Kudos to TriState Health Partners for obtaining a favorable clinical integration advisory opinion letter from the Federal Trade Commission (FTC offers clearer guidance on clinical integration agreement, April 27 ).
There is much to be learned from what TriState is doing. It should be a source of comfort to many of us working toward sustainable regional health information exchanges to see the FTC advisory opinion.
As we anxiously await what will be accomplished with the HITECH portion of American Recovery and Reivestment Act of 2009, we should all be thinking about how our efforts to create local, state and national health information exchanges will be sustained in the long run. As a practicing physician, I know that it is a rare occurrence when I have all the information about a particular patient that I need when and where I need it. This is a true statement despite the fact that I have been using electronic medical records for more than 10 years. It sounds like TriState has done a nice job of aligning patient, physician and payer incentives.
While hospitals often seem to be the obvious place for HIEs to begin, there is little in it for them to do so under our current reimbursement system. An exchange that would allow physicians access to their patients data from payers, pharmacies, hospitals, other physician offices, lab and radiology facilities would benefit hospitals the least of all the other stakeholders. Physicians stand to gain huge efficiencies and better ability to care for their patients; patients stand to gain better care and less duplication of services. Insurers gain a healthier population of patients and tremendous cost savings.
TriStates ability to align the incentives between payer and physician is something we need to pay close attention to. We should be screaming for similar alignments as we move forward with health information exchange efforts. Hospitals and others may be able to get RHIEs started with stimulus dollars but payers need to be a big part of the mix. If we believe that health information technology is the first step toward real healthcare reform then we have to believe that payers need to begin paying for services in a way that encourages us all to do the right thing for our patients.
While we all understand that there are flaws in using claims data to draw clinical conclusions, we have to believe that when we all (payers, physicians, hospitals, labs, pharmacies) merge our data in a meaningful way, no one loses.
Wendy Frieling, M.D.Chief information officerVice president of information technologyNewton (N.J.) Memorial Hospital Submit a letter to the Modern Physician Reader Blog. Please include your name, title, company and hometown. Modern Physician reserves the right to edit all submissions.