CyncHealth consolidates 14 disparate technology systems and data for 5 million patients to create a longitudinal health record with Rhapsody Interoperability Suite

CyncHealth is a health data utility (HDU) serving as the statewide health information exchange (HIE) for Nebraska and Iowa, as well as the prescription drug monitoring program (PDMP) administrator for Nebraska. CyncHealth works to transform healthcare through community collaboration while protecting the security and privacy of medical information. 

The mission of CyncHealth is to empower communities through steadfast pursuit of advancing interoperability, bringing data democratization, cultivating economic value, and delivering a health data utility. CyncHealth partners with a network of health systems, hospitals, clinics, clinicians, payers, consumers of healthcare, and other community stakeholders to share health data, providing seamless access to information that is agnostic to any one health system, electronic health record (EHR) vendor, or payer. This ensures that health data follows the person wherever they receive care and ensures providers have access to a comprehensive, longitudinal clinical record and robust HIE services. CyncHealth has over 1,100 facilities across the Midwest and supports 5 million patients with comprehensive health data. 

As CyncHealth expanded the type of data they were integrating from hospital EHR integrations to include pharmacies, clinics, long-term care facilities, ambulatory surgery centers, community-based organizations and more, they recognized a need to consolidate their technology systems across the enterprise.  

“At one point we had between four and seven EMPI systems. Each one of our vendors worked in their own way, and this created a lot of challenges in downstream systems,” said Dr. Naresh Sundar Rajan, chief data officer of CyncHealth. “When we put the data together to create a longitudinal health record for patients, it became really challenging for us to aggregate at that level.”  

CyncHealth also needed to connect across the silos of data that they were aggregating but not yet linking.  

“We needed an integration engine that allowed us to be independent in aggregating different kinds of data from across the ecosystem and not be limited by an EHR or a point-to-point connection,” said Dr. Jaime Bland, President and CEO of CyncHealth. 

On top of the challenges they were already navigating, the COVID-19 pandemic added an increased level of urgency to consolidate their systems. In the midst of a public health emergency, it was more crucial than ever for CyncHealth to support the population with comprehensive health data. 

“Our users rely on us to deliver comprehensive patient information to support their various clinical and business objectives, and they value our ability to create a holistic picture and comprehensive longitudinal record of each patient in our region through data,” Bland said. 

CyncHealth selected Rhapsody Integration Engine and Rhapsody EMPI to consolidate their core technology platform to a single vendor for scalability, infrastructure modernization, and flexibility. 

“We were looking for a best-of-breed type of approach, and that’s why we partnered with Rhapsody — to be able to have independence and flexibility in the kinds of data that we connect to and in the kinds of data that we need to think about connecting to in the future,” said Bland. “That independence requires a more sophisticated tech stack rather than having a relationship with single monolithic system.” 

Working with data from multiple states and organizations across the community, CyncHealth selected Rhapsody because of its ability to support a containerized deployment. This allows the CyncHealth team to focus on specific instances and replicate in the future. 

CyncHealth has a 100% cloud-based infrastructure, so it was important for them to find a partner that supported cloud-based deployment. “Before Rhapsody’s containers came into play, we deployed Rhapsody instances in AWS cloud for the particular state within governance tied to it,” Rajan said.  

Rhapsody interoperability solutions combined with Amazon Web Services gives CyncHealth the security, resiliency, and scalability they need. 

“We chose Rhapsody because of scalability, along with the approach of modernizing our infrastructure in the cloud-based deployment,” Rajan said. 

Because CyncHealth aggregates data from multiple sources across a community, a best-of-breed enterprise master person index was key to ensuring that they were linking patient records not only across different health systems but across the community.  

“We took an enterprise-wide strategy that we would go with one EMPI solution that would be truly helpful for us. With that in mind, we moved forward with the Rhapsody EMPI,” Rajan said. 

By partnering with Rhapsody, CyncHealth was able to consolidate down from 14 disparate EMPI and integration systems for sharing and connecting data to two, leading to cost savings and more efficient operations. 

Rhapsody EMPI helps create a single, centralized, and accurate view of every person, which can be shared upstream and down to drive more efficient, better-quality care. As part of the migration to Rhapsody EMPI, CyncHealth identified more than 550,000 duplicate patient records out of what was believed to be more than 4.2 million unique patients. Since moving to Rhapsody EMPI, CyncHealth was able to achieve a transactional identity data match rate between 93% and 95%, significantly increasing the accuracy of the information it shares amongst its participants. 

“Identity matching is core to our tech stack,” Bland said. “The Rhapsody EMPI is foundational to a longitudinal health record and the ability to link between disparate systems.”  

Rhapsody has easily been able to scale to meet the significant data processing requirements for CyncHealth to operate at scale. In 2022, Rhapsody Integration Engine processed more than 54 million messages on a monthly basis; Rhapsody EMPI processed 6.2 million API calls over that same timeframe. Overall, Rhapsody health solutions have processed more than 1.5 billion transactions for CyncHealth in service of the people of Nebraska and Iowa. 

“By partnering with Rhapsody from an integration engine perspective, we brought on about 400 different organizations in a year. If we look across the ecosystem at our peers, many of those similar types of organizations accomplished that in five years,” Bland said. 

Adopting an approach that relies on innovative application programming interfaces (APIs) is also contributing to their success. “API connectivity is something that we are leveraging heavily for our systems,” Rajan explained. “As we think about the national movement toward creating API-based ecosystems, the Rhapsody EMPI fits very well within that roadmap. We were able to easily scale our EMPI by using the API connections.”  

CyncHealth is using the same standards-based strategy to support its other clinical data offerings, as well as implementing a social determinants of health (SDOH) platform. The SDOH platform includes novel data that can be difficult to standardize and exchange using legacy methods, enhancing the importance of being able to ingest and match the data to the right individuals in a reliable manner. 

CyncHealth has leveraged solutions from the Rhapsody Interoperability Suite to support several health and wellness initiatives including:  

• Empowering Nebraskans to self-refer to meet their health and social needs, helping them connect with more than 4,000 health and social agencies and programs to improve health and health equity across the state  
• Providing Nebraskans access to their health data through a web-based application that brings an individual’s health information from multiple providers into one place to be accessed and used as they see fit  
• Utilizing data exchange and population health analytics capabilities to provide critical insights to inform the region’s COVID-19 response activities for those affected by the virus 
• Connecting this data creates a longitudinal health record, which enables care managers to provide better care recommendations and influence outcomes downstream. 

“Rhapsody helps us put the power of data to work for better health outcomes, lower costs, and thriving communities,” Bland said. “Bringing data exchange, identity data management, and terminology management together into a suite is an inspired idea and well aligned with our business challenges.”    

Leveraging multiple solutions from the Rhapsody Interoperability Suite allows CyncHealth to consolidate the number of vendors they work with. This increases efficiency while minimizing risk. Another benefit for CyncHealth is having a true partnership that they can rely on when looking ahead at goals and future initiatives. 

“The benefit of working with one partner is to extend that relationship and have deep communication about our enterprise goals. Understanding our goals as an organization is definitely a benefit for us in the long-term trajectory of meeting those goals and initiatives,” Bland said.