AxolotlCorp

Arkansas Office of Health Information Technology Selects OptumInsight for Statewide Health Information Exchange Services

ewatts@axolotl.com (Elvia Watts) — Thu, 09 Feb 2012 07:00:00 +0000

Axolotl HIE facilitates sharing of electronic health information among health care providers across Arkansas

LITTLE ROCK, ARK. Feb. 9, 2012 - The Arkansas Office of Health Information Technology (OHIT) today announced that OptumInsight's health information exchange (HIE) technology has been selected to build the infrastructure for the State Health Alliance for Records Exchange (SHARE), Arkansas's statewide health information exchange.

Ray Scott, who was appointed by Governor Mike Beebe to serve as the state coordinator for health information technology and directs the activities of the OHIT said; "The selection of OptumInsight and their Axolotl HIE solution represents a major milestone in Arkansas's efforts to expand the use of electronic health information that will benefit patients, care providers and payers. OptumInsight's extensive experience in enabling the exchange of medical information about patients, who are treated by multiple unaffiliated health care providers, means better coordinated care and ultimately better health for Arkansans."

OHIT is the state-designated entity responsible for establishing the State Health Alliance for Records Exchange and for coordinating health information technology throughout the state. Through the use of federal and state funding, OHIT and SHARE's mission is to improve the quality of health for Arkansans by making the delivery of health care services more efficient and affordable, while improving patient safety. The state received $7.9 million in funding as part of the State Health Information Cooperative Agreement Program made available through the Office of the National Coordinator for Health Information Technology (ONC).

Using OptumInsight's Axolotl HIE solution, SHARE will create a secure infrastructure to connect disparate health information systems to facilitate the exchange of information with existing community and private HIEs as well as ambulatory electronic health record systems (EHR's) across the state. Participating physicians, authorized health services professionals, and hospital facilities will have the ability to exchange patients' clinical information securely and access up-to-date and historical medical information at the point of care. This information may include the patient's relevant clinical care summaries of diagnoses, treatments, lab test results, allergies, radiology images and medications from all care providers connected to SHARE.

SHARE will be implemented in phases. Phase 1 will provide secure messaging, which will facilitate and expand the secure, electronic movement and use of health information between unaffiliated health care providers. In Phase II, SHARE will evolve into a more robust health information exchange, giving all participating health care providers the ability to share patient information among hospitals, physicians and public health entities connected to the exchange. The benefits will include accurate and timely patient health care information available to care providers at the point of care, reduction of duplicate tests and medical errors to ultimately deliver safer, more affordable health care. Additional benefits to the patients will include electronic access to their own health information to promote more patient involvement in their care.

Through collaboration with the Arkansas Foundation for Medical Care and its division, HITArkansas, which serves as the Arkansas Regional Extension Center (REC), OHIT will provide strategies for assisting health care providers to quickly reach stage 1 meaningful use, as well as developing the infrastructure needed by labs, e-lab orders and structured lab results. Recognizing that physician adoption is the key to any successful HIE, OptumInsight partnered with the Arkansas Foundation for Medical Care and Oleen Pinnacle Healthcare Consulting, a national HIT healthcare consulting firm located in Little Rock, Ark. Oleen Pinnacle brings more than 20 years of HIT experience in hospital and ambulatory health information technology and most recent success with state and regional HIE deployments.

"The selection of OptumInsight to build the infrastructure for Arkansas's health information exchange is a tremendous step in improving health care through health information technology," said Ray Hanley, president and CEO of the Arkansas Foundation for Medical Care, the parent company of HITArkansas, the state's Regional Extension Center. "OHIT has been a great partner in our efforts to aid health care providers in the transition to electronic health records, and we look forward to the next steps in that process."

"OptumInsight is excited to work with the Arkansas Office of Health Information Technology to deploy a complete HIE infrastructure and solution that will make health care more efficient and affordable for care providers and patients, all while improving patient safety," said Glenn Keet, senior vice president of business development for OptumInsight. "OHIT will deploy a point to point network using Direct protocols as an adjunct to Axolotl's Clinical Messaging® between physicians and patients, and will also have the leading solution for enabling authorized access to complete medical records for patients regardless of where the patients have received their care."

The Arkansas Office of Health Information Technology is OptumInsight's tenth statewide HIE customer, after Health Information Network of Arizona, Michigan Health Information Network Shared Services in Michigan, HealthInsight in Nevada, Health Information Partnership for Tennessee (HIP TN), among other leading statewide (Idaho, Maryland, Nebraska, Utah and in partnership with Affiliated Computer Services Inc. Kentucky) Health Information Exchanges that have selected OptumInsight's Axolotl HIE solutions. Today, Axolotl HIE is connecting more than 55,000 physicians, 165,000 healthcare professionals, 375 hospitals, and 26 regional health information organizations (RHIOs) - including 5 Beacon Communities as part of the Beacon Community Cooperative Agreement Program.

The Axolotl HIE Solution
An HIE network connects all of the participating care providers and their patient record systems within its defined medical community - a hospital, independent delivery network (IDN), region or state. Once connected, patient-authorized participants can instantly receive and exchange their patient's clinical results as well as access a complete and up-to-date medical record at the point of care, directly from their system of choice. This supports clinical decisions and efforts to improve quality of care and patient safety.

The Axolotl HIE Solution from OptumInsight connects hundreds of thousands of health care professionals across statewide exchanges and regional health information organizations, as well as Beacon communities, accountable care organizations and independent delivery networks. For more information visit www.axolotl.com.

About the Arkansas Office of Health Information Technology
The Arkansas Office of Health Information Technology (OHIT) is responsible for establishing the State Health Alliance for Records Exchange (SHARE), the statewide interoperable health information exchange, and for coordinating health information technology activities throughout the state. Through the use of federal and state resources, OHIT and SHARE will improve the quality of health for Arkansans by enabling the more effective use of electronic health information technology to improve the delivery of healthcare services. For more information about OHIT, visit www.ohit.arkansas.gov ; for further information on SHARE, visit http://sharearkansas.com

About OptumInsight
OptumInsight provides health information, technology and consulting services. Commercial health plans, physicians, hospitals, life sciences companies, government agencies and other organizations that comprise the health care system depend on OptumInsight solutions and insights to improve their performance. OptumInsight is part of Optum, a leading information and technology-enabled health services company dedicated to making the health system work better for everyone. For more information, visit www.optuminsight.com.

About AFMC and HIT Arkansas
HITArkansas, a division of the Arkansas Foundation for Medical Care, is the federally designated Health Information Technology Regional Extension Center (HITREC) for the state of Arkansas. HITArkansas' purpose is to help health care providers in their use of health information technology by offering guidance, technical assistance and education of financial incentives associated with transitioning to the use of electronic health records (EHR's).

About Oleen Pinnacle Healthcare Consulting
Oleen Pinnacle is a national healthcare consulting firm focused solely on information systems with an expertise in the business and practice of healthcare. Our clients include all types of healthcare organizations, from integrated delivery systems to HMO's, medical practices, hospitals and State healthcare agencies. Since 1988, Oleen Pinnacle has assisted clients with every aspect of the information management process including project management, analysis, business process reengineering, implementations, conversions, custom programming, training, EDI, and facilities management. Oleen Pinnacle services clients from corporate offices in Little Rock, Arkansas.

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Annual IHE Connectathon Tests Validate OptumInsight Technologies’ Ability to Enable a More Connected Health System

ewatts@axolotl.com (Elvia Watts) — Mon, 30 Jan 2012 07:00:00 +0000

Tests confirm that OptumInsight innovations support Health IT Interoperability, which is essential to providing better-coordinated, higher-quality patient care

EDEN PRAIRIE, Minn., January 30, 2012 - OptumInsight's health information exchange and computer-assisted coding solutions have achieved the highest industry standards for enabling health system interoperability at the annual Integrating the Healthcare Enterprise (IHE) North American Connectathon. Tests performed at the event validated the abilities of OptumInsight's advanced health care technologies to help connect health care stakeholders and support better-coordinated, higher-quality patient care.

The annual IHE Connectathon promotes the adoption of IHE standards-based interoperability in commercially available health care IT systems. During the event, participating companies subjected their technologies to a series of tests of their abilities to connect and securely exchange information with other suppliers. The technologies must successfully complete IHE Profiles, meaning they process all the transactions for their respective roles in support of defined clinical-use cases.

Success in these tests is an important indicator that participating applications can support physicians, hospitals and other groups in state, regional and national health networks as they connect, share information and collaborate to enhance patient care and care outcomes.

OptumInsight completed testing of its Axolotl Open Access Service Oriented Architecture (SOA) platform for the following IHE integration profiles, which are cornerstones for enabling secure health information exchange:
• XDS.b (Cross Document Sharing-b) registration, distribution and access to health documents across health organizations
• PIXv3 (Patient Identifier Cross-Reference HL7 V3) patient identity cross-reference manager services
• PDQv3 (Patient Demographic Query HL7 V3 profile) patient demographic supplier
• XCA (Cross Community Access) record locator services to query for documents across a health community
• XCPD (Cross Community Patient Discovery) locate patient information across a health community

In addition, the company successfully demonstrated interoperability of its A-Life computer assisted coding Life solution via the HL7 CDA (Clinical Document Architecture) standard. This solution, powered by Optum's patented LifeCode® natural language processing (NLP) technology, enriches CDA documents with standardized ICD-9 (International Classification of Diseases, 9th Edition), CPT (Current Procedural Terminology) and HCPCS Level II (Healthcare Common Procedure Codes, Level II) codes.

"OptumInsight is committed to delivering technologies that make it easier and simpler for health professionals to connect, share information and collaborate to enhance patient care and improve the way the health system works," said Tom Boehning, senior vice president, OptumInsight. "The Connectathon tests validate that our solutions advance interoperability across local, regional and national health information networks, in support of those objectives."

OptumInsight will demonstrate its solutions and capabilities that support health system interoperability at the Interoperability Showcase of the Annual Healthcare Information and Management Systems Society (HIMSS) Conference & Exhibition, Feb. 21-24 in Las Vegas.

For more information about Axolotl IHE integration can be found here.

About Optum
Optum is a leading information and technology-enabled health services business dedicated to making the health system work better for everyone. Optum is comprised of three companies - OptumHealth, OptumInsight and OptumRx - representing over 30,000 employees worldwide who collaborate to deliver integrated, intelligent solutions that work to modernize the health system, improve overall population health and build Sustainable Health Communities. Visit www.optum.com for more information.

Idaho Health Data Exchange Signs Agreement with Greenway Medical for Instant EHR Interoperability with the HIE

ewatts@axolotl.com (Elvia Watts) — Tue, 10 Jan 2012 07:00:00 +0000

Boise, Idaho, January 10, 2012 - The Idaho Health Data Exchange (IHDE), Idaho's state designated Health Information Exchange (HIE), announced today that it has signed an agreement with Greenway Medical Technologies, a provider of electronic health record (EHR), ambulatory healthcare and clinical research business solutions and services.

As part of this agreement, small and large physician practices across the state can easily participate and connect to the Idaho health information exchange without having to make modifications to their existing Greenway Medical EHRs, or build costly point-to-point interfaces to participate in the HIE.

Idaho physicians using Greenway's integrated EHR, practice management and interoperability solution PrimeSUITE® 2011, can immediately connect to the state HIE and have access to community wide clinical data from all participating data sources and health care providers instantly and securely. Through a single interface, Greenway practices and clinics can seamlessly push or pull information from any participant that feeds data into the Idaho Health Data Exchange. The interface will save practices, providers and clinics time on interface building, and cost for connectivity thereby allowing the practice to focus and provide for the needs of the patients.

Coupled with this agreement is an arrangement with a number of physician practices through HighPoint Medical, a provider of medical practice management services, to connect to IHDE. "HighPoint Medical is honored to participate with the Idaho Health Data Exchange and Greenway in offering our medical providers a comprehensive electronic solution to accessing their patient's health history," said Skip Meyer, President, HighPoint Medical. "We feel strongly that this will not only simplify the providers' efforts but will also improve the patient experience through timeliness and quality of care."

"As reliable and scalable data exchange becomes paramount for care coordination, Greenway is gratified to help execute this advancement in care delivery," said Chief Operating Officer of Greenway Medical Technologies Greg Schulenburg. "These types of partnerships with the Idaho HIE and Highpoint Medical, further fueled by exchange engines like that of Axolotl HIE, provide the quality abilities of standard data exchange to reach across states, regions and the eventuality of a national health information network (NwHIN)."

The Axolotl Interoperability Hub from OptumInsight clinically networks disparate, certified EHRs and legacy systems, enabling complete interoperability and fully collaborative patient care via HL7, CCR, CCD and other structures. With a single interface, physician practices are immediately able to exchange data with all participants on a HIE, while also indicating which of their specific data is to be made available for query - providing authorized HIE participants with a more complete picture of a patient's health. EHRs may also connect to the HIE using IHE profile technology, facilitating query and retrieval for the EHR.

"Greenway is the first of several EHR vendor connections that we plan to complete over the next several years," said IHDE Executive Director Scott Carrell. "With Greenway's ability to develop a hub-to-hub connection and HighPoint Medical's support of bringing practices to IHDE, patients across Idaho will benefit from more collaborative and cost effective care."

New health care providers and physicians that participate and connect to IHDE will have access to clinical data from participating data sources including; Kootenai Medical Center, St. Joseph's Regional Medical Center, St. Mary's Hospital, Clearwater Valley Hospital, Saint Alphonsus Regional Medical Center, St. Luke's Health System, Pathologists Regional Laboratory, Treasure Valley Laboratory, Boise Pathology, PAML, Idaho's Division of Medicaid, Blue Cross of Idaho, Regence Blue Shield of Idaho and others.

Powered by the Axolotl HIE platform from OptumInsight, IHDE enables authorized and participating health care providers to securely exchange critical patient information electronically from hospitals, labs, radiology centers and other business partners, and sending referrals or consults to other health care providers in real-time. IHDE has successfully connected several hospitals, more than 400 participating users and independent reference labs to the statewide exchange, and is actively working to connect additional physician practices, hospitals, lab and radiology centers, and all other health care stakeholders across Idaho.

About HighPoint Medical, Inc.
HighPoint Medical provides a step by step approach in making the crucial change from paper to EMR/EHR. Embracing this technology can bring physician practices to optimum performance levels and significant revenue improvements. The company's specialties include: Medical Practice Management, Electronic Health Records and IT Support & Hosting. For more information visit www.highpointmed.com.

About Greenway Medical Technologies, Inc.
Greenway Medical Technologies provides innovative EHR, ambulatory healthcare and clinical research business solutions and services to more than 33,000 healthcare providers nationwide, in 30 specialties and subspecialties, by enhancing the delivery of patient care through advanced health IT software and on-demand services that allow physician practices to function at their highest level of efficiency in group practice, IDN, REC, HIE, IPA, Accountable Care Organization (ACO) and Patient Centered Medical Home (PCMH) settings. Established in 1998, Carrollton, Ga.-based Greenway is a privately held company with more than 500 employees. For more information, go to www.greenwaymedical.com.

About The Idaho Health Data Exchange
The Idaho Health Data Exchange, Inc., a 501(c)(6) non-profit corporation, was established to govern the development and implementation of the health data exchange in Idaho. IHDE is governed by a Board of Directors which provides direction and oversight to the organization. The Board includes representation from both the public and private sectors, including the health care delivery and financing systems, health care providers and consumers.

The IHDE was created as a result of the efforts of the Health Quality Planning Commission. The Health Quality Planning Commission was created by the 2006 Legislature. The Commission was charged with promoting improved quality of care and health outcomes through investment in health information technology.

Initial funding for the effort was appropriated by Idaho's Legislature and ongoing funding comes from participants in the Exchange and ARRA grant dollars. For more information visit http://www.idahohde.org and follow us on Twitter and Facebook.

Faster Diagnosis and Treatment, Reduced Radiation Exposure and Health Care Cost Savings Enabled by Image Exchange Implemented for RHIO Serving Western New York by eHealth Global Technologies and OptumInsight

ewatts@axolotl.com (Elvia Watts) — Tue, 10 Jan 2012 07:00:00 +0000

ROCHESTER, N.Y. Jan. 10, 2012 - eHealth Global Technologies, Inc. (eHGT) and OptumInsight will deploy an innovative medical image exchange service for HEALTHeLINK, a Regional Health Information Organization serving eight counties of western New York, including Buffalo and Niagara Falls. This partnership will enable faster diagnosis and treatment, improved outcomes, reduced radiation exposure and health care cost reductions.

Powered by OptumInsight's, Axolotl® Image Exchange, the new service enables rapid, secure access to diagnostic quality radiology and cardiology images that support clinical decisions made by providers that participate in HEALTHeLINK. The ability to access images with a single click, within the context of each patient's community-wide medical record and without disrupting the caregiver's workflow will support efforts to enhance patient care.

"We are excited to offer our healthcare providers and their patients so many new opportunities to enhance care, improve efficiency and lower cost. We expect the implementation of this service to lead to a reduction of unnecessary imaging exams, thus minimizing patient radiation exposure and reducing the cost of care. Immediate access to images, when and where they are needed, will also allow our physicians to provide faster diagnosis and treatment, with tighter care coordination and improved outcomes. Finally, the burden of reproducing, transporting, and attempting to view physical storage media such as CDs will be lifted from patients and caregivers alike, allowing them to focus on much more important priorities such as recovery and wellness," stated Dan Porreca, HEALTHeLINK's Executive Director.

"Many benefits that have never been realized before will now be enjoyed, all ensuring a higher standard of efficiency and quality of care. The Axolotl Image Exchange offers notable advantages over other more conventional methods of sharing images. Thanks to our hybrid-federated architecture, most images are available in full diagnostic quality in seconds; rather than minutes, hours or even days. Since this service "image enables" HIEs, there is no need to establish a separate, costly mechanism to ensure patient privacy and security, as the same rules that govern the exchange at large also apply to imaging. Images are made available within the context of the entire patient record, not as a part of a separate system. And finally, physicians can view their patient's images in a single web-enabled viewing environment regardless of how many different PACS technologies and imaging provider locations they may have originated at," stated Gary Larson, COO and General Manager, HIE Services, from eHGT.

For more information about Axolotl Image Exchange, click here.

About HEALTHeLINK
The not-for-profit organization was established through funding from BlueCross BlueShield of Western New York, The Catholic Health System, Erie County Medical Center Corporation, Independent Health Association, Kaleida Health, Roswell Park Cancer Institute, Univera Healthcare and the Health Care Efficiency and Affordability Law for New Yorkers Capital Grant Program (HEAL NY) from New York State. HEALTHeLINK also received one of the country's largest awards as part of the United States Department of Health and Human Services' Beacon Community Cooperative Agreement Program.

HEALTHeLINK stakeholders include a broad representation of healthcare professionals and organizations throughout the eight-county Western New York region such as the State University of New York at Buffalo, P2 Collaborative, Chautauqua County Health Network, the WNY Rural Area Health Education Center and local county public health departments. For more information on HEALTHeLINK, visit www.wnyhealthelink.com .

About eHealth Global Technologies, Inc. (eHGT)
eHGT is the leading medical record retrieval and diagnostic image exchange service provider, serving 50% of the nation's top 100 hospitals and leading health information exchanges (HIEs), including 13 of the top 17 hospitals selected to the prominent Honor Roll of the Best Hospitals from the 2011-2012 U.S. News & World Report. The company's services include eHealth Connect® Diagnostic Image Exchange and eHealth AccessTM Record Retrieval Service. Our services utilize innovative health information technology to access medical records and diagnostic images in any format, and then securely deliver them to providers and clinicians in a digital format to improve continuity of care. Web: www.eHGT.com

East Tennessee HIE Selects OptumInsight

ewatts@axolotl.com (Elvia Watts) — Mon, 02 Jan 2012 07:00:00 +0000

CMIO Magazine

The East Tennessee Health Information Network (etHIN), a regional health information exchange (HIE) initiative based in Knoxville, will use the Axolotl HIE platform from OptumInsight to connect healthcare providers in 17 Eastern Tennessee counties to the statewide HIE run by the Health Information Partnership for Tennessee.

According to the Eden Prairie, Minn.-headquartered OptumInsight, etHIN Executive Director Leigh Sterling hopes that the move will improve care coordination in the region.

East Tennessee Health Information Network Selects OptumInsight Health Information Exchange Technology to Support Better Patient Care Coordination

ewatts@axolotl.com (Elvia Watts) — Tue, 20 Dec 2011 07:00:00 +0000

Secure clinical network facilitates easy access to patient information to support medical decision-making

Axolotl HIE solution enhances connectivity, collaboration among care providers across Tennessee

KNOXVILLE, Tenn., Dec. 20, 2011 - The East Tennessee Health Information Network (etHIN) has selected OptumInsight's health information exchange (HIE) technology to help physicians, hospitals and other health care providers in the region improve patient care coordination and quality.

"Our vision is to securely connect hospitals, physicians and other health care providers with each other and to critical health information at the point of care to enable significant improvements in patient safety, health outcomes and opportunities for practice efficiencies. We feel confident that OptumInsight is the best partner to help us accomplish this," said Leigh Sterling, etHIN executive director.

etHIN is a collaborative group composed of eastern Tennessee's major health systems. The network will use the Axolotl HIE platform from OptumInsight to create a secure clinical network that connects participating physicians, hospitals, laboratory services providers and pharmacies in the region. This will enable medical professionals to access and share critical health information, including electronic medical records, to support faster, more effective clinical decision-making and coordination with other care providers.

Further, through the Axolotl HIE platform, participating physicians and hospitals will easily be able to connect to the state Health Information Partnership for Tennessee Network to coordinate patient care and access clinical data from Immunization Services, Public Health Reporting, Lab Reporting Services and other qualified organizations across the state.

"Since before etHIN was formalized in 2003, providers in our region have been working together to enable the exchange of health information to improve health care outcomes and reduce costs for our community. Our selection of OptumInsight's Axolotl HIE solution came after an in-depth evaluation and emerged as the solution that met our criteria and fit into our vision of a robust Health Information Exchange," stated Mike Ward, president of the East Tennessee Health Information Network.

"HIE technology from OptumInsight provides a secure bridge between medical professionals, improving access to information and facilitating communication between caregivers. This initiative will help reduce duplicate testing, provide safer transitions of care and reduce administrative costs," said Glenn Keet, president of Axolotl at OptumInsight.

The Axolotl HIE platform
An HIE network connects all of the participating care providers and their patient record systems within its defined medical community - a hospital, independent delivery network (IDN), region or state. Once connected, patient-authorized participants can instantly receive and exchange their patient's clinical results as well as access a complete and up-to-date medical record at the point of care. This supports clinical decisions and efforts to improve quality of care and patient safety.

The Axolotl HIE platform from OptumInsight connects hundreds of thousands of health professionals across nine statewide exchanges and 25 regional health information organizations, as well as beacon communities, accountable care organizations and independent delivery networks. For more information visit www.axolotl.com.

About The East Tennessee Health Information Network
The East Tennessee Health Information Network (etHIN) is regional health initiative based in Knoxville, Tenn., comprised of major hospitals and health systems in the region, including Covenant Health, University of Tennessee Health Systems, Tennova Healthcare, Blount Memorial Hospital, East Tennessee Children's Hospital and Summit Medical Group. Since its inception in late 2003, etHIN has a mission to improve patient care, safety, and quality as well as lowering the cost of healthcare delivery. As a community driven project, the network will ultimately serve the needs of health consumers in a 17 county region in East Tennessee.

Marketing for HIE Success…but to whom?

ewatts@axolotl.com (Elvia Watts) — Tue, 20 Dec 2011 00:31:06 +0000

Healthcare-Exchange

By Glenn Keet

President, Axolotl
SVP, Business Development, OptumInsight

In our last post of the HIE patient consent series, we described why attaining patient consent is necessary to the success of an HIE. But to the average patient - you know, the one who isn't a hospital CIO in their downtime - the concept of an HIE can raise privacy concerns. To overcome this, healthcare organizations need to educate patients on how HIEs work, assure them that their information will remain confidential and secure, and explain to them the benefits of electronically sharing patient information via this exchange.

According to the American Medical Association and the Markle Foundation, four in five American consumers believe that using an online patient health record (PHR) would yield major benefits to them in managing their health care. In spite of this, the usage of PHRs has been very low to date, due in some part to patient concerns about privacy of their personal health information.

There are similar privacy concerns with an HIE. However, the HIE plays a critical role in the population of PHRs with clinical data from sources around the health care community. HIE stakeholders - such as hospitals, health plans, individual practice associations, etc. - should consider sponsoring or supplying a PHR to patients that is not only already pre-integrated to the HIE, but also empowers patients by allowing them access to the PHR on their own terms. By letting patients set the consent policies and access rules for their records on the HIE, the HIE potentially is helping to quell these patient concerns.

Effective patient education is key to increased patient involvement and empowerment, and this can be achieved by PHRs connected to the HIE. Doing so enables them to send and receive health care information to their own PHR and share it efficiently with the professionals providing care. But how do you promote this participation successfully?

One way is to go directly to the patient. They need to be presented with the facts about HIEs when they are registering. Registration personnel should be well-trained to explain the exchange and its benefits in layman's terms, and address any questions from patients.

Beyond just the patient visit though, HIEs can implement broader, community-wide consumer education programs to help garner patient participation. These campaigns often include radio or TV commercials/appearances, direct mailings, billboards, presentations at local community meetings, and/or fact sheets, and can serve as resources for patients who have questions about an HIE or concerns about participating in one.

Alternatively, making clinical staff aware of the exchange and explaining the benefits of their participation allows them to advocate for an HIE and encourage patient participation. Physician champions can lead to increased buy-in from patients, peers, and community leaders.

The best marketing program for each HIE will depend on its unique market, but at the heart of it all is the educated consumer. Informed consumers are engaged consumers, and engaged consumers are satisfied consumers. As the health care industry becomes more competitive and moves toward coordinated care and market-based economics, business models that place the consumer at the center of the health care universe will be in positions of strength.

Up, Up and Away! Healthcare’s Future “In the Clouds”

ewatts@axolotl.com (Elvia Watts) — Wed, 14 Dec 2011 07:00:00 +0000

Anand Shroff
VP, Product Management
OptumInsight

Healthcare-Exchange

By Anand Shroff

It's no secret that healthcare has historically been slow to adopt the latest and greatest in technology and even slower to embrace technological paradigm shifts, as evidenced by the continued presence of client-server computing in healthcare in the age of the Internet. While strides to catch up have been made in recent years - with shifts toward electronic health records (EHR), advanced health information exchange (HIE), and mobile computing devices - the world of business is changing rapidly, and the industry needs to do a better job of keeping pace.

Cloud computing is one such paradigm shift. Like other advances before it, cloud computing took root with consumers - think Apple's iCloud and Google's Gmail services - and has since triggered a shift in the way enterprises think about doing business. What began as a simple question of whether files could be stored in the cloud quickly shifted to a discussion of whether business processes could be hosted there as well, e.g. Salesforce.com. Now, entire business processes have been moved to the cloud and previously unthinkable workflows are achievable because of private (and public) cloud integrations made possible by secure cloud communications. Salesforce.com has built an entire ecosystem of extended business processes through its force.com platform, which relies on cloud-to-cloud integration.

Healthcare presents unique challenges to cloud infrastructures, operating under some of the most stringent data privacy and security regulations, but that doesn't mean cloud is completely out of reach. As hospitals and health systems continue to adopt technologies to capture data and share it over an increasing number of miles, they'll also need to think about how to store and access that data most efficiently, and cloud solutions could be the answer. Public cloud environments - where information is accessed entirely via the Internet and hosted outside the organization - may be too risky, but private cloud environments, which exist in healthcare today, can offer similar benefits and efficiencies with less risk. It's also possible to take a hybrid approach, which is what I envision will work best in healthcare. For example, consumers could use their OpenID (public cloud technology) to authenticate with providers after passing additional levels of verification (private cloud offering).

Whether or not patients care about cloud, providers will have to care as their EHRs grow, but they aren't the only constituencies that should pay attention. Vendors too will need to consider cloud infrastructures, privacy and security for its hospital customers. They'll need to start with bolstering security, paying close attention to special certifications and solutions available to help instill confidence in cloud. Payers - given that they have such influence on the industry itself - are sure to capitalize on cloud computing as well.

Silicon Valley receives the attention it does for good reason. Whether it is business or consumer facing technology, human lives are transformed by the innovations made here. Healthcare can recognize the benefits of improved agility and efficiency by keeping closer tabs on how its technology industry counterparts are propelling the world forward.

Enterprising Organizations

ewatts@axolotl.com (Elvia Watts) — Thu, 08 Dec 2011 18:18:59 +0000

Healthcare Informatics

By Jennifer Prestigiacomo

The Latest Hospital Organizations to Reach HIMSS Analytics Stage 7 all have Something in Common: An Enterprising Spirit and Set of Systems.

To measure electronic medical record development in hospitals and health systems, HIMSS Analytics, a division of the HIMSS organization, created its HIMSS Analytics EMR Adoption Model, an eight-stage schematic (encompassing Stages 0 through 7) that helps healthcare IT leaders assess their progress in EMR implementation. Since HIMSS Analytics created the model in 2005, it has formally recognized 61 hospitals as reaching Stage 7-61 in the U.S. and one in Seoul, South Korea (as of press time).

Becoming a paperless enterprise is a long and winding road, as the latest Healthcare Information and Management Systems Society (HIMSS) Analytics Stage 7 healthcare organizations-Tucson Medical Center; University of California, San Diego Health System; and Nemours Children's Health System-can attest. It is one fraught with hard work and challenges, but ultimately rich in patient care benefits and financial payoffs.

EXECUTIVE SUMMARY:

Here's an inside-and detailed-look at how three hospital systems achieved HIMSS Analytics Stage 7, an objective measure of progress toward EMR implementation.

The commonalities among the latest winners, says John Hoyt, executive vice president, organizational services, HIMSS, are medical staff adoption and the energy to accept the organizational change to make the “best of a new world.” He also notes that having an enterprise system for clinical and financial information doesn't hurt, either. “It's not the only way to do it,” he says. “But it seems to be the most effective for enterprise adoption and the fastest route to goal achievement, which is process redesign and quality improvement.”

The Stage 7 criteria are rigorous, with contenders being analyzed against a 12-page checklist that includes such elements as disaster recovery, quality improvement, deployment methodology, training methodology, governance, HIE, and data warehousing. Hoyt conducts a phone interview before the site visit to ensure the organization is ready for Stage 7. During the day-long site visit, the organization gives a 60- to 90-minute presentation on its IT strategy, and then Hoyt walks the floors (medical imaging, pharmacy, ED, the med/surg floors, and the HIM department, among others), accompanied by two CIOs and a CMIO to evaluate the organization's paperless-ness. The team then makes its decision onsite.

As of yet, there is no Stage 8, but additional stages involving HIE and accountable care readiness are likely to be created. There will however be an ambulatory adoption model rolled out in next few months that will assess patient engagement strategies, as well as other meaningful use criteria. What follows are stories from the latest organizations to reach Stage 7.

TUCSON MEDICAL CENTER

On its way to becoming an accountable care organization, Tucson Medical Center (TMC), a 612-bed community hospital, reached HIMSS' highest level of EMR adoption. In late 2008, the organization took a concerted approach to move to an enterprise electronic health record (EHR) its leaders have dubbed OneChart. Starting in 2001, TMC replaced its order entry system and pharmacy module (with software from the Verona, Wis.-based Epic Systems Corp.), and in January 2009, implemented the rest of the Epic modules, including revenue cycle management.

Frank Marini, vice president and CIO, says TMC began to see improvement in cash collections and denials, as well as improvement in turnaround times, from the ED to inpatient admission. Brian Cammarata, M.D., CMIO, an anesthesiologist by trade, says that medication turnaround time dramatically reduced from an average of 166 minutes to under 10 minutes. Further improvements came when TMC went live with its bar code medication administration (BCMA) in a big-bang approach in June 2010; the hospital averted 6,000 medication errors within the first six months.

Hoyt is impressed by the lack of clinically oriented paper at TMC and with the fact that its electronic medication administration record (eMAR) is the one place to look for all patient medications. Clinical information at TMC is reviewed by the medical executive community via dashboards that are customized for cardiac, neurosurgery, nursing, and other areas, in addition to specific reports for the quality care committee of the board of directors.

Even though the hospital is waiting till 2012 to apply for Stage 1 meaningful use, at this point, it is compliant with most, if not all, of the Stage 1 measures. The hospital is currently looking at Stage 2 requirements across the board and performing a readiness assessment to focus on problem list usage.

Beyond meaningful use, TMC is engaged in many ACO preparation activities like information exchange, which happens rather seamlessly, says Marini, in the OneChart program which operates on a common patient database. TMC's employed physician group, Saguaro Physicians, also uses it and is able to see all inpatient information. TMC intends to connect the hospital to a number of practices, specialty and primary care physicians (PCPs), and ancillary services like laboratory and radiology using the Axolotl exchange technology. TMC has also agreed to participate in the recently announced statewide exchange Health Information Network of Arizona (HINAZ) linking all payers and providers.

The second core element to TMC's ACO foundation is a robust analytics engine (provided by the Eden Prairie, Minn.-based OptumInsight) that will allow clinicians to analyze clinical data, with future advanced capabilities to support clinical activities over the continuum of care and transitional care services. “The real objective is to utilize this data and get it into the hands of physicians in the community caring for these patients, so as an organization we can provide the most cost-effective, high quality care to everyone in the community,” says Cammarata.

Beyond moving forward on its ACO initiative and meaningful use, TMC is focused on its transition to ICD-10. Like its OneChart implementation, it will encompass the whole hospital, but fortunately for this single-platform organization, IT challenges will be mitigated moving forward.

Reaching Stage 7 is not easy, and involves much change management, says Marini. “For something as big, expensive, and risky as an electronic medical record implementation you absolutely need to have your executive team and your CEO on board, fully engaged and committed for the long haul,” he says. “Getting the organization to understand that an initiative like this is not an IT project [is key]. The minute it is looked at as an IT project, you know you're headed in the wrong direction. This is really an organizational initiative; it needs to have leadership from the medical staff, as well as the nursing and operational staff.” Hoyt was impressed by the scope of TMC's IT team, which includes about 100 IT personnel and 20 informatics professionals. “It's clearly a multi-disciplinary effort,” says Hoyt.

Marini acknowledges the importance of Stage 7 achievement, but says it's really a byproduct of what TMC is trying to pursue. “We didn't think about Stage 6 or Stage 7 when we set out to do this. It was really about the realization that patient care requires better tools; our clinicians require better tools, and that's really what we pursued,” he says. “It was gratifying and validating to use HIMSS Analytics as a benchmark to see that we are on the right track.”

UCSD HEALTH SYSTEM

The story of the University of California, San Diego Health System (UCSD) is one of iterative change, says its CMIO, Josh Lee, M.D. The health system has made many early important decisions that helped it reach Stage 7. The organization, which is comprised of a few specialty centers and two hospitals, UC San Diego Medical Center and Thornton Hospital, operates under one license, with a combined licensed capacity of 552 beds. UCSD has been focused on increasing patient care quality and patient safety through health IT for the last 12 years.

Recently, the system has been transitioning its hybrid systems into a more streamlined, enterprise approach. "We believe that all information that is needed for provision of patient care is best to be in one environment, so that care providers don't have to go to multiple, different areas to get that information," says Ed Babakanian, who has a team of more than 200 people and has been the system's CIO for 16 years. "That system is supported by these specialized systems like labs, pharmacy, cardiology, imaging, but you have to deploy those in a way like a human body, in that they are integrated and transparent in what they need to do-so a pharmacy system can't be an island of automation all by itself."

It was UCSD's transition to a unified inpatient EHR that struck Hoyt when he was reviewing the system for Stage 7. In February 2011 the system transitioned its Siemens inpatient system to match its ambulatory system (Epic Systems), so patients could benefit from a centralized registration system and have a record that followed them throughout their care. "I don't think we've ever had a hospital achieve Stage 7 in 12 months of go-live, but that's because they had previous experience, and they were probably at a Stage 5 with their previous system. So they knew what they needed to do, and they put their heads down and did it," says Hoyt.

Lee says a novel decision that made its inpatient transition smoother was asking clinicians what they felt was the most important element to preserve; their overwhelming response: transitions of care. About 10 months before the big bang go-live, the IT team brought up the medication reconciliation module, which was a new discharge summary system that forwarded certain communication internally and externally.

On the ambulatory side during medication reconciliation, Lee says his team facilitated workflows for vaccinations at time of discharge, so it could happen at a logical time for clinicians. "We recognize that people need to be introduced to things that clearly meet a demonstrated business need, and we delivered on that early, and they were happy," says Lee. "Nurses and doctors started to see the inpatient presence of our new EMR, so by the time the change happened, it was already a familiar part of [their work environment]."

UCSD provides its staff with complex dashboarding to give clinicians quality report cards, short-term retrospectives, and over time trending to develop practice-based and evidence-based care approaches. For instance, to improve frail patients' risk of fall, a real-time audit is generated for each patient to see if all the appropriate interventions have been taken.

The health system is currently migrating its entire ambulatory and inpatient revenue cycle/billing and appointment schedule system to its enterprise vendor, as well as other modules like its health information management system, ED, perioperative and anesthesia system, and imaging. UCSD is also refreshing its clinical decision support system, as well as implementing a clinical trials system, research informatics for genome sequencing, and a medical education system to train clinicians. "We have a unique combination of talented IT professionals who move beyond simple IT configuration," says Lee. "But really do workflow analysis almost to the point of becoming an internal consulting agency for the enterprise."

UCSD has a robust patient portal, which is used by 30,000 patients to send clinical messages, request refills and appointments, complete health maintenance activities like setting reminders for care activities, and update problem lists. In October, patients will be able to download a free MyChart app to manage their health via mobile device. Soon, Lee says that the portal will be able to capture non-urgent medical images, like a photo of a rash, so patients can provide more information to their providers.

Another way UCSD connects with its patients is through telemedicine. Approximately 10 specialties are doing doing telemedicine amounting to approximately 40 distinct contracts, and 10 to 20 more specialties are in the pipeline to begin telemedicine use soon. UCSD is now preparing to see stroke and psychiatry patients remotely, as well as constructing a new telemedicine building to train future physicians. In September UCSD expanded its outreach to rural communities and launched its eVisits program.

UCSD has been recognized nationally for its outreach efforts by becoming one of the 17 Beacon Communities. A year and half ago UCSD obtained the Beacon grant in large part, Babakanian says, because several clinicians on his team started integrating UCSD with several hospitals across San Diego and linking and interfacing community physician practices through an internal HIE to provide for patient-centered medical homes.

The Beacon project, called the San Diego Safety Net Health Information Exchange (HIE), will allow physicians to electronically make follow-up appointments at participating community clinics for patients being treated in the hospital or emergency department who don't have a PCP. Other Beacon activities include expanding pre-hospital emergency field care and electronic information transmission to improve outcomes for cardiovascular and cerebrovascular disease, patient engagement through web portal and mobile technology, and improving continuity of care for veterans and military personnel through the Veterans Affairs/Department of Defense Virtual Lifetime Electronic Record (VLER) initiative.

"I view Stage 7 as our start," says Lee. "It's really not a finish; I think you have to achieve this stage to now move into the real exciting part of patient engagement and interoperability, but you have to reach this stage first."

Nebraska Doctors Participating in NeHII Are Now Sharing Patient Immunization Information with Nebraska State Immunization Information System

ewatts@axolotl.com (Elvia Watts) — Mon, 05 Dec 2011 11:00:00 +0000

Omaha, NE, December 5, 2011 - The Nebraska Health Information Initiative (NeHII), Nebraska's statewide Health Information Exchange (HIE) announced today that physicians participating in the exchange will have access to electronically share patient immunization information to NESIIS, the Nebraska State Immunization Information System.

The Nebraska State Immunization Information System is a secure, statewide, web-based system that connects and shares immunization information among public clinics, private provider offices, local health departments, schools, hospitals and other health care facilities that administer immunizations and provide medical care to Nebraska residents.

Immunization information is currently shared among physicians using NeHII. Integrating NESIIS into the exchange, will further improve the ability of public health practitioners, planners and clinicians in preventing the spread of vaccine-preventable diseases. The increased exchange of immunization information is expected to result in more accurate and up-to-date immunization records, and state officials expect the continued growth of information exchange to improve issues related to missed immunizations and over-immunization.

Dr. Joann Schaefer
CMO, State of Nebraska, Department of Public Health

Dr. Joann Schaefer, Chief Medical Officer for the State of Nebraska, Department of Public Health said, "This is not only a step in proving the value of electronic health information sharing but it is going to improve our vaccination rates and save more lives over time."

The exchange of information between NeHII and NESIIS will further current national goals for increased consumer engagement through health information technology. According to the National Coordinator for Health IT Farzad Mostashari, improving patient access to health information will be a critical part of consumer engagement in Health IT. NESIIS provides patients with secure online access to their immunization records, and the addition of patient data from NeHII is expected to increase the quality and quantity of their information.

Deb Bass
Executive Director
NeHI

NeHII Executive Director Deb Bass said, "We have worked diligently to offer this functionality through NeHII. We are excited to announce yet another opportunity to demonstrate the value of health information exchange."

A later phase will involve securely sending statewide immunization data from NESIIS to NeHII. At that time, the full range of statewide immunization data will be accessible to participating physicians through NeHII's Virtual Health Record.

Powered by the Axolotl HIE platform from OptumInsight, NeHII electronically delivers clinical information to the point of care, integrating a wide variety of patient clinical data including laboratory results, ER reports, discharge summaries, radiology reports, progress notes, transcription, medications and other medical information. NeHII is the first to go live with the Axolotl Immunization Gateway.

About NeHII:
As an early adopter and national leader for Health Information Exchange, NeHII, a non-profit 501(c)(3) organization has functioned as a public-private collaborative that currently reaches nearly 85 percent of lives in Nebraska and a substantial number of individuals in Nebraska's six border states. NeHII's vision is to be a leader in the secure exchange of health information, enabling a healthier Nebraska.

URMC Joins Medical Image Exchange

ewatts@axolotl.com (Elvia Watts) — Mon, 05 Dec 2011 07:00:00 +0000

Rochester Business Journal

The area's largest health care provider, the University of Rochester Medical Center, has joined the Rochester Regional Health Information Exchange's medical image exchange, officials said Monday.

The addition of URMC, which runs nine area medical-imaging sites, to the image-exchange system means that the majority of X-rays, MRIs, CAT scans and other diagnostic images are instantly available to some 1,200 doctors and 13 hospitals in 13 counties, said Ted Kremer, the local RHIO's executive director.

In addition to images, RHIO participants can electronically share patients' test results and medical histories, cutting the chances of physicians ordering duplicate tests or making prescribing errors.

Technology to transmit images among RHIO members is provided by Brighton-based eHealth Global Technologies Inc., which provides electronic medical retrieval services to hospitals and RHIOs nationally.

San Diego Area Health Care Providers to Launch Technology to Improve Patient Care

ewatts@axolotl.com (Elvia Watts) — Mon, 14 Nov 2011 22:21:42 +0000

Federal Beacon Program Set to Go Live at Select Health Care Locations

San Diego, CA, November 14, 2011 - As part of a federal initiative designed to improve medical care through health information technology (health IT), several San Diego health care providers announced today that they are ready to launch a health information exchange (HIE) that will link area hospitals, clinics, ambulances, and other health care facilities electronically to improve communication and allow for the exchange of vital patient information.

The San Diego Beacon Community (SDBC) was one of 17 communities nationwide chosen by the Office of the National Coordinator for Health Information Technology (ONC) to demonstrate how information technology could measurably improve the health of a region. SDBC was awarded a three-year, $15.3 million grant to target four specific areas: improve care for emergency cardiac patients, reduce hospital readmission, reduce unnecessary CT scans and improve rates and reporting of childhood immunizations.

A major component of the project will be building a community health information exchange that will link health care providers electronically. Once connected, authorized physicians will be able to request and access a complete and up-to-date medical record from other participating physicians who have also seen the patient for clinical care. Transmitted medical information will include recent diagnoses, medications, allergies, lab test results, radiology results and discharge summaries. In essence, the patient's medical record will follow them regardless of where they received care in San Diego. With access to better patient information, physicians will be able to provide higher quality care, reduce unnecessary repeat tests and procedures, and lower the risk of potential medical errors.

SDBC selected OptumInsight (formerly Axolotl) to build San Diego's health information exchange. "Patient privacy and data security are our top priorities in this project," said Ted Chan, MD, San Diego Beacon Program Lead. "It was critical for the SDBC to select a vendor with proven and compliant technology that meets state and national standards." San Diego is OptumInsight's fifth Beacon community including Utah, Colorado, Western New York and Cincinnati.

Patients will be fully in control of their medical information by providing one of three consent options: emergency (only allow access in the event of an emergency), full (access information for all health care encounters), or none (do not allow access). Patients will be able to provide consent at their doctor's office and can change their consent status at any time. Physicians at participating Beacon sites are only allowed to access information when providing medical care to the patient.

"Most people maintain and keep better records for their cars than they do their own healthcare," said Supervisor Ron Roberts. "With the Health Information Exchange, an emergency room doctor could quickly and independently get lifesaving information about a patient, even one who has arrived unconscious."

John Dalton, a local cardiac patient attributes his survival and quick recovery from a heart attack to the ability of health care providers to exchange and share his medical data. Paramedics were able to send Dalton's ECG electronically from the ambulance to the hospital where the Emergency Department physician and cardiologist were able to access the information before he arrived.

"Years ago they would have had to wait until I arrived in the ER before the paramedics could tell the doctor what they thought was going on," said Dalton. "My ECG arrived to the ER before I did, and my doctor knew immediately that I was having a heart attack. That information allowed him to make an informed decision about my treatment before he even saw me. Modern medicine is great as far as I'm concerned."

The health information exchange will launch in early December at selected sites of participating organizations including Children's Primary Care Medical Group, Rady Children's Hospital, UC San Diego Health System, Sharp Community Medical Group, and VA San Diego Healthcare System. The health information exchange will be implemented within other sites throughout the San Diego health care community over the next 14 months.

Physicians, patients and other San Diegans interested in learning more about the San Diego Beacon Community project and how to participate in the health information exchange are encouraged to visit www.SanDiegoBeacon.org for more information.

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Multiple States and Vendors Agree On Standard Health Data Connectivity Specifications

laith@laithsinawi.com (Laith Sinawi: Admin) — Wed, 09 Nov 2011 02:19:53 +0000

Workgroup defines "plug and play" connections between electronic health records and health information exchanges

New York, NY, November 8, 2011 - A group of states and vendors focused on eliminating the barriers to sharing electronic health records (EHRs) today issued a set of technical specifications to standardize connections between healthcare providers, health information exchanges (HIEs) and other data-sharing partners. The specifications are now available for the public to view at www.interopwg.org.

The objective of the EHR/HIE Interoperability Workgroup is to define a single set of standardized, easy-to-implement connections to increase the adoption of EHRs and HIE services. The effort leveraged existing published standards for interoperability from the Office of the National Coordinator (ONC). Ultimately, the specifications aim to remove impediments that make it difficult for EHRs to connect to HIEs, including technical specification differences, wait times for interface development, and high costs.

The workgroup was originally formed by the New York eHealth Collaborative (NYeC) and is comprised of its federally designated counterparts in seven states (California, Colorado, Maryland, Massachusetts, New Jersey, New York, and Oregon) representing approximately 30% of the country's population. The eight EHR vendor members include Allscripts, eClinicalWorks, e-MDs, Greenway, McKesson Physician Practice Solutions, NextGen Healthcare, Sage Healthcare Division, and Siemens Healthcare. In addition, there are three HIE services vendors participating, including Axolotl, InterSystems, and Medicity.

Doug Fridsma, MD and PhD, Director of the Office of Standards & Interoperability at the Office of the National Coordinator of Health Information Technology, commented, "I am encouraged by and excited about this type of collaboration, which has the potential to advance real-world pilots, implementation and feedback on standards for health information exchange. The results of this kind of initiative can help us advance health IT nationwide."

"This is a crucial step," said David Whitlinger, Executive Director of NYeC. "We started this as a New York State initiative, but we soon realized that many other states were facing the same interoperability challenges and many of the EHR and HIE vendors were also looking for clarity from the marketplace to define their product roadmaps. Collectively, the group is now looking forward to widespread adoption and market preference for the products that employ the specifications."

The first set of specifications focuses on two use cases and the detailed data and metadata specification for a compliant Continuity of Care Document. The first use case, Statewide Send and Receive Patient Record Exchange, describes how encrypted health information can be transmitted over the internet. The second, the Statewide Patient Data Inquiry Service Use Case, describes the clinician's ability to query an HIE for relevant data on a specific patient.

The workgroup members collaborated to leverage existing HL7 standards, technical frameworks from IHE International, and HIE implementations to provide a fully detailed implementation specification. The implementation specifications were also aligned with Beacon community guidelines to be capable of gathering information required for reporting to the ONC.

"I applaud the work that the EHR/HIE Interoperability Workgroup is doing to move states from implementation guides to production. I expect that the flexibility and agility of the EHR/HIE Interoperability Workgroup will serve as an ideal laboratory for standards that are rapidly evolving," stated John Halamka, MD, Co-Chair of the HIT Standards Committee, Chief Information Officer of Beth Israel Deaconess Medical Center, Chief Information Officer at Harvard Medical School, Chairman of the New England Healthcare Exchange Network.

About The New York eHealth Collaborative

The New York eHealth Collaborative (NYeC) is a not-for-profit organization, working to improve healthcare for all New Yorkers through health information technology (health IT). Founded in 2006 by healthcare leaders, NYeC receives funding from state and federal grants to advance health IT throughout the State of New York. NYeC works to develop policies and standards, to assist healthcare providers in making the shift to electronic health records, and to coordinate the creation of a network to connect healthcare providers statewide. The goal of NYeC is that no patient, wherever they may need treatment within the State of New York, is ever without fast, secure, accurate, and accessible information.

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Blue Shield of California grant to expand Santa Cruz HIE

ewatts@axolotl.com (Elvia Watts) — Mon, 07 Nov 2011 17:43:59 +0000

Santa Cruz Sentinel

Physicians Medical Group has been awarded $475,000 from Blue Shield of California to bolster efforts to track patient care.

It's one of 18 grants totaling nearly $20 million Blue Shield awarded to California hospitals, health systems, clinics and physicians to help them participate more effectively in "accountable care organizations," a payment model expected to become more common under federal health care reform.

"Blue Shield will be working closely with PMG and Dominican Hospital, providing metrics and reporting to track the effectiveness of the clinical initiatives which are designed to improve quality and cost effectiveness." said Dr. Nancy Greenstreet, medical director of Physicians Medical Group.

The initiative will require two new positions, a program manager and a care transition manager, coordinating care provided by Dominican Hospital's staff, hospitalists and Physicians Medical Group's more than 400 providers during and after inpatient or emergency department care.

Part of the funding will be used to expand Santa Cruz Health Information Exchange, an electronic network used by doctors, hospitals, labs and clinics in the county.

The goal is to give physicians more information at the point of care and eliminate data redundancy according to Dr. Satish Chandra, board president of Physicians Medical Group, lead organization of the network.

More than 1 million web transactions occur each month as well as thousands of electronic prescriptions and refill requests, pre-treatment authorizations, referrals and transcribed documents.

Rochester General Hospital Medical Records Go Electronic

ewatts@axolotl.com (Elvia Watts) — Mon, 07 Nov 2011 17:38:25 +0000

Democrat and Chronicle

By Patti Singer

Rochester General Hospital switched to electronic medical records today, potentially linking providers and patients to a wider network designed to improve care.

"The big thing patients will notice is a lot more computers," said Dr. Robert Biernbaum, chief medical information officer for Rochester General Health System. "We'll be using (laptops), iPads and desktop computers to do the documentation instead of flipping through charts."

Seven doctor offices in the Rochester General Health System also went online today. More practices will be wired in the next few months, Biernbaum said.

The move to EMR is part of federal health reform, and hospital systems receive incentives for meaningful use that improves patient safety and quality of care.

The hospital systems are linked to the Greater Rochester Regional Health Information Organization, a secure health information exchange. Patients give permission to have their test results, medications and other health facts shared electronically with providers who are part of the RHIO. The goal is to avoid duplication and reduce errors and get information to doctors more quickly, which is crucial in an emergency.

Having EMR puts the health systems in good position for other aspects of health reform, such as medical home models and accountable care organizations, said Ted Kremer, executive director of the RHIO.

Approximately 4,000 doctors and other health care providers have been using the RHIO. More than 500,000 people in an 11-county area have given permission for their doctors to share that information among themselves.

Unity Health System also uses EMR, as does Lakeside Health System, according to its website.

Rochester General and the University of Rochester Medical Center are more closely connected - they bought EMR from the same company. Patients at either Rochester General or URMC can give their permission for providers to view treatments they have received in either system.

Biernbaum estimated that about 75 percent of Monroe County residents go either to Rochester General or URMC. According to the RHIO, more than 230,000 people have provided consent for it to share their information with Rochester General or URMC.

Sharing of information with patient permission isn't new. The electronic transfer replaces the fax that someone invariably would have to wait for.

"If a patient came to Rochester General Health System who had been seen at the URMC emergency department and we had patient consent, we would do a search ... and we would be able to pull that visit information right up," Biernbaum said. "It's invaluable."

The same procedure would take place if a person came to Strong or Highland and said they'd been seen at Rochester General.

While consent to the RHIO is in effect until the person revokes it, permission for Rochester General and URMC to share information is only for that specific instance.

"We can't browse information in other systems," said Jerry Powell, chief information officer for URMC.

University of Michigan Health System Partners with Great Lakes Health Information Exchange

ewatts@axolotl.com (Elvia Watts) — Mon, 24 Oct 2011 16:19:10 +0000

OKEMOS, MI, October 24, 2011 - The Great Lakes Health Information Exchange (GLHIE) announced today an agreement that was adopted on October 17th to connect the University of Michigan Health System (UMHS) to the GLHIE, extending the availability of electronic patient health information across much of lower Michigan and northern Ohio.

"This new partnership affirms our commitment to using the latest information technology solutions to benefit our patients," says Jocelyn DeWitt, PhD, chief information officer, U-M Hospital and Health Centers."

"We will significantly expand our ability to access clinical data for UMHS and non-UMHS patients in Michigan through GLHIE. Secure access to relevant medical information about individual patients from multiple sources will help our clinicians improve treatment, prevent errors and avoid duplicate testing."

"We welcome this partnership with U of M Health Systems as an opportunity to improve the quality of health care for UMHS patients across the region," said Carol Parker, executive director of the Great Lakes Health Information Exchange. "When an institution of this caliber selects you as a partner, it is confirmation of your technology and organizational model."

The GLHIE enables the secure exchange of patient health information from across multiple providers using the Axolotl HIE platform from OptumInsight, which has also recently been selected by the Michigan Health Information Exchange to connect sub-state HIEs statewide.

GLHIE is a substate HIE, and along with other sub-state HIEs in the Michigan will eventually feed into the Michigan Health Information Network that will enable the exchange of patient date throughout the state. The broader vision for the future is that the National Health Information Network would connect all the state networks.

About Great Lakes Health Information Exchange

The Great Lakes Health Information Exchange, formerly known as the Capital Area Regional Health Information Organization (RHIO), is a collaborative health information exchange (HIE) governed by its partners, including Michigan State University, Sparrow Health System, Hayes Green Beach Hospital, Clinton/Eaton/Ingham Community Mental Health, Ingham County Health Department, the State of Michigan, Capital Area Health Alliance, and local physicians. For more information, visit www.glhie.org.

In or Out? HIE Patient Consent 101

ewatts@axolotl.com (Elvia Watts) — Mon, 24 Oct 2011 07:00:00 +0000

Healthcare-Exchange

By Glenn Keet

In this three-part series on Healthcare-Exchange, we'll explore some of the issues around patient consent for HIEs and propose some tips to help organizations and providers collaborate to promote patient participation.

As healthcare organizations continue to implement HIEs, task forces are challenged with determining how to best attain the keystone of the operation: patient consent. For an HIE to be successful, patient data is critical, but it's not as simple as just collecting it. Here are some things that healthcare organizations need to keep in mind in order to populate a successful HIE with the right data, while simultaneously maintaining patient privacy and ensuring patients' comfort:

Know the options. HIE access can be controlled, so make a decision and stick with it.

No Consent: All patient health information is available, and patients are unable to opt out.
Opt Out: Patient health information is available unless a patient explicitly chooses to opt out.
Opt Out with Exceptions: Similar to opt out, but the patient can selectively exclude certain categories of data, certain providers, or the use of his/her data for specific purposes.
Opt In: Patient health information is available to clinicians if and only if the patient has specifically opted to make it so.
Opt In with Restrictions: Similar to opt in, but the patient is able to refine his/her consent in one or more ways: by provider, data type, intended use of information, date, etc.
Hybrid: This model blends capabilities from two or more of the models above. For example, the organization may choose the opt-out model for "consent to access" and the opt-in model for "consent to disclose."

Understand local laws. Federal and state laws guide how patient information must be treated, and since some laws can seem to conflict or be open to interpretation, it is important for HIE implementors to work within the regulations of each state they operate in.

Research the exceptions. Sensitive health information - such as substance abuse and mental health treatment, HIV/AIDS status, and abortion services - may fall under separate confidentiality regulations that impact how and by whom it can be accessed. Health information for minors can also be more strictly regulated. Addressing these special cases with the consent model prevents tricky privacy disputes down the line.

Consider emergencies. Because emergency situations can and will arise with patients who have opted out or not opted in, organizations must determine under what circumstances, if any, healthcare personnel can "break the glass" to obtain the patient's health information in an emergency.

Talk to other HIE implementors. Other HIEs have been there before. Other providers have gone through the patient consent model selection process and know what has worked and what hasn't. Using others as a resource can help providers refine their selection and reap the maximum benefits.

Don't forget the patients. Access to data is important for deriving the benefits of HIEs, but no one should forget whose data it is. Patients need to be educated on an HIE and what it all means to them. Whether the HIE communicates with patients directly or through providers, patients need to feel confident that their privacy is ensured if the HIE is to be successful.

14 critical access hospitals link to Nebraska HIE

ewatts@axolotl.com (Elvia Watts) — Fri, 14 Oct 2011 07:00:00 +0000

Healthcare IT News

Within the past month, 14 critical access hospitals have joined the Nebraska Health Information Initiative (NeHII), Nebraska's statewide health information exchange.

Powered by the Axolotl HIE platform from OptumInsight, NeHII electronically delivers clinical information at the point of care, integrating a wide variety of patient clinical data including laboratory results, ER reports, discharge summaries, radiology reports, progress notes, transcription, medications and other medical information.

The hospitals that recently joined NeHII are:

Antelope Memorial Hospital, Neligh
Avera Creighton Hospital, Creighton
Avera St. Anthony's Hospital, O'Neill
Chase County Community Hospital, Imperial
Cherry County Hospital, Valentine
Community Hospital, McCook
Community Medical Center, Falls City
Community Memorial Hospital, Syracuse
Lexington Regional Health Center, Lexington
Memorial Health Center, Sidney
Perkins County Health Services, Grant
Plainview Area Health System, Plainview
Providence Medical Center, Wayne
Tri Valley Health Center, Cambridge

"Memorial Health Center is committed to providing the highest quality care possible, from the latest in technology and equipment to electronic information accessibility," said Kelly Utley, Memorial's chief financial officer. "Being able to exchange health information electronically between providers is the latest step toward achieving that high quality. We are very excited to be a part of this information exchange because it keeps our hospital on the leading edge, not only in the state of Nebraska but in the country."

Small hospitals may be certified as critical access hospitals to help implement initiatives to strengthen the rural healthcare infrastructure. The Medicare Rural Hospital Flexibility Program was established in 1997 to promote regionalization of rural health services in the state and to improve the quality of healthcare and access to hospital and other health services for rural residents of the state.

Among other requirements, critical access hospitals (CAHs) must be located in rural areas separated from other hospitals by at least 35 miles or less in mountainous terrain or areas with only secondary roads available, and are required to provide emergency services 24 hours per day. Nebraska has among the most CAHs in the nation, with 65.

Physicians working with the HIE-linked CAHs will have secure access to electronic exchange and share clinical patient information and medication history with other hospitals and healthcare providers across the state who care for their patients.

"This is a thrilling announcement for Nebraskans," said NeHII Executive Director Deb Bass. Because of the extensive rural populations in the state, the CAHs play a critical role in the delivery of quality healthcare. With the CAHs participation in NeHII, they will be able to retrieve information on their patients returning from larger referral health systems across the states. With the implementation of health information technology and telehealth, there will be opportunities for the patient to remain at the CAH and recover in familiar healthcare settings surrounded by their families."

14 Rural Hospitals Join Nebraska Health Data Exchange

ewatts@axolotl.com (Elvia Watts) — Fri, 14 Oct 2011 01:15:09 +0000

InformationWeek Healthcare

By Marianne Kolbasuk McGee

Nebraska Health Information Initiative adds more than a dozen critical access hospitals while some U.S. health information exchanges struggle.

The Nebraska Health Information Initiative has signed 14 critical access hospitals to its statewide health information exchange in recent weeks, with others expected to join as more hospitals roll out digital health record systems.

Nebraska, which has a population of about 1.8 million, is one of the most rural states in the U.S., and with 65 critical access hospitals, or CAHs, has more of these facilities than most other states.

And while more than a dozen CAHs just joined the Nebraska Health Information Initiative, many of the remaining CAHs in Nebraska "are still implementing e-health records," said Deb Bass, a former nurse and NeHII executive director.

"Until these other hospitals get that work done, having all of them part of NeHII is still a pipedream," she said. There are many constraints on CAHs rolling out EHRs, including "a lack of technology skills," she said. "Many have only a part-time IT person," she said. Some of those hospitals in Nebraska are so small that they treat fewer than five patients a day, she said.

Still, having the state's CAHs part of NeHII is vital, she said in an interview with InformationWeek Healthcare.

Among other government requirements, CAHs must be located in rural areas and separated from other hospitals by at least 35 miles, or less in mountainous regions.

For many people in Nebraska, there may be a four-hour or more drive to the nearest hospital, said Bass. "That's why HIEs are so critical, especially in very rural areas like this," she said. "When a doctor refers a patient to a hospital, information about that patient need to be sent back and forth," including upon discharge from a hospital, she said.

Among the data exchange services supported by NeHII are the sharing of patient information such as medication and allergy lists, problem lists, pathology and radiology reports, progress notes, and instructions related to transition of care.

NeHII is powered by technology products and service provided by Axolotl, which is part of United Health Group's OptumInsights unit.

To date, NeHII supports data sharing for 1.9 million patients, including some who live in neighboring states but have received care by healthcare providers in Nebraska. Approximately 1,400 healthcare professionals have signed up to use the NeHII service, which costs physicians a monthly license fee of about $51.66, Bass said. "That's cheaper than cable TV service," she quipped.

NeHII received a $4.9 million grant as Nebraska's statewide integrator for its HIE. So moving forward after its grant money is spent, for NeHII like most other HIEs that received grants, a sustainable business model will likely depend on subscriptions.

The momentum at NeHII comes during a time when the HIE landscape is in great flux. There are more than 200 HIEs in the U.S., many launched over the last year or two.

Some efforts are struggling to maintain sustainable business models after seed money or grant funding dries up. Others are consolidating into larger HIEs in their communities or states.

Among those HIEs recently closing up shop was CareSpark, a regional HIE in Tennessee, and also the Minnesota Health Information Exchange, the latter which consolidated with the Community Health Information Collaborative.

In a brief issued earlier this month, the National Association of State Chief Information Officers (NASCIO) urged state CIOs who are developing HIEs to improve their business strategies, including mapping out ways to generate revenue to cover operating costs before public funds they already received run out.

The 14 CAHs that have joined NeHII are Antelope Memorial Hospital in Neligh; Avera Creighton Hospital in Creighton; Avera St. Anthony's Hospital in O'Neill; Chase County Community Hospital in Imperial; Cherry County Hospital in Valentine; Community Hospital in McCook; Community Medical Center in Falls City; Community Memorial Hospital in Syracuse; Lexington Regional Health Center in Lexington; Memorial Health Center in Sidney; Perkins County Health Services in Grant; Plainview Area Health System in Plainview; Providence Medical Center in Wayne; Tri Valley Health Center in Cambridge.

Fourteen Critical Access Hospitals Join the Nebraska Statewide Health Information Exchange

ewatts@axolotl.com (Elvia Watts) — Wed, 12 Oct 2011 17:04:23 +0000

Omaha, NE, October 12, 2011 - The Nebraska Health Information Initiative (NeHII), Nebraska's statewide Health Information Exchange (HIE) announced today that within the past month, fourteen Critical Access Hospitals (CAHs) have joined NeHII in an effort to access and share health information across the state. Powered by the Axolotl HIE platform from OptumInsight, NeHII electronically delivers clinical information at the point of care, integrating a wide variety of patient clinical data including laboratory results, ER reports, discharge summaries, radiology reports, progress notes, transcription, medications and other medical information.

Critical Access Hospitals that have joined NeHII include:

Antelope Memorial Hospital, Neligh, NE
Avera Creighton Hospital, Creighton, NE
Avera St. Anthony's Hospital, O'Neill, NE
Chase County Community Hospital, Imperial, NE
Cherry County Hospital, Valentine, NE
Community Hospital, McCook, NE
Community Medical Center, Falls City, NE
Community Memorial Hospital, Syracuse, NE
Lexington Regional Health Center, Lexington, NE
Memorial Health Center, Sidney, NE
Perkins County Health Services, Grant, NE
Plainview Area Health System, Plainview, NE
Providence Medical Center, Wayne, NE
Tri Valley Health Center, Cambridge, NE

"Memorial Health Center is committed to providing the highest quality care possible, from the latest in technology and equipment to electronic information accessibility," stated Kelly Utley, Chief Financial Officer at Memorial Health Center. Utley also noted, "Being able to exchange health information electronically between providers is the latest step toward achieving that high quality. We are very excited to be a part of this information exchange because it keeps our hospital on the leading edge, not only in the state of Nebraska but in the country."

Small hospitals may be certified as Critical Access Hospitals to help implement initiatives to strengthen the rural healthcare infrastructure. In 1997 the Medicare Rural Hospital Flexibility Program was established to promote regionalization of rural health services in the state and to improve the quality of healthcare and access to hospital and other health services for rural residents of the state.

Among other requirements, CAHs must be located in rural areas separated from other hospitals by at least 35 miles or less in mountainous terrain or areas with only secondary roads available, and are required to provide emergency services 24 hours per day. Nebraska ranks among the highest in the number of CAHs in the nation with 65.

Physicians working with the newly-participating CAHs will have secure access to electronically exchange and share clinical patient information and medication history with other hospitals and healthcare providers across the state that care for their patients.

NeHII Executive Director Deb Bass said, "This is a thrilling announcement for Nebraskans. Because of the extensive rural populations in the state, the CAHs play a critical role in the delivery of quality healthcare. With the CAHs participation in NeHII, they will be able to retrieve information on their patients returning from larger referral health systems across the states. With the implementation of health information technology and telehealth, there will be opportunities for the patient to remain at the CAH and recover in familiar healthcare settings surrounded by their families."

Leaders of the initiative expect further CAHs to elect to participate throughout 2011.

About NeHII:
As an early adopter and national leader for Health Information Exchange, NeHII, a non-profit 501(c)(3) organization has functioned as a public-private collaborative that currently reaches nearly 85 percent of lives in Nebraska and a substantial number of individuals in Nebraska's six border states. NeHII's vision is to be a leader in the secure exchange of health information, enabling a healthier Nebraska. For more information, visit www.nehii.org.