Health info exchange can take mixed forms [Central Penn Business Journal (PA)]

REGiON

As health systems, health care providers and insurers move toward integration of patients' health information, they are considering issues including security, technical improvements, business relationships and cost, midstate health leaders said.

Th e electronic health record system alone has provided improvement in medical care and better health outcomes, according to studies published in Th e New England Journal of Medicine and conducted by the University of Pennsylvania.

C o n n e c t i n g information from one provider's electronic records to another can increase collaboration as well as cut redundant steps, said Beverly Reider, an electronic data interchange specialist, co-owner and president of Cumberland Countybased Medical Revenue Solutions.

"Th e ability to exchange information reduces complexity, frustration and redundancy, both for those delivering health care services and for those receiving them," said Steven Roth, chief information offi cer for PinnacleHealth System.

Information exchanged between systems and providers can include clinical data from patient charts and demographic information, he said.

Pinnacle launched its own health information exchange in 2009 after physicians in the community began asking for an easier way to receive medical information from the Harrisburgbased health system, he said.

"We looked at is as a business opportunity to improve our relationships with the physicians in addition to the benefi ts of an information exchange," Roth said.

He described Pinnacle's exchange as a cart wheel, with Pinnacle and other providers as the spokes and the hub at the center hosting participants' information.

"About 780 physicians in the community can access Pinnacle's patient record information electronically via that hub," Roth said.

The data automatically loads from Pinnacle's records into the physicians' systems, he said. Doctors can see only the information on a need-to-know basis and with patient permission, he said.

Area physicians upload their patient data to the health information exchange for Pinnacle to access. Physicians also can view information from each other's practices outside of Pinnacle via the information exchange, he said.

Right now, that information between physicians and physician-to-Pinnacle is exchanged in document form. In the future, Pinnacle is working with several providers to have data auto-populate in standardized fields, Roth said.

Pinnacle's health information exchange is manually audited to ensure anyone accessing patient records is doing so under the guidelines of the 1996 Health Insurance Portability and Accountability Act, known as HIPAA, and subsequent updates to the rule by the U.S. Department of Health and Human Services.

"HIPAA compliancy requires any transfer of electronic information to be encrypted and secure," Reider said.

The government has taken steps to protect patient privacy in the rapidly developing technology of health care, so patients should feel comfortable that their health information is not available for anyone to read without explicit permission and need, she said.

Dauphin County-based health insurer Capital BlueCross does not plan to install its own health insurance exchange, but it is in discussion with local providers on methods to integrate some clinical information along with claims information, Chief Information Officer Mark Caron said.

National trends in health care encourage the connectivity between the provider and the insurance company, he said. The trends include organizations working together for more care coordination and primary care physicians coordinating all parts of individual patients' care.

With clinical data that eventually could be received through health information exchanges, the insurance company could create a real-time picture of what care is being delivered and help to follow up with patients, Caron said.

Some health care organizations are pursuing a different way to exchange information.

Instead of a health information exchange hub, Lancaster General Health is working on operating with a point-to-point data exchange system. Rather than storing information in an exchange, data is given when needed directly between systems, Medical Director of Clinical Informatics Dr. Michael Ripchinski said.

"National standards of information helped create a common language for medical charts to use," easing the connectivity between records systems, he said.

A continuity of care document, containing a basic summary of a patient's health information, is the current focus of LGH's initiative to share health information, he said. Test results also are a part of future plans, Ripchinski said.

LGH is working with about a dozen providers to set up the point-to-point exchange. It's already live for exchanging data between the health system and Nemours Children's Clinic in East Hempfield Township, he said. For now, the information isn't integrated between the software automatically; physicians can see the patient data and manually incorporate it into their software, he said.

Physicians in the community are preparing to participate in electronic record exchanges in various forms to help their efficiency and patient care, health care leaders said.

Dr. Rena DeArment, an independent physician in Cumberland County, hopes to integrate her electronic records with laboratory results.

Having the information immediately available will help her office run more efficiently, as many of the endocrinologist's patients need testing, she said.

A health information exchange is being formulated at the state level, though it will function as more of an umbrella over other networks created by individual systems throughout Pennsylvania.

The state plans to create a community shared services portal for connecting health information networks. The system will include some core directories to decrease replication among the networks, health information technology coordinator Robert Torres said. The services portal will include a provider directory, a patient consent index and a record locator, according to the drafted strategic plan of the state's eHealth Collaborative effort.

"All participants maintain their own information, and no patient clinical information will be stored centrally," the draft states.

Pennsylvania also will pursue creating a health information exchange within the multiple state government agencies for outside health organizations to access, according to the draft.

Legislation was introduced in the state Senate on Feb. 8 to create a Pennsylvania Health Information Exchange Authority as a governing entity. The authority would consist of public and private leadership to guide the use of a $17 million grant the state received as a part of the American Recovery and Reinvestment Act of 2009 to install a health information exchange.

"National standards of information helped create a common language for medical charts to use."

Dr. Michael Ripchinski, Lancaster General Health

BY HOLLY WHITE

[email protected]