By Thomas Vincz, Public Relations Manager

When nurse coordinator Stamatoula Cianfarra, RN, called to check in on a patient after his bladder cancer surgery, she was surprised.The patient did not recall the name of his urologist.

Fortunately, Cianfarra didn’t have to rely on the man’s memory to make sure he got the follow-up care he needed. As a nurse and care coordinator with Continuum Health, Cianfarra uses HealthSphere to help patients navigate the health care system, manage their health needs and follow their doctors care directions. This data-sharing platform was developed by Horizon and its health care partners across the state to pull together health records from different sources and give care delivery teams a complete picture of a patient’s health.

“After being discharged from the hospital, this patient needed to keep seeing the right doctors, who could help him remain cancer-free,” said Cianfarra. “Through HealthSphere, I could see the patient’s medical record and all of his providers in one place so I could reach out to them and schedule his next appointment.”

HealthSphere is designed to improve this kind of care coordination, which is key to helping increase health care quality, lower costs and improve the patient experience.

Horizon’s other data-sharing tools – including a collection of visually dynamic analytics reports – look at population-based health. Armed with this information, a health system can easily see how well its doctors are closing gaps in care or identify patients whose total cost of care is meaningfully higher than the practice’s average.

A complete medical record, right at doctors’ fingertips

With HealthSphere, care delivery teams can see a 360-degree view of a Horizon member’s office visits, diagnoses, prescriptions and lab work over the past three-to-four years. Doctors can then access these records through a secure website right in the exam room.

This comprehensive medical record is made possible because HealthSphere links some of the state’s largest hospital systems, pharmacies and physician practices with the health insurer’s own massive database of insurance claims.

“HealthSphere centralizes a wealth of hard-to-find patient information, which makes it easier for us to provide patients the best care,” said Vashona Edwards, LPN who also works for Continuum Health. Edwards and Cianfarra have been using HealthSphere for about six months.

Today, about one-third of the state’s hospitals are sharing data through HealthSphere, and about 50 physician practices have access to these records, a number that Horizon is looking to steadily grow.

“Health care data is everywhere, and historically it hasn’t been linked,” said Joseph O’Hara, director of healthcare marketplace innovations for Horizon. “With HealthSphere, we can give care teams a lot more information than in the past so they can improve the quality and experience of care.”

This connectivity is especially important for Horizon members with higher medical risk, such as patients with diabetes. Using HealthSphere, care coordinators like Cianfarra and Edwards can check a single record to see whether patients are filling their prescriptions or getting the recommended bloodwork.

HealthSphere is adept at helping doctors look at a patient’s past, said O’Hara. But it could also be used to help predict their future. “We’re building capabilities that can help us identify patients who could benefit from an intervention even before an event happens,” said O’Hara.

Seeing population data in a brand new light

While HealthSphere can help improve the quality of care delivered to an individual patient, Horizon is also working on data solutions that can do the same for entire populations.

Take, for example, patients with cancer. Using information contained in its millions of claims, Horizon can analyze nearly 100 factors affecting their care, such as which treatments have been successful or their number of hospital stays.

Horizon then works with health systems to select the 10 or so factors that are most relevant for impacting their care. For example, a health system can see which of its patients are meeting quality standards or which of its doctors are doing the best job at providing the most cost-effective care.

With increased transparency, Horizon and its provider partners can work toward their value-based care goals of improving quality and lowering costs, said Liz Rubin, director of analytics at Horizon. “By looking at the same data, we can hold each other accountable for doing the right thing by our patients,” said Rubin.

Sharing data isn’t new for Horizon. But how it shares data has evolved since Horizon began its value-based care partnerships in 2011. Back then, Horizon delivered hard copy reports with rows and rows of data, said Rubin. Today, Horizon uses visualization software called Tableau that presents the data in interactive graphs and charts, which can be updated in real-time.

What’s more, doctors previously weren’t very interested in looking at population-level data that didn’t relate to individual patients. “Now, people are craving information, saying, ‘I want to know the patients that haven't been in my practice, that I haven't seen, because I need to engage them, and I need to make sure they're compliant with all their prevention measures", said Rubin.

As the entire health care system becomes more focused on measuring cost and quality, having the right data will be key in measuring progress. And Horizon is in the position to help because it has so much of that data, explained Rubin.

“If you're a Horizon member, you don't just have the benefit of you and your doctor. You have the benefit of all the knowledge that we have, all the claims experience, and the collective medical histories of 3.7 million additional members that we can analyze for your benefit,” said Rubin.