Jan Lee, MD is Chief Executive Officer of Delaware Health Information Network (DHIN), serving providers and consumers of care through innovative solutions that make health data useful. A statutory entity of the State of Delaware, DHIN was created in 1997 as a public-private partnership. The first operational state-wide health information exchange, today, DHIN is fully self-sustaining, employing 35 full-time employees in Delaware and remotely on the East Coast. DHIN securely delivers more than 14 million clinical reports and data annually to medical professionals caring for patients in Delaware and beyond.
In an exclusive conversation with Aspioneer, Dr. Lee shared insights into her career journey, the changing business landscape and how DHIN’s data services can help combat the cost crisis in healthcare.
“The biggest problem we want to solve is the silos of health data and the resulting fragmentation of healthcare.”
Q. Tell us what ignited your passion for quality healthcare?
Dr. Lee: I am a family practice physician, and I joined this company because I see the potential of health information technology and services to address many of the issues that have most frustrated me across my years of clinical practice. I could give numerous examples of how missing information has compromised the care of patients and consumed inordinate amounts of staff time in trying to locate what was missing. Technology introduces a different set of problems, and I am not indifferent to the frustration and burnout that many physicians currently feel based on poorly designed technology that doesn’t fit their workflow or clinical thought process. But I do believe that these problems will be solved, and the next generation of physicians will never experience some of the frustrations that were a daily part of my life in clinical practice.
Q. How is DHIN contributing to the healthcare ecosystem?
Dr. Lee: DHIN was established by the State of Delaware to address the following:
First, securely exchanging health data between care settings (lab to hospital to doctor’s office, etc.) and second, collecting and analyzing health data on behalf of the State of Delaware for public health reporting purposes.
The biggest problem we want to solve is the silos of health data and the resulting fragmentation of healthcare. This creates endless frustration for both patients, who expect their doctors to communicate with each other and know everything about them they need to know; and doctors, who often find that critical elements of health history are not readily accessible to them at the point in time they are needed for good clinical decision making.
In addition to our core services of results delivery and the Community Health Record (our database of more than three million patient records), DHIN has recently added an All Payer Claims Database to our mix of nearly twenty services. By including healthcare claims data with the corresponding clinical information, DHIN is able to provide insights as to the cost and the resulting quality of medical care. This has great potential to assist in driving reductions in healthcare costs here in Delaware and more broadly as part of the triple aim of healthcare: Better quality of care, improved patient satisfaction and lower costs.
Dr. Jan Lee, Chief Executive Officer, Delaware Health Information Network (DHIN)
Q. What makes DHIN stand out?
Dr. Lee: When DHIN went live in 2007, we were the first state-wide health information exchange organization in the country, with no competition for our core services. That has since changed, with every major electronic health record (EHR) vendor now offering data exchange services and tools to access data they may not have themselves. DHIN has the advantage of being almost universally adopted across the healthcare community of Delaware, so we do have a certain home-court advantage. We are seen as the trusted, neutral purveyor of health data exchange in Delaware. Our strategy is to stay relevant by wrapping services around the data and bundling those services into value-added packages that the EHR vendors cannot easily replicate.
Q. What’s happening in healthcare that we should be aware of?
Dr. Lee: Our industry is in a period of rapid and profound change, mixed with a lot of uncertainty.
For providers of healthcare and related services, the uncertain outcome of the current administration’s attacks on the health policies of the previous administration is creating instability and anxiety.
For physicians, federal regulators are imposing requirements that have resulted in technology vendors producing products that meet the regulations, but at the expense of ease of use, contributing to an alarming rate of physician burnout.
On the payment and reimbursement side, our customers and stakeholders are struggling with the transition away from traditional fee-for-service healthcare payment models towards value-based payment arrangements.
For health information exchanges like DHIN, new players are entering the health information technology space, including tech giants like Apple and Google, along with the previously mentioned competitive service offerings of EHRs.
For patients, there is a growing trend toward the consumerization of healthcare. This means that patients may soon have access to their own extensive healthcare records and the corresponding responsibility to understand and protect that information.
And for all of us, cybersecurity threats are evolving at a staggering pace.
Through these challenging times, DHIN’s corporate strategy focuses on remaining the trusted neutral facilitator of health data collection, exchange and analytics services within our market.
Q. What is DHIN focused on right now?
Dr. Lee: DHIN has a unique opportunity to combine clinical and claims data in ways that can help answer questions about the costs of healthcare services and the resulting quality. The addition of this claims data gives DHIN a platform by which to bolster our data analytics capabilities, making this one of our flagship services. The following highlight some early uses of this important new capability:
Cost of elective surgical procedures: Delaware’s State Employee Benefits Committee analyzed claims data to evaluate a specific set of high-cost elective surgical procedures for cost and resulting quality. Armed with this information, they created a “network of excellence” for these procedures that directs beneficiaries to care settings that have consistently good clinical outcomes at the best price point.
Frequency of childhood brain injury: The State Council on Persons with disabilities has requested data on the frequency and prevalence of childhood traumatic brain injury as a result of sports injuries to help inform public policy.
Spending on primary care: The Primary Care Consortium, in partnership with the Delaware Department of Insurance, seeks data on the overall spending on primary care as a percentage of the total cost of care.
Price transparency for healthcare services: Delaware’s Department of Health and Social Services has requested a price transparency dashboard that will allow consumers to proactively know where they can get needed care at the lowest cost to them
Reliable. Valuable. Competitive. Sustainable.
DHIN’s mission is to serve providers and consumers of care through innovative solutions that make health data useful. We are all deeply committed to providing a public good, not just doing a job. While yesterday’s successes are part of the history we proudly celebrate, we must look to the needs of today and tomorrow to continue to be successful.