by Kaiser Permanente and the Robert Wood Johnson Foundation, the Gravity Project’s new partnership with HL7 will strengthen the capacity for SDOH information exchange between stakeholders, including clinical providers, patients, community organizations, and payers.”

The Gravity Project has established a public collaborative process initially focused on three domains: food security, housing stability and quality, and transportation access. The project is working to do the following:

• develop use cases to support documentation for screening, diagnosis, treatment/intervention, and planning activities within EHR and related systems;
• identify common data elements and their associated value sets to support the use cases;
• formulate a consensus-based set of recommendations on how best to capture and group these data elements for interoperable electronic exchange and aggregation; and
• create an HL7 Fast Health Interoperability Resource Implementation Guide based on the defined use cases and associated data sets.

“The AAFP is pleased to act as convener for the Gravity Project and support information interoperability efforts,” says Shawn Martin, senior vice president of advocacy, practice advancement, and policy for the AAFP. “Our vision is to transform health care by addressing the social determinants of health through efforts such as our innovative HealthLandscape geoanalytics platform and The EveryONE Project to help family physicians take action and confront health disparities head-on. The important work of the Gravity Project will advance data exchange and allow family physicians to better care for patients and communities.”

The Blue Cross Blue Shield Association (BCBSA) is an active member of HL7’s initiatives to advance interoperability and has joined SIREN and AmeriHealth Caritas in cosponsoring the Gravity Project launch. Additionally, both the BCBS System and AmeriHealth Caritas have several programs in place to address SDOH, including actively collecting SDOH health data, engaging community health workers, providing rides to doctor appointments, and delivering healthy, affordable meals to people’s homes.

“The social and environmental conditions in which we live, such as access to healthy food and housing or reliable transportation, are critical to our health,” says Trent Haywood, MD, JD, chief medical officer for BCBSA and president of the Blue Cross Blue Shield Institute. “The Gravity Project will help enable the data interoperability that allows the entire health care community to address barriers that limit the ability to achieve optimal health.”

The Gravity Project has convened more than 500 experts from across the nation including clinical and community-based provider groups and payers to health technology developers and standards stewards, to collaboratively develop recommendations for how best to capture data about food, housing, and transportation risks and needs, for interoperable electronic health information exchange.

“AmeriHealth Caritas has been actively collecting social determinants of health data from member households for the past two years to help us better address their needs,” says Andrea Gelzer, MD, senior vice president of medical affairs for AmeriHealth Caritas. “The Gravity Project affirms our collective belief that standardizing the ways in which we all collect data will enable providers, plans, and other supportive agencies to quickly and more strategically mobilize care for the populations we serve.”

Participation in the Gravity Project is open to all interested organizations and individuals.

“We are pleased to coordinate and facilitate an open, transparent, and virtual community via the HL7 suite of collaboration tools,” says Evelyn Gallego, MBA, MPH, CPHIMS, program manager for the Gravity Project and EMI Advisors CEO. “We invite all interested parties to visit the HL7 Confluence page to learn more about the Gravity Project, including how to become a participant and/or a sponsor of this important endeavor.”

— Source: Health Level Seven International

Tenet to Spin Off RCM Unit Conifer

Tenet Healthcare Corporation recently announced its intention to pursue a tax-free spin-off of its Conifer business as a separate, independent, publicly traded company. The company expects to complete the spin-off by the end of the second quarter of 2021. This announcement is the culmination of the Conifer strategic review process announced in December 2017.

Ronald A. Rittenmeyer, executive chairman and CEO of Tenet, says, “After an extensive review of Conifer’s strategic alternatives, in which we evaluated multiple options for the business while simultaneously driving significant and sustainable improvements in performance, we are pleased to announce plans to spin off Conifer into a separate, publicly traded company. This decision supports our longstanding objectives to maximize the value of Conifer, build on its strong growth potential and deliver the best outcome for Conifer and for Tenet shareholders.”

Rittenmeyer continues, “Conifer has unmatched experience and scale in offering revenue cycle management solutions for health care providers and a proven track record of delivering high-touch, high-value services to clients. Pursuing a tax-free spin-off is an important step forward in Conifer’s evolution, and we believe the business is well-positioned to capitalize on its growth opportunities as a standalone company.”

Rittenmeyer adds, “We were pleased with Tenet’s performance in the second quarter, with Adjusted EBITDA comfortably within our Outlook range and consistent with consensus estimates. Volume growth strengthened in our hospital business, with increases in both admissions and adjusted admissions. USPI also delivered favorable volume growth and Conifer had another strong quarter. We remain excited about the future of our health care services offerings at our 65 hospitals and approximately 500 outpatient centers, which will remain part of the Tenet enterprise.”

— Source: Tenet Healthcare Corporation

Ciox Secures Equity Investment From Merck Global Health Innovation Fund

Ciox Health recently announced a $30 million equity investment to enhance its core capability of providing clinical data liquidity to reduce health care costs and improve the quality of patient outcomes. New investor Merck Global Health Innovation Fund and private equity owner New Mountain Capital led the financing.

Ciox rapidly and securely facilitates access to clinical records on behalf of its health care provider customers, enabling increased data liquidity and the improvement of health care outcomes. In this newly announced relationship, Ciox is continuing to enhance its core capability of providing clinical data liquidity to reduce health care costs and improve the quality of patient outcomes.

The financing will be used to accelerate the development of Ciox’s Digital Patient Clone (DPC)—a health data repository that brings deidentified real world patient data to researchers at scale and on demand. Through its DPC platform, Ciox can stitch together the digital fragments of a patient’s story from disparate clinical information systems, then normalize the data for use by researchers. The investment also will enable Ciox’s provider partners to contribute to advancing clinical research and development without introducing additional administrative burden or complexity.

“We are pleased to partner with Ciox, a leader in moving data and information among provider systems, patients and clients,” says David M. Rubin, PhD, managing director of Merck Global Health Innovation Fund. “Ciox brings a unique approach to accessing real world data at scale, and we expect them to partner intimately with companies within the GHI oncology digital health portfolio. Ultimately, Ciox’s technology will advance clinical research and accelerate the launch of new treatments.”

— Source: Ciox Health