34 Chicago-area hospitals to join health information exchange

Dec. 01--Thirty-four Chicago-area hospitals are banding together to share secure patient data through a new health information exchange. Health care officials say the effort will help hospitals better care for patients and reduce unnecessary and expensive tests.

MetroChicago HIE, scheduled to launch early next year, is an online portal that will allow for patient information, such as lab tests, imaging, health conditions, medicines and treatment, to be shared in real time among hospitals, doctors and eventually patients themselves.

The initiative, led by the Metropolitan Chicago Healthcare Council, a trade group representing 170 hospitals and health care organizations, is expected to be announced Monday. The group said it will be among the country's largest health information exchanges.

Digitizing patient health information and allowing it to be shared among disparate providers can help prevent errors by ensuring that everyone involved in a patient's care, including primary care doctors, specialists and emergency departments, has access to the same information, said Guy Alton, chief financial officer at St. Bernard Hospital.

"Certainly all of us feel that we'll be able to get a lot more information quickly about what tests patients have had, what drugs they're on and ultimately be able to diagnose and treat them quicker," Alton said. "That's got to lead to improved care, which should lead to reduced costs overall to the health care system."

The 210-bed Englewood hospital, which treats a largely transient and poor population of patients, sees between 10,000 and 12,000 patients in its emergency room each year who have limited means to pay for services. Often, Alton said, those patients also have received treatment recently at other hospitals, where they may have had lab tests or imaging services or been given prescription medicines.

By tapping such information, doctors will be able to make faster decisions on treatment. "Rather than starting from scratch, our doctors will be able to get their hands on a patient's information immediately, and that might help him make a quicker and better decision," Alton said. "We're finally using technology to provide better health care in a larger setting, and that's a big step forward, potentially."

For patients, particularly those with chronic illnesses and thick medical files, the data repository can help reduce the time they must spend filling out paperwork and briefing providers on their medical history. It also can help by tracking their prescriptions, which can be difficult for some with complex medical conditions.

Hospitals, meanwhile, see the information exchange as a chance to save money, reduce medical errors and coordinate patient care, all increasingly important initiatives because of changes in the way they're paid by government and private insurers.

As more hospitals and health systems enter into shared-risk contracts with private insurers, large employers and government programs to take care of groups of patients, they're often rewarded with shared savings if they're able to keep costs down while maintaining certain quality and outcome-based standards.

Under some of these programs, hospitals also will be penalized with lower payments for not meeting certain quality benchmarks, including unnecessary hospital readmissions.

Those factors are pushing hospitals to reduce duplicative services and engage more fervently with patients to ensure they stay healthy after they get home and schedule follow-up appointments.

Sharing data metrowide is "a logical and necessary step in how health (information technology) can positively impact clinical care," said Dr. Julio Silva, the information exchange's medical director and the chief medical information officer for Rush University Medical Center.

"If you think about any individual institution's ability to provide an environment that allows for great quality of care as efficiently as possible, the availability of this new data is incredibly valuable."

That's particularly true in a region as large as Chicago, where the hospital and health care market remains largely fragmented, despite a recent wave of consolidation. For example, a patient might seek primary care in the suburbs but have a specialist at an unaffiliated hospital downtown. A patient might visit a separate emergency department or urgent care center.

The initial group of hospitals participating includes 10 owned by Advocate Health Care, 10 by Presence Health, four by Sinai Health System, three by Rush and two each by Centegra Health System and Franciscan St. James Health. Three independent safety-net hospitals -- Norwegian American, St. Bernard and Swedish Covenant -- also will participate.

From 20 to 30 others in the region are expected to join by summer. Officials hope that eventually, each of the Chicago metro area's 89 hospitals will sign on. Plans to expand include other organizations, including skilled nursing centers and long-term care facilities.

The council hired Ft. Worth, Texas-based Sandlot Solutions Inc. to host the exchange. Terms were not disclosed.

Dan Yunker, the council's senior vice president, who is also chief executive of the startup insurer Land of Lincoln Health, said the cloud-based service is secure and adheres to privacy standards set by the Health Insurance Portability and Accountability Act.

Patients may elect to opt out of the system.

Hospitals generally will be charged on a per-record basis. Though officials would not discuss details of the contract, St. Bernard Hospital plans for annual costs of roughly $100,000, Alton said.

Nationally, Chicago is somewhat late to implement a health information exchange. Other regions, including the Milwaukee area, western Michigan, Peoria and northwest Indiana, have run programs for several years.

In Milwaukee, a 2011 study funded by the insurer Humana Inc. found "definitive decreases" in four of the five top emergency department-based procedures, including CT scans, electrocardiograms, lab testing and diagnostic radiology, over a 15-month period ending in March 2010.

On average, emergency departments at 10 hospitals saved $29 per patient visit, in large part due to the reduction of test duplication, according to the study.

"There have been fits and starts, and the level of success varies by market," said Laura Kreofsky, a principal for Impact Advisors LLC, a Naperville-based firm that advises hospitals and other health care providers on IT.

Generally, she said, the systems implemented within the last few years have had better success because of evolving technology and an increasing appetite among providers -- even competitors -- to share data.

"Finally, the technology and the data standards have advanced to a level where we can be successful with this," she said. "I don't think this is a passing fad."

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