Bill Beighe is the only nonphysician among the six individual AMDIS award winners this year. Beighe is chief information officer of the 300-provider, 100-location Physicians Medical Group of Santa Cruz (Calif.) and CIO of the 600-plus-member Santa Cruz Health Information Exchange.
The exchange, founded in 1998, connects not only members of Beighe's IPA, but also two area hospitals, two imaging centers, national and local reference labs and several county health and federally qualified health centers. The exchange moves 1.2 million transactions a month, including electronic prescriptions, pre-treatment authorizations, referrals and transcribed documents. Beighe started working in Santa Cruz in 1998 as a consultant and joined the IPA full time in 2001.
He says there are two keys to creating a vibrant, self-sustaining health information exchange. First, it has to offer enough stuff.
“Providers will find value with a service that brings them a lot of data they need to do their business,” Beighe says. “If all you have is labs, it's not nearly as compelling as the labs, referrals, radiology and the transition-of-care data that providers need.”
A “virtual care record” summary compiled by the exchange's Web-based technology vendor, Axolotl Corp., includes a patient's major conditions, allergies, immunizations, contact information and providers, most of what would be included in a continuity-of-care record, but not in that specific data transfer format. The Santa Cruz exchange interfaces to nine different EHR brands, but also hosts a McKesson Corp. EHR product on its own servers.
“We've been doing e-prescribing here since 2005,” he says.
Beighe says he's optimistic about the future of information exchanges, even though many have not made it past the initial stages of grant dependency. One reason for optimism, he says, is because Santa Cruz, launched in the pre-grant era, succeeded by developing a business case for the exchange from its inception. It means, though—and that's the second key to success—that someone or some thing has to take both an administrative and financial lead to get an exchange up and running,
“It's going to take a number of years,” Beighe says. “You're going to see a shakeout of organizations that did get grant funding but didn't cross the bridge to sustainability. But I'm optimistic, and it's going to happen the way it did here. You don't need an IPA, but you do need an organizing force. It could be an IDN or a medical society, but it has to be something that moves beyond the walls of the organization.”