Movement on Interoperability and Portability

HIE Expansion Across the Nation

March 12, 2014

The Patient Perspective• HIPAA gave patients the right to obtain

copies of their records• HITECH required HIPAA-covered entities

to provide electronic copies AND transmit those copies to a designated third party

• OCR clarified final rules in January:– Patients can make written requests via

electronic media– Patients who request non-secure

transmission must be accommodated

Guidance from the ONC• Toward a learning health system with a

feedback loop • Working to fill gaps in health IT standards

and interoperability – patient data is available across the continuum– used not just for care delivery, but for quality

and safety and evidence-based healthcare• Streamlining such use cases as:

– targeted query of patient records– data migration and patient portability

Voluntary Compliance• Providers would not have to

update to meet the meaningful use program

• The new rule addresses issues in the 2014 certification to make it simpler for folks to comply

• And references updated standards and implementation guides to continue the momentum toward greater interoperability

The "next chapter" of American medicine can be defined by its pursuit of innovation, if the government offersthe right mix ofpolicy.

Karen DeSalvo, MDNational Coordinator for HealthInformation Technology

Read Them and Cheer!• In Arizona, new partnership

leads new roadmap• Midwest HIEs link up• Kaiser health plan moves into

HIE• No HIE a 'lost opportunity'

ArizonaArizona Health-e Connection (AzHeC) and Health Information Network of Arizona (HINAz) joining forces under an organizational umbrella• AzHeC will do:– policy development– Education– Engagement

• HINAz will serve as the statewide HIE network

Missouri & Kansas• Tiger Institute Health Alliance

(TIHA) and Lewis and Clark Information Exchange (LACIE), are now able to share the data of 2.5 million patients across Missouri and Kansas

• Connects 30 hospitals and >4,000 physicians operating at >500 clinics and other care venues that use several different electronic health record systems

Colorado• Kaiser Permanente Colorado to join the

Colorado Regional Health Information Organization (CORHIO)

• Deal will provide Kaiser physicians with holistic data on their members when care is provided outside of the health plan's network

• Information exchanged between HIE participants is highly secure and restricted to authorized medical practitioners

New York• HEALTHeLINK, the Western New York Clinical

Information Exchange estimates that utilizing lab ordering data from a health information exchange could save $1.3 million, just from avoiding the scores of duplicate CT scans being ordered for patients

• 90% of physicians ordering 2,763 potentially unnecessary CT scans don’t use HEALTheLINK

• 95% of the scans were done in a hospital setting

• An estimated 29,000 cases of cancer in the US can be attributed to CT scans

The Bottom Line• The use of HIEs is gaining

momentum• Patients, providers, and payers are

recognizing the benefits• The federal and state governments

are getting smarter about how to incentivize and encourage more and better data sharing

• More regulation changes are needed to ensure timeliness

ReferencesBrino, Anthony. “In Arizona, new partnership leads new roadmap.” HIEWatch.

http://www.HIEwatch.com/news/arizona-new-partnership-leads-new-roadmap (accessed February 24, 2014).

Brino, Anthony. “The ONC rethinks policy horizon.” HIEWatch. http://www.HIEwatch.com/perspective/onc-rethinks-policy-horizon (accessed February 24, 2014).

Gonzales, Angela. “Phoenix, Tucson health networks announce affiliation.” Phoenix Business Journal. http://www.bizjournals.com/phoenix/blog/health-care-daily/2014/02/phoenix-tucson-health-networks.html?page=all (accessed February 24, 2014).

McCann, Erin. “Kaiser health plan moves into HIE.” HIEWatch. http://www.HIEwatch.com/news/kaiser-health-plan-moves-HIE (accessed February 24, 2014).

McCann, Erin. “No HIE a 'lost opportunity'.” HIEWatch. http://www.HIEwatch.com/news/no-HIE-lost-opportunity (accessed February 24, 2014).

Milliard, Mike. “Midwest HIEs link up.” HIEWatch. http://www.HIEwatch.com/news/midwest-HIEs-link (accessed February 24, 2014).

Rasmussen, Christopher. “An HIE of one.” Center for Democracy and Technology. https://www.cdt.org/blogs/chris-rasmussen/1806patient-managed-health-information-exchange-%E2%80%9Chie-one%E2%80%9D (accessed March 12, 2014).

Sullivan, Tom. “Pockets of interoperability.” HIEWatch. http://www.hiewatch.com/news/pockets-interoperability-progress (accessed March 12, 2014).