The Health Information Management Systems Society's (HIMSS) Annual Conference and Exhibition, HIMSS11, has come and gone, but attendees of the pre-conference HIE Symposium returned home with numerous lessons learned and best practices presented by veterans in the health information exchange field.
With health information exchange becoming more prominent as a requirement for the meaningful use of health IT, the education sessions addressed timely issues that are impacting stakeholders across the healthcare industry.
[See also: Health IT boosts Indiana's patient care, economy.]
David Walczak, CIO AVP of technology for Bayhealth Medical Center in Dover, Del., noted that Bayhealth was one of the original hospital investors of the Delaware Health Information Network (DHIN) in 2002. DHIN was established in 1997 with an administrative focus, but shifted to clinical information exchange by 2006 and went live with the data in May 2007.
In the next two years, DHIN will be working on several projects, including Medicaid connectivity, quality reporting, patient portal and personal health record connectivity, referrals and consults, and benefit eligibility.
Walczak said the hospital's participation in DHIN was not treated as a "real project" at first and found that much more effort was required than the hospital had anticipated.
He stressed the importance of putting the patient at the center of the efforts, developing trust among providers, keeping HIE neutral and providing constant - not just initial - feeding and care of the HIE project. "You need to be actively engaged," he said.
[See also: NeHC releases stakeholder survey on HIE concerns.]
John Kansky, vice president of business development for the Indiana Health Information Exchange (IHIE) assured the audience that an exchange of IHIE's scale is possible. Founded in 2004, IHIE is the largest HIE in the country, serving a market area with a population of more than 4 million people.
"One caveat is that for sustainability purposes, bigger is better," he said. While it took 15 years for IHIE to get where it is today, other HIEs should enjoy "significant acceleration," thanks to the HITECH Act and advances in technology and interoperability.
Christopher Sullivan, technical health information exchange manager for Health Choice Network in Florida, Florida HIE's state-level participation agreement and shared his expectations as a provider working with the state. The draft of the participation agreement is based on the Data Use and Reciprocal Support Agreement (DURSA). Thus far, the agreement is "a moving target," he said.
The agreement covers expectations of participants and their reciprocal duty to provide healthcare data such as all patient encounter data to the Florida HIE. It also puts into place policies and procedures for governance. While the agreement provides a good framework, Sullivan said existing problems need to be resolved. For example, the agreement has yet to be vetted by all participants.
In a town hall meeting about the next-generation HIE, James Delle Bovi, technical advisor for the Centers for Medicare and Medicaid Services (CMS), talked about how HIEs are so strategic to CMS' success or failure and how off-loading data onto a higher bandwidth infrastructure is becoming an urgent need.
In 2011, CMS will be working with the Regenstrief Institute, CareSpark and the Brooklyn Health Information Exchange on bi-directional health information exchange. If successful, expect CMS to expand the project, he said.
Liesa Jenkins, former executive director of CareSpark and program director, State HIE Technical Assistance Program for Deloitte Consulting, noted that there must be a complementary role for federal and state governments and the private market in HIE development. "While the proportion has shifted to the public sector, the real desire is to embrace private sector investments that don't duplicate public funding," she said.