Health Information Exchange (HIE)

Trend: Hospitals, health systems building their own networks

Anne Zieger — Sun, 17 Aug 2008 11:04:57 -0400

For years now, hospitals have struggled to create health information exchanges that not only served some broad community purpose, but also hooked up their physicians with their central systems. Unfortunately, the process has been a long one, as RHIOs/HIEs have been slow to take off, dogged by financial and administrative obstacles. However, of late it appears that hospitals and health systems are beginning to take matters into their own hands.

Increasingly, systems and individual hospitals are building their own hospital-centered networks, connecting their facilities with local doctors rather than wait for regional or statewide health data networking efforts to get their acts together. While some facilities allow read-only access to hospital data, it's still a start, and a tangible result in markets where RHIOs haven't actually been launched. A growing percentage of hospitals, meanwhile, are serving as application service providers, giving their doctors remote access to outpatient records via the web.

Hospitals and health systems are increasingly being pressured to build their own networks as they face greater pressure to capture their referrals in a brutally-competitive marketplace. It's particularly important for hospitals to link up with specialists in key areas, such as cardiology and oncology, to build their reputation as a "center of excellence," notes Michael Mytych of Health Information Consulting LLC. Besides, it makes sense to link up with a physician's office if you're going to supply them with an EMR anyway, which many systems are of course doing these days.

To learn more about this trend:
- read this Health Data Management article

Related Articles:
RHIO/HIE solutions emerge
Report: Local RHIOs aren't likely to become national
Why RHIOs shouldn't exist
Long-lived CA RHIO shuts down

California HealthCare Foundation donates $10M in code to open source effort

Anne Zieger — Sun, 17 Aug 2008 09:38:13 -0400

The California HealthCare Foundation this week agreed to turn over key components from the software behind a $10 million health information exchange project it put together a few years ago to an open source organization. The software was originally developed for the Santa Barbara County Care Data Exchange, an early RHIO that closed its doors in 2006. CHCF turned the components over to the Open Health Tools, a collaborative effort between national health agencies, healthcare providers, researchers, academics and international standards bodies in several countries. OHT's goal is to develop shared health IT products and services, and offer tools and components that speed the availability of health data interoperability. The donation was assisted by CollabNet, a collaborative software development platform, and Palamida, an application security solution for open-source software.

To learn more about the donation:
- read this CHCF press release
- read this description of the Open Health Information Exchange Project

Related Articles:
IBM hopes open source will open healthcare IT silos
Free, open source RHIO software coming
Open source EMR struggles with business model
Can open-source EMRs boost adoption?

VT funds EMR adoption with health plan tax

Anne Zieger — Sun, 20 Jul 2008 13:26:33 -0400

In a move that may be the first of its kind in the country, Vermont legislators have created a trust--funded by a quarterly tax on health plans--that will provide support for healthcare providers who want to implement EMRs. The fund will also support the further development of a statewide HIE and kickoff of a new medical home project. Over the next five years, the fund is expected to help physicians boost EMR use from 13 percent to 50 percent.

Health plans, which will be required to submit their first payment on October 1, will choose between paying two-tenths of a percent on all healthcare of the previous quarter's claims for their Vermont members, or a fee based on proportion of last year's overall claims. All told, this should raise $32 million over the next seven years, state officials project.

Leaders of Vermont Information Technology Leaders, the non-profit public-private partnership that runs the state's HIE, will manage the trust. Physicians will be able to apply to VITL or state government to get funding. State leaders are particularly focused on getting funding to about 300 independent physicians who aren't affiliated with a hospital or large group practice and tend to get lower reimbursements.

To learn more about the fund:
- read this Government Health IT News piece

SC plans to launch Medicaid HIE

Anne Zieger — Sun, 13 Jul 2008 09:28:30 -0400

South Carolina officials have set plans to launch a health information exchange for the state's 700,000 Medicaid patients. The South Carolina Health Information Exchange, known as SCIEx, will connect hospitals, doctors, clinics and other healthcare providers with access to Medicaid beneficiaries' medical records. It was paid for by HHS, which contributed $250,000 to implement the system. It's also backed by the South Carolina Hospital Association, the South Carolina Primary Care Association and several state agencies.

The SCIEx system includes a records locator service along with a system that links disparate health databases. Providers will now have access to a broad medical history on patients, including diagnoses, medications and test results. Officials say this will be particularly helpful for beneficiaries who live in rural areas and may only get sporadic care or see varied doctors, as it will make sure that their histories travel with them. They also note that the new HIE should save money for the state, since it will avoid a wide range of paper, printing and storage costs.

To learn more about the HIE:
- read this article from The Greenville News

Related Articles:
Study: RHIOs/HIEs backed by states will win
Study: 75 percent of states developing HIEs
NJ set to move ahead with statewide HIE plans
Minnesota backs statewide HIE

AT&T, Covisint and Microsoft plan to expand health network nationwide

Anne Zieger — Sun, 29 Jun 2008 02:02:49 -0400

AT&T, Microsoft and Compuware subsidiary Covisint have announced plans to create a nationwide health information exchange which expands on a smaller network already in place state-wide in Tennessee. In Tennessee, the MidSouth eHealth Alliance and the Governor's eHealth Council had already been running an electronic health network for doctors across the state, running on Covisint's On-Demand Healthcare Platform.

The broader eHealth network will use Covisint's platform and run over AT&T's MPLS network. The new network will give consumers access to records based on Microsoft's HealthVault PHR technology, while giving them the ability to share that information with all providers who connect to AT&T's Healthcare Community Online. The Healthcare Community Online is a virtual private networking-based portal which allows electronic health data exchange between existing systems used by providers and physicians, including large files such as X-ray images, MRIs and CT scans. The AT&T network allows doctors, hospitals, labs, pharmacies and patients to access test results, prescription records and medical histories. It also offers physicians the ability to use e-prescribing functions.

What's interesting here is that the parties involved don't mention what their services will cost, or even what pricing model they'll use (a connectivity charge, a flat fee, a fee per transaction, some other option?). I wonder if this model will be any more affordable than the costly, largely unsustainable RHIOs/HIEs not-for-profit groups and governments have attempted to bring together.

To learn more about plans for the network:
- read this Microsoft press release

Related Articles:
Study: 75 percent of states developing HIEs
RHIOs and HIEs backed by states will win
NJ set to move ahead with statewide HIE plans
Minnesota backs statewide HIE

NAHIT name game gives some vendors a headache

Mon, 09 Jun 2008 06:59:55 -0400

In theory, it doesn't make sense to move ahead with major IT initiatives until the industry has at least some clue as to how to define key terms. However, a recent effort by the National Alliance for Health Information Technology (NAHIT)--particularly in defining the difference between EMRs and EHRs--seems to be creating as many problems as it solves. Over several months, NAHIT came up with definitions for key terms in HIT, including EHR, EMR, personal health record, health information exchange and regional health information organization. Most notably, as NAHIT defines things, an EMR is a record used internally in a medical practice that can't share information with other practices, while EHRs can do so.

The problem with this is that NAHIT seems to have defined some vendors right out of their marketing position. There are several companies that use the term "EMR" to define themselves, such as NextGen Healthcare Information, and have gotten their interoperability certification from the CCHIT. If they have to go back and rebrand themselves as an "EHR" they'll be a bit annoyed, to say the least, officials note.

To learn more about the terminology dispute:
- read this Modern Healthcare piece (reg. req.)

Related Articles:
CCHIT makes EMR certification simpler
CCHIT gets official, approves new vendors

ALSO NOTED: CMS official admits industry unready for NPI switchover; HHS to announce EMR demo project participants; and much mo

Tue, 27 May 2008 06:59:50 -0400

> Now, even CMS officials are admitting that the industry may not have been prepared for last week's deadline for switching over to using the National Provider Identifier for Medicare claims processing. Article

> HHS will soon announce which 30 communities it has chosen to participate in its EMR demonstration project, under which participating doctors will get Medicare incentive payments for using certified systems. Article

> Maryland-based Erickson Retirement Communities is working with three Baltimore-area health systems to create a health information exchange. Article

> A group of specialist volunteers soon plan to begin offering long-distance telemedical consultations over the Internet to physicians trapped in war zones. Article

And Finally... Want to relax, but too tired to travel? Try a 'staycation.' Article

HIEs on the upswing despite tough odds

Mon, 28 Apr 2008 06:59:59 -0400

Color me impressed: If today's issue is any indication, HIEs may have a brighter future than I'd previously thought. For one thing, this week we saw at least one powerful employer--the California Public Employees Retirement System--throw its weight behind a statewide HIE organization. In the same issue, you'll learn that about 75 percent of states have an HIE on the way.

After watching RHIOs/HIEs struggle for a couple of years, I'd gotten pretty pessimistic that they would be viable any time in the near future. Most privately-held ones seemed on the verge of financial collapse, while state projects looked like they'd be bogged down by bureaucracy for ages. But it appears that things have changed. States seem to have grown past their (justifiable) infatuation with e-prescribing and become willing to fund the longer-term HIE vision, as well.

This is quite an act of faith on their part. To back an HIE you've got to be willing to wait for the cost-savings from lower waste to mount up, and for evidence of quality improvements to trickle in gradually. And you've got to have an awful lot of capital available to you, both politically and financially, to get all of the stakeholders on board and connect them efficiently.

Now, with states getting involved, I'm willing to wager that we'll see more private, commercial organizations making the kind of commitments necessary to keep RHIOs/HIEs afloat. But it's been a long, hard road getting here. Let's hope that everyone's faith is rewarded in the next year or two. - Anne

Study: 75 percent of states developing HIEs

Mon, 28 Apr 2008 06:59:56 -0400

A new study has concluded that three-quarters of states have begun developing some form of HIE. The study, released by the State-Level HIE Consensus Project, found that while many projects are on the drawing board, some HIEs are almost ready to begin exchanging data. (The Consensus Project is supported by the Office of the National Coordinator for Health IT.) Why so much HIE activity? In large part, state health reform efforts are helping to fuel this trend, as many reformers believe that HIEs are central to improving the way care is delivered. In fact, many of the groups hope to serve, not only as conduits for data, but also to support quality measurement and pay-for-performance initiatives.

To find out more about the study:
- read this Government Health IT article

Related Articles:
RHIOs and HIEs backed by states will win
NJ set to move ahead with statewide HIE plans
Minnesota backs statewide HIE
Kentucky moves ahead with HIE plans

Study: More providers joining HIEs

Mon, 21 Apr 2008 06:59:54 -0400

While the process is slow, it appears that more healthcare providers are gradually linking up with health information exchanges, according to a new study released by IDC-HII. For example, 15 percent of hospital respondents to one IDC-HII survey said they were participating in an HIE, and 35 percent more said they were in active discussions to do so. Meanwhile, in a February 2008 IDC-HII poll of community hospital CIOs, 22.7 percent said their health system was participating in an HIE, 18.2 percent planned to do so within less than a year, and 27.3 percent were considering the HIE option. One side note was that 33 percent of the CIOs who were involved in an HIE said they were part of a "proprietary HIE," one tied to a sponsor such as an integrated delivery network. To me, this suggests that while HIE penetration may be growing, the national health information network remains painfully far from being realized.

To learn more about IDI-HII's research:
- read this Healthcare IT News piece

Related Articles:
Joint Commission calls for national HIE
Study: RHIOs/HIEs backed by states will win
Report offers HIE keys to survival
What is the business model for sustaining a RHIO?