North Carolina Department of Information Technology Content Creation
NC HIEA Updates
I prepare an update each month, detailing important information for providers as well as changes and updates to the advisory board, the NC HealthConnex service, and statewide rules and laws. Below are samples from two newsletters released in April of 2023 and February of 2024.
NC HealthConnex Provides Data to Support a Study Addressing Disparities in Health Outcomes for Black Mothers
Every April, the health care community observes Minority Health Month, an effort to build awareness about the disparities in premature death and illness in minority populations. Within this broader effort, Black Maternal Health Week is held to address solutions to the disproportionate rates of mortality and illness among Black mothers and infants. This year, that week fell on April 11 – 17.
According to data from the CDC, Black women are three times more likely to die from a pregnancy-related cause than white women. Black infants are also two times more likely than white infants to be born with a low birth weight.
NC HealthConnex is assisting in developing solutions to these disparities by fulfilling the data exchange and dashboard requirements of the UNC-led study, ACURE4Moms, or Accountability for Care through Undoing Racism and Equity for Moms.
The study seeks to improve health outcomes for Black mothers and infants by addressing institutional racism and bias in health care processes, gathering health care data, and providing community-based, social support in the form of doulas.
The 40 North Carolina clinics participating in the study are full participants of the NC Health Information Exchange Authority (HIEA). This allows for a bi-directional flow of health data that will be necessary for several of the study’s four arms:
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The control group will provide standard care management and enter standard obstetrics and other health data into their electronic health records software (EHR).
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The data arm will add practice-based data interventions to their standard care practices. This would include the use of the Disparities Dashboard and Maternal Warning System alerts. These two systems are explained below.
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The doula arm will match high-risk patients with doulas who are trained to provide care and support during prenatal and postnatal appointments.
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A combined data and doula arm will combine standard care management, practice-based data interventions, and community-based doula support.
The primary desired outcome for the study is to decrease low birthweights, indicating the underlying causes have been addressed by health care providers. To that end, an alert system will notify certain clinics when a patient has a risk factor for low birthweight, including any physical, mental, or social risk factors related to the study.
This Maternal Early Warning System generates alerts with information available through NC HealthConnex and is set up through NC*Notify, a subscription-based alert service offered to full participants of the NC HIEA.
Data related to pregnancy-related complications will be presented quarterly to clinics in the data arms using a Health Disparities Dashboard, created and maintained by the NC HIEA. The dashboard will show gaps in health care processes and outcomes broken down by race and ethnicity. Data elements to be collected include expected due date, date of the first prenatal visit, baby birthweight, and other health data available through NC HealthConnex.
One of the study’s goals is to reduce discrimination experienced by Black patients’ during their prenatal care visits. The data in the dashboard will help providers see where differences in pregnancy complications are occurring across patients of different races so they can respond to increase the quality of care for those patients.
In addition to the dashboard, a survey will be sent to patients both during pregnancy and after they have given birth. Staff at all participating clinics will also have access to Racial Equity Training and an NC AHEC facilitator to help clinics improve care workflows and patient communication.
The participating clinics were randomly assigned to one of the four arms last year and are currently in the onboarding process. Each practice will be supported for two years. Those in the control arm will be able to start implementing either data or doula interventions or both starting in July 2025, with support until July 2026.
What Can My Practice Do with a Full Participation Agreement (Even If We’re Not Yet Live)?
The HIE Act requires that all health care providers that receive state funds, such as Medicaid or the State Health Plan, for the provision of health services submit demographic and clinical information to the network. A Submission Only Participation Agreement allows providers to meet the requirement of the HIE Act to submit this data from their EHR to NC HealthConnex.
While this submission is beneficial to reducing some reporting burdens to NC Medicaid and helping public health initiatives, the ultimate benefit of NC HealthConnex lies in the ability of provider to access patient data across the care continuum. This access is possible through a Full Participation Agreement.
The NC HIEA’s value-added services are available to providers who have signed a Full Participation Agreement and a Business Associates Agreement. These services are available at no additional cost.
As soon as you have your signed and executed agreement returned to you, you can begin training and use of any of the services listed below. You do not need to wait for your connection to be live or even for your connection project to begin before taking advantage of these services.
The 2023 Annual Report for the Government Data Analytics Center
This report covers accomplishments in the given year, goals for the future, and how progress from previously started projects has come along. Writing this report takes several months of constant communication with stakeholders, experts, and project sponsors. I take data, summaries, and roadmaps and mold it into a report for presentation and dissemination at the end of year presentation.
Excerpt from pg.16, section NC HealthConnex (N.C. Health Information Exchange Authority)
The NC HIEA operates North Carolina’s state-designated health information exchange, NC HealthConnex. NC HealthConnex is a secure, standardized electronic system through which providers can securely share important patient health information, such as labs, diagnostics, history, allergies, medications and more, helping create a more complete longitudinal clinical patient record. This results in less duplicative testing, more efficient and accurate diagnoses, recommendations and treatment, and improved coordination across all levels of care.
In addition to health care providers, NC HealthConnex supports state agencies. Efforts include improving continuity of care for incarcerated persons with NCDPS and N.C. Department of Adult Correction and providing population health data through registries including the N.C. Stroke Registry Dashboard and the Diabetes Registry Dashboard for NCDHHS.
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NC HIEA remains focused primarily on building technical connections to grow the patient data available to NC HealthConnex participants, helping providers meet their state reporting requirements and providing data and analytics services to NCDHHS to facilitate Medicaid transformation and promote more efficient public health surveillance.
The North Carolina Longitudinal Data Service Website
I created the below landing page with the conscious decision to highlight the frequently visited pages of each major section on the site. Our users are interested in getting information relevant to them as quickly as possible and this design allows for that. The content that exists on each site is as simple as possible for the complexity of the topic.
For example, on the topic of a future expansion of the LDS: "Preparing custom datasets sometimes can be time-consuming. In response, NCLDS Contributors are in the process of creating pre-prepared, record-level, de-identified, and linkable datasets comprising their most frequently requested data elements. Because these datasets are pre-prepared, the time required to fulfill requests for them will be shorter than the time required to create custom datasets."
