The Greater New York Hospital Association has formed a joint venture with the metropolitan area's three major healthcare insurers to develop a community health information network.
Initially, the focus of the CHIN will be on simplifying the electronic claims process, which has caught on in the New York area but now involves navigating multiple incompatible computerized systems, said Dana Sherwin, senior policy adviser for health affairs at the GNYHA.
The hospital association's three insurer partners collectively represent 70% of privately insured hospital patients in the New York City area, Sherwin said. They are Empire Blue Cross and Blue Shield, Health Insurance Plan of Greater New York, and Group Health.
Also taking part in the CHIN's formation is the United Hospital Fund, a research and philanthropic organization.
The five sponsoring organizations will contribute a total of $500,000 to begin planning the CHIN. A technical advisory group of healthcare information technology professionals, mainly from hospital information systems staffs, will help advance the development of a strategic plan that will decide on specific CHIN functions, Sherwin said.
The venture also is looking to hire an executive director, she said.
Since April 1994, state law has required hospitals and insurers to submit and accept claims electronically. But the law didn't have the teeth to enforce that requirement, and participation isn't 100%, Sherwin said.
In addition, the entry of more HMOs into the New York market has increased the number of third parties involved in claims as well as the number of disparate claims systems to which hospitals must adjust, she said.
CHIN sponsors want one network to connect all the electronic systems and provide one process for claims. Additional goals, which will be more difficult, will be to provide one process for the communications involved in managing and authorizing care, such as eligibility for coverage, pre-admission certification and referrals to specialists, she said.
The New York area has "a little bit of catching up to do" on CHIN development considering that others in metropolitan areas such as Chicago, Cincinnati, Cleveland and Detroit are a year or more into the process, Sherwin said.
But that's allowed New York to study the others' progress in such areas as business plans and relationships with technology vendors, giving the fledgling initiative a chance to develop more quickly by "not making the same mistakes and going to the heart of the matter," she said.