We’re pleased to learn more about Interop Hero Christopher Mack and the team from Sutter Health including Kat Brooks in this video interview! We got the opportunity to sit down with Christopher Mack, Executive Director of Strategy & Business Development, and Kat Brooks, Specialty Network Referral Consultant from Sutter Health. Christopher has been with Sutter Health for 20+ years. Sutter Health is a not-for-profit integrated healthcare delivery system located in Northern California.

Kat has been with Sutter Health for 10 years. The Sutter Specialty Network is a concierge referral service and serves as a front door for internal and external customers looking to access specialty care within Sutter Health.

Interoperability at its’ core is about expeditious and easy information flow between organizations. Kat and Chris were both lucky to have Dr. Steven Lane as a mentor within Sutter Health who showed them the importance of interoperability.

Sutter Health was an early adopter of Epic and in Sutter Health’s integrated network, Epic serves as the single instance of their EHR.  One of the greatest challenges is about the 48 different Electronic Health Records within their network. It is not just Epic-to-Epic but there is an inner-EHR exchange where they witness interoperability firsthand.

“The demand [for interoperability] was created by the innovators in the healthcare space.”

The employer programs or traditional pharmacies drove the demand at first, even partnering with payers who had incentives with employer programs to exchange data in a better way. This helped the Sutter Health team see how we can change the way referrals are exchanged.  With their FQHC trading partners, Sutter Health encouraged a Direct workflow that was bidirectional and would help patients benefit from Direct referrals.

They like to help the FQHCs offices access care through Sutter Health and they do that via Direct. This helps them shave off time in the referral process and assists these offices in accessing specialty care in areas where patients would not have been able to access care previously.

Historically, “a referral could take many days… but via the Direct workflow, these messages are sent and can be received within minutes”

Sutter Health can just pull the information they need and help navigate that care through the Sutter Health organization. The streamlining of this process has been able to shave off days from the whole referral process and patient care.

“Everyone in health care is looking for automation especially where it benefits the patient. Right off the bat, when you adopt a Direct workflow, people aren’t necessarily going to see this initially, but it is automation.”

You can have your vendor create processes that look for metadata that look for metadata that will help drive the referral. You can shave off individual work right from the start. We have noticed about 4 days being shaved off the referral process just by switching to Direct.

“We have noticed about 4 days being shaved off the referral process just by switching to Direct.”

Physician burnout and clinician burnout is a real thing. Part of the resistance when advocating for Direct is that clinicians were anxious that the number of messages coming into their inbox would increase. The Sutter team worked on systems and processes that would help drive the Direct messages to the right place including adopting a facility/organization-level Direct address specific for referrals.

“The Sutter Specialty Network has been able to demystify the referral process via Direct.”

With a matrixed organization like Sutter Health, offices find it difficult to navigate through their system. Through Direct they can navigate through messages from diverse senders and look at the intricacies of them and transport it to the appropriate place.

Kat first finds a trading partner, then figures out whether or not they are on a Direct-enabled EHR. Then it starts with testing, one of the most intimidating parts. After testing, it is just a simple workflow of what both parties expect to see happen with the referral once it is facilitated. Then the exciting part is watching that number continue to grow as people spread that process throughout organizations.

As the referral process has made its’ way into the masses, there are two parallel tracks. The first track is a traditional Direct message that happens seamlessly in the background. Then there is the referral process discussed today that is more traditional and somewhat manual. The manual part also has had some challenges. The initial payload with the traditional CCDA might not include some of the things that you need to fill that referral. You have two options to overcome those barriers: work with your partner and figure out if they are amenable to changing the structure of their CCDA or create augmented documentation that contains non-discrete data put into a PDF or some type of image to allow you to facilitate the referral without a fax machine or phone calls.

“A lot of people are afraid to use the technology because they think they are going to do something wrong.”

There is a barrier in the technology itself.  This is one of those things where the more we demystify the process and demystify what happens when you send a Direct Message, the more people will start to utilize it.

Having somebody who can represent the clinical aspect on the team is important. Forming a multidisciplinary team is important to a successful interoperability team. They work together to not only exchange information but also to understand what happens when information is exchanged.

“When you have multiple folks at the table solving for leveraging Direct, you have the ability to reduce costs in your healthcare delivery system while at the same time efficiently taking care of the patients.”

Thank you to the Interop Heroes at Sutter Health for sharing their experience and perspective with us!

Learn more about the Interoperability Hero Initiative and check out our first class of Interoperability Heroes!

This post was contributed by Cora Bauman.