HealtheConnections, a Syracuse, N.Y.-based health information exchange also known as the Regional Health Information Organization of Central New York, is now up and running.
It is linking its founding four local hospitals—Community-General Hospital of Greater Syracuse, Crouse Hospital, St. Joseph's Hospital Health Center and Upstate University Hospital—as well as the Laboratory Alliance of Central New York and five physician practices with “a couple of hundred docs,” according to Executive Director Rob Hack.
But the long-term goal, Hack said in an interview, is to connect all 19 hospitals serving 1.4 million people in 11 central New York counties.
Hack says the RHIO was launched on grants, but he thinks he has a business plan that will make it a self-sustaining enterprise.
“So far so good,” Hack says. “We've got sustainability funding from the insurance companies in the region.”
And the price of insurance company participation wasn't the often-asked for pound of flesh—use of patient clinical data.
“There is no access at all by insurance companies, none,” Hack says. “They pay for it because they work with businesses and consumers” that want the service. “It is all for clinical use.”
Hack says the RHIO is a hybrid of the federated model in that the exchange services vendor, Axolotl, stores the healthcare information from the participants on its own edge servers and operates a master patient index that points to available records when providers send a query for patient records to the exchange. San Jose, Calif.,-based Axolotl was snatched up last August by acquisitive Ingenix, a division of the nation's No. 2 private payer, UnitedHealth Group.
Patients have no say on whether their data will be sent by their providers to the exchange, but, under New York law, they do have a measure of control over who gets to see their data once they are in the exchange.
For each provider, patients must opt in to have their outside records—such as prescription histories or labs—made accessible to that provider through the exchange. An emergency provider with a patient who has not yet made a declaration of consent, one way or the other, can have access to that patient's health records through the exchange under a “break the glass” proviso. But if that patient previously has declared he or she doesn't want that provider to access exchange information, the provision isn't operable.
Few patients, given the choice, refuse to join, Hack says. “We are seeing 98.5% participating rates.” Consent preference are recorded either electronically via an interface with the healthcare organization's patient registration system or via a web-based user interface where the consent choices are transcribed from a paper consent form.
Consent documents for the RHIO are co-branded with the provider's name appearing on the form, and that seems to assure patients their data will be protected, according to Hack. “The reason consents are so high is, one, most people trust their care providers, and (two) they see the value of sharing their electronic health records.”
Follow Joseph Conn on Twitter: @MHJConn.