Electronic record exchanges benefit both providers and patients, resulting in more effective and efficient care.
If you’ve stepped foot into a physician’s office recently, you’ve likely noticed some changes. Increasingly, medical offices are moving away from paper-based medical charts and into the age of electronic software, often referred to as an EHR—electronic health record.
This modernization is no small feat, and providers across the region are to be applauded for their leadership in this endeavor. It wasn’t long ago that less than 10 percent of physician practices nationally were using electronic software. Today, in central Illinois, electronic offices are the majority.
But a challenge remains. Being electronic within an office does little good when a patient needs to see a provider outside of that office. Exchanging records beyond organizational boundaries tends to be handled in the same way it has been for decades—by mail, phone or fax, or by patients hand-delivering paperwork from one office to another.
The year 2013 brings with it a new era for medical records exchange through the collaborative work of local healthcare organizations and Central Illinois Health Information Exchange (CIHIE—pronounced “see-high”), a new nonprofit organization headquartered in Peoria.
Moving Beyond Organizational Silos
Planning for Central Illinois Health Information Exchange began in 2009, funded by a 12-month planning grant from the State of Illinois. The goal of the initial planning period was to determine if a regional health information exchange could be created and sustained. By the end of the grant, more than 200 representatives from healthcare organizations across a 20-county region were involved. When asked whether they were interested in continuing the work beyond the state-funded period, the answer was a resounding “yes!”
Seven hospitals and four non-hospitals committed seed funding to set up the nonprofit organization and get the initial technology in place. In January 2012, CIHIE celebrated its “grand opening,” and by June, data was actively available for exchange from Methodist Medical Center of Illinois, Decatur Memorial Hospital, St. Mary’s Hospital in Decatur, and St. Mary’s Hospital in Streator.
Most recently, CIHIE has successfully connected with OSF Healthcare System, which makes patient records available from all seven of its Illinois hospitals. Other implementations that are imminent for early 2013 include Advocate Bromenn Medical Center in Normal and Advocate Eureka Hospital, as well as Dr. John Warner Hospital in Clinton.
In total, CIHIE participants currently include 15 hospitals (and their associated physician practices), plus nine other organizations, including two federally qualified health centers (FQHC), a health department, two behavioral health providers and several specialty physician offices. An updated list of participating members is maintained on CIHIE’s website, cihie.org.
How HIE Works
Health information exchange is a fairly simple concept: when a patient sees a participating doctor and mentions that he/she has been seen elsewhere, a clinician is able to instantly retrieve the records from another provider in real time by electronically requesting that information through software, rather than having to call the other office and wait for records to be faxed or mailed. The result is a more complete picture of the patient’s care and a more efficient delivery of important clinical communication, so the right decisions can be made without delay. The technology is similar to what might be used when booking online travel. If you want to fly from Peoria to New York, you type the necessary info in, and the system pulls the currently available travel options.
One of the best examples of how health information exchange will make a difference is in the emergency room, where it is easy to imagine a patient arriving in medical crisis, completely unable to communicate what is happening. A quick search of the health information exchange software could reveal that the patient is likely having complications from a recent procedure performed elsewhere.
In addition to being able to instantly look up key information like medications, allergies, labs and procedures, the software also provides clinicians with a secure way to send messages to each other to aid in coordination of patient care. For example, when a patient is discharged from the hospital, a discharge planner can send a quick message to the patient’s primary care physician regarding the hospitalization to make sure that the office knows that the patient should be coming in for an important follow-up. Similarly, a primary care physician can send a referral to a specialist through secure clinical messaging, and the specialist can send his or her consultation report and recommendations back the same way.
Connecting Globally, Controlling Locally
The ability to exchange health information electronically is the foundation of efforts to improve healthcare quality and safety. Healthcare providers are increasingly seeing attention being given to this issue at both the federal and state levels. In fact, significant federal financial incentives are being distributed over the next few years to eligible providers who make the required technology upgrades. One of the requirements to get funds includes the ability for data exchange.
Through establishment of the regional, nonprofit exchange, CIHIE’s charter members created a mechanism by which:
- Local healthcare providers can participate in exchange and meet the incentive payment requirement;
- Local healthcare providers can send/receive records within the region, as well as statewide and nationally, through a single connection; and
- Local healthcare providers can participate in governance to influence the future direction of the exchange.
This emphasis on local influence and control is consistent with CIHIE’s central Illinoisan roots, and so far, the approach seems to be working. CIHIE’s ability to catalyze its stakeholders led to its position as the first operational exchange in Illinois. The emphasis on listening to the clinician voice resulted in unique features not available through the non-regional exchange.
Over the coming year, watch for more clinicians to use CIHIE as their primary way to send and receive records associated with your visits. Like pay-at-the-pump gasoline and smartphones, we could someday wonder how we ever got along without it. iBi
Joy Duling is the executive director of Central Illinois Health Information Exchange.