CHIME Time: HIEs can contribute to community data exchange

Moore (Okla.) Medical Center, a satellite site of Norman (Okla.) Regional Health System, took a direct hit from the terrible tornado that killed 24 people and injured 377 others May 20. It will most likely never open its doors again.

However, as Modern Healthcare reported, the medical center had been part of SMRTnet, a regional health information organization, for more than five years, and had many of its patient records backed up through the RHIO. The article noted that, “Records stored by the exchange include patient demographics, visits, procedures, lab results, vital signs, histories and physicals, discharge summaries, discharge medications and radiology reports.”

In the bedlam after the tornado, valuable medical information was accessible because of the backup that had taken place, creating a lifeline for Moore Medical Center, and support for those requiring medical attention after the storm.

This should raise questions for healthcare leaders: How is your hospital or health system functioning with your state health information exchange or RHIO? If a disaster occurred, would you look to your HIE to retrieve patient records? What other features does your HIE provide that create a true value proposition for your organization?

The 2009 Health Information Technology for Economic and Clinical Health Act focused on accelerating information technology adoption. This reform relies heavily on IT and health information exchanges to help achieve patient-centered care, with a goal of increasing the value of care while improving health outcomes. To help establish data connections throughout the healthcare continuum, the federal government provided $564 million to create statewide HIEs. The main focus of these HIEs is to acquire and aggregate data, provide access to the data, assist with electronic health-record adoption, and use analytical tools to enhance the healthcare system and health of the population.

In Oklahoma, HIE technology provided a clear benefit, but can we say the same of other state HIEs? Surprisingly, in 2012, the eHealth Initiative identified 222 public and private HIEs in the country—a nearly 13% decline from 255 in 2011. This drop suggests that HIEs are struggling to consistently deliver value. If HIEs are a crucial component for healthcare reform, what do providers need to do to derive value and engender tangible support for them? How much time, effort and financial support do we need to provide to champion the role of HIEs in our states?

States and healthcare providers need to be proactive in interacting with HIEs to bring about positive benefits and look toward future healthcare continuum requirements.

In June, the state of Michigan conducted a three-day educational workshop, “Connecting Michigan for Health,” which brings healthcare leaders, health information exchanges and legislators together to best understand Michigan's HIE roadmap.

The conference provided information on Michigan's HIE landscape, including creating a vision for a “connected state.” There was a focus on additional benefits to be derived from HIEs regarding transitions of care and patient data notifications. This has become a critical issue because accountable care organizations must manage these for their defined populations.

The conference also provided an analysis of how current events and legislation affect healthcare and HIEs. Topics included patient data-matching strategies, achieving interoperability, security/privacy issues, and meaningful use stages 2 and 3.

Because data sharing is a critical component of HIEs, conference workshops involved technical discussions on standards and interface requirements, and participants shared lessons learned from standards committees and vendors. Organizations came together to challenge the requirements for data sharing and interoperability—a great example of a state leading the way in enabling HIEs to improve health outcomes.

If I have one bit of advice for CIOs, CEOs and other healthcare leaders, it's this—don't be passive about HIEs. Ask HIEs what they are doing to improve the healthcare landscape in your state. Is your HIE assisting in acquiring and aggregating data in the community? Does it assist with EHR adoption? What analytical tools does the HIE employ to enhance the healthcare continuum?

For HIEs to succeed financially and contribute to the changes Americans need, they absolutely must have real-world answers to these questions. If they don't, they may become a thing of the past, which will not help any of the patients we serve.

Donna Roach, CHCIO, FHIMSS