Electronic medical records (EMRs) have enhanced patient care through efficient information exchange. However, with over 60 different types of EMRs in the Arkansas healthcare system, patient information can be difficult to share from setting to setting. The State Health Alliance for Records Exchange (SHARE) has enhanced efficient information sharing statewide, allowing providers to access specific patient information whenever they need it. Anne Santifer, Executive Director of SHARE, and Justin Villines, HIT Policy Director for SHARE, recently went on AFMC TV to discuss SHARE’s impact on healthcare delivery in Arkansas.

What is SHARE?

SHARE is Arkansas’ only statewide health information exchange, offering a centralized hub connecting healthcare providers with crucial patient information. This system collects data from EMRs, allowing patient records to follow them electronically through their healthcare journey.

“Back in the day, we used to have to bring our papers with us to the doctor or get our old medical records from one doctor and bring it to our new doctor. We don’t have to do that anymore, thanks to this technology,” Anne said.

“It really takes the burden off hospitals and clinics,” Justin added. “They can see clinical data, labs, cardiology reports, and more, right when they need it.” SHARE not only saves money for healthcare systems but also results in healthier patients due to a more streamlined process of data exchange.

SHARE also lessens duplication of services. If a doctor has access to a patient’s previous medical record through SHARE, they’re less likely to recommend that a test or procedure be redone. Tests and assessments can be costly to patients who have to deal with copays and coinsurance.

A Push-Based Approach

SHARE is different from other HIEs across the nation in that it receives rosters from Medicare, Medicaid, and private insurance companies, which it uses to track patients and send patient information to care teams as they need it. “The hardest part is that you have to know that a person had an event somewhere else before you can ask for that information,” Anne said. “Rather than providers having to do that, we push the information out to providers as they need it.”

Local Impact with National Connections

Although SHARE primarily operates within Arkansas, its reach extends to neighboring states, facilitating care for Arkansans who travel. “We rely on zip codes for patient addresses,” Anne said. “So, if a patient goes to a hospital in Oklahoma, and the hospital sees the patient has an Arkansas zip code, they can send an information request to us, and we send the information they need.”

This works bi-directionally. So, if a patient travels to Arkansas from out of state, the SHARE team can request that patient’s information from their state’s health information exchange (HIE).

Many states have HIEs, and SHARE helps connect the dots between Arkansas and other states to ensure healthcare professionals nationwide can better assist patients regardless of the patient’s location. The federal government has also emphasized support for qualified health information networks (QHINs), allowing more nationwide access to health data.

“We have plans to join a QHIN, but they are still in development right now,” Anne said. “The policies are still being written, but once they settle, our goal is to join a QHIN.”

The New Movement: Health Data Utility

With technological advancements over the last 15 years, SHARE’s role has expanded into a health data utility service that benefits various health sectors, including health plans and state agencies.

“The COVID-19 pandemic highlighted the need for real-time patient data,” Anne said. “We’ve supported the health department and the Arkansas Department of Human Services (DHS) on many of their initiatives, including the public health unwinding.” During the pandemic, many hospitals had to submit reports to DHS that included information on the availability of beds and the number of positive tests. SHARE has automated those reports so that participating hospitals no longer have to submit that documentation.

Since the pandemic ended, SHARE has helped hospitals and clinics in the state submit reports to DHS that include key data elements like the number of patients hospitalized from the flu and RSV.

“Our health insurance plans have come around to the idea of using data,” Anne said. “They know if they can get that information in real-time, that can expedite prior authorizations, claims processing, and help them meet federal reporting requirements, such as A1C results. You often don’t see that information in a claim, but we have it in the clinical data, so we’re able to supply that to them.”

A Focus on Maternal Health

This year, SHARE has focused on maternal health, a priority echoed by Arkansas Governor Sarah Huckabee-Sanders. “We are in contact with DHS and coordinating with hospitals who wish to participate in the Arkansas’ maternal homes program,” Anne said. “We are also talking to our WIC services at the health department about supporting them, utilizing the products and services we have, and repurposing them to meet maternal health needs.”

SHARE can be used to track women’s health journey during pregnancy. If they are admitted to the hospital, the woman’s provider will receive an alert that their patient is in the hospital. “This allows us to coordinate care and hopefully improve the quality of care that patient receives,” Anne said.

Because SHARE is currently connected to over 60 different EMRs in the state it’s easy to support healthcare professionals during transitions of care from one setting to the next. “We facilitate a bi-directional exchange of information, which not only ensures data security but also allows hospitals and practices to specifically query if we have any information about a particular patient.”

Participation Benefits The Entire Healthcare System

There are 116 hospitals and over 3,000 clinics participating in SHARE, including four major hospitals utilizing EMRs. “There is no shortage of clinics and hospitals who wish to participate in SHARE,” Anne added. “Hospitals want to know what’s happening in the clinics before patients show up in their care. So, if you’re an organization taking on risk, such as a member of an ACO or a clinically integrated network, data is an important aspect of success in a value-based program.”

Those programs are connecting with SHARE to gain access to a pipeline of information that allows them to see what is going on with patients outside of their walls. “The more people that participate, the more complete the record is,” Anne explained. “The less you have to go out and look for paper records and contact providers to get the information you need.”

“We try to keep up with the movement of the metrics and policy directives within our state to be able to assist providers in all lines,” Justin added. “We want to help them accomplish the goals they’re trying to meet and learn not only what’s happening inside their facility but also outside, too.”

Despite this nationwide movement, however, there are still some clinics that have not yet participated due to EMR changes and limitations. “No two EMRs are the same,” Anne explained. “Even though Baptist, UAMS, and Children’s Hospital all use Epic, their EMRs are all set up differently. It all depends on how you contract and what modules you purchase.”

“It’s really important when talking to our providers or nurses if they don’t know a patient’s updated phone number or address because it’s hard to get that patient back in the clinic if you can’t reach them,” Justin added. “With all of our statewide connections, we’re constantly updating the patient’s phone number, home address, and email address if we have it, so that the provider and nurse have the most up-to-date contact information to get a hold of the patient.”

Benefits for the Healthcare Community

SHARE’s innovative approach to health information exchange facilitates efficient information sharing, enhances patient care, and improves the efficiency of healthcare providers. The Arkansas healthcare community can greatly benefit from the wealth of shared knowledge and seamless connectivity that SHARE offers. As the provider burden increases, SHARE is looking to automate patient data collection and reporting so that providers can focus more on caring for patients while SHARE provides them with real-time data as they need it.

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