Data Exchange Helps Patients, Providers Get A Handle On Medical Records

March 24--The Idaho Health Data Exchange has an existential problem: People keep getting it confused with the Idaho health insurance exchange, which doesn't exist, at least so far.

The data exchange is a nonprofit corporation with a board of directors and a staff of six, and the only thing it buys and sells is information access.

Q: What kind of information goes into the system?

A: Test results, current medications, radiology records, transcriptions and other information. Some demographic data can be shared.

Health insurers are feeding in coverage information, but not medical claim information, about their members. Insurers are only contributing information, not viewing it.

The exchange is still being developed. For example, radiology records such as X-rays and MRIs are described only in text, not transmitted as images. Scott Carrell, executive director of the data exchange, hopes to have images moving by May.

"St. Joseph's Regional Medical Center in Lewiston is the pilot for that," he said.

Q: What's the benefit to patients?

A: There are already a handful of advantages the Idaho Health Data Exchange touts:

- If you go to the emergency room with a heart attack and can't talk, doctors and nurses can get your health information -- if you've had a recent surgery, if you have diabetes -- without having to ask you. Soon, the exchange will also be able to tell an ER physician whether you're allergic to a drug.

- Health care providers will have more of the information they need -- such as how your blood-sugar level changes over the years -- and can graph some of that data to help diagnose illnesses.

- Can't remember the name of the doctor you saw three years ago, and didn't think to get a copy of your patient record? The Idaho Health Data Exchange should make that irrelevant, helping doctors avoid duplications like re-doing lab tests. That can save patients money.

Patients cannot yet access their records from a smartphone or tablet computer, but such access is a goal, Carrell said.

"We've got to engage the consumer" in making decisions to improve their health by giving them information, he said. "The real impact to changing health care is going to lie in the laps of the patient."

Q: How did the exchange come about?

A: The concept of an exchange emerged in 2006, when local health industry leaders were asked by Gov. Jim Risch, "'How do we crack this health care dilemma?'" Carrell said.

Until the 2009 federal economic stimulus law, the exchange was being developed with state dollars and in-kind contributions from early participants, including hospitals and insurers. After the law passed, the exchange got a $5.9 million stimulus grant.

The exchange hopes to be self-sustaining within five years, as it adds members from the health care industry who will help pay for it.

"Revenues have been coming in higher, expenses are lower" than predicted, Carrell said.

The 2010 health care reform law -- the same law that will require Idaho to have a health-insurance exchange by 2014 -- set up a financial incentive for health care providers to go paperless with their records. That's helping the exchange grow.

Q: Who is using it?

A: The exchange had more than 1.5 million patient records at the beginning of this year, up from 900,000 in the fall.

It has more than 500 authorized users, four laboratories and three Idaho health insurers participating, including the state Medicaid program.

One new member, OB/GYN Associates, has offices in Meridian, Caldwell and Eagle staffed with nurse practitioners and doctors.

The obstetrics and gynecology practice signed a contract with the Idaho Health Data Exchange in January. It already trades information with West Valley Medical Center, but as it transitioned to electronic records, it wanted to broaden its reach.

"We anticipate being able to receive results from ... St. Luke's as a key benefit of that relationship" with the exchange, said executive director Kristi Jo Lynn.

But cost factored in, too. The Idaho Health Data Exchange added OB/GYN Associates to its group at no cost, using some of the grant dollars, Lynn said. Interfaces to exchange records with a system like St. Luke's "are expensive and difficult to arrange," she said. "Those costs were a barrier to us as we considered it (before this year)."

Q: What if I don't want my information included? Can I opt out?

A: Yes, by visiting www.idahohde.org and clicking on "Opt-Out of the IHDE."

But some people who opt out have second thoughts when they learn how their medical providers can use it to help treat them.

Your data automatically upload to the exchange whether you opt out or not, but opting out keeps anyone from seeing it, Carrell said. "It's, in essence, mothballed."

The purpose of keeping the data flowing even though a patient has opted out is so the patient can change his or her mind and not lose the information.

The exchange does comply with federal law for maintaining patient privacy. The system is built around maintaining those privacy and security rules, Carrell said.

More than 1,000 people have opted out, but some of those have since re-joined.

Carrell said the organization hasn't "spent any time or money on educating the consumer-patient population, but with additional resources now, we'll be creating education campaign initiatives."

A marketing person for the Idaho Health Data Exchange was hired a few months ago.

Q: How does my information get to the exchange?

A: Hospitals are funneling the most information into the exchange.

The data exchange hopes to add more providers to its current list of participants. But its selling point -- health data -- is something it needs more of. Those data have to come from participating providers.

So the exchange is doing a promotion of sorts: Providers who join get the first year free. The exchange will waive its fees for that year in hopes the providers will get hooked and stay on board.

A longer-term plan is to connect with other state health information exchanges, so that a patient in Idaho Falls who sees a doctor in Salt Lake City doesn't have to go the old-style route of requesting to have medical records sent to the new doctor.

The Idaho Health Data Exchange has "not even tapped markets like getting dentists on board" or nursing homes, said Carrell.

Audrey Dutton: 377-6448

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