Along with new participating organizations, new ways to improve care coordination are being launched.
While it is unpleasant to think about, imagine just for a moment what would happen if a call came in right now about an unconscious family member being transported to the emerg ency room. How quickly do you think that family member’s critical health history would be available to the responding medical professionals?
- Would they know about the new medication that was just prescribed the day before?
- Would they know about a previous history of strokes?
- Would they know about an adverse reaction that happens every time a certain medication is administered?
- Would they know about a recent abdominal surgery?
Too often, relaying critical healthcare information requires the patient to be able to recall details and accurately communicate those details during a medical encounter. This is tough for most people to do during a routine appointment, but even more difficult during a stressful medical emergency or when one’s medical history is complicated. It is completely impossible to do when the patient is unable to communicate at all.
Central Illinois Health Information Exchange (CIHIE), pronounced “see-high,” is a nonprofit organization created by local hospitals and other healthcare providers to make it easier for patient records to follow the patient. Using software provided by the HIE, a physician (or other authorized member of the clinical team) can pull up a patient’s recent health history from all participating healthcare providers with just a few keystrokes.
More than 35 regional healthcare organizations currently participate in CIHIE, but the list is ever-expanding as new ways to utilize the exchange to improve care coordination are being launched.
Connecting to Emergency Services
With 40 Advanced Life Support ambulances and three critical care nursing units, AMT has the largest fleet of emergency transport vehicles in the region and is Illinois’ only ambulance service provider nationally accredited by the Commission on Accreditation of Ambulance Services. AMT chose to roll out utilization of the HIE in a three-stage process, starting with the five nurses on staff to help them review patient information before a scheduled transport between hospitals. The second step includes training of critical-care paramedics and finally, training paramedics for use during 911 response.
Access to the HIE offers a new source of information for these staff members, who had often been limited in the information that could be ascertained from a patient, family member or the patient’s surroundings, such as looking for pill bottles.
Connecting to Long-Term Care
Among the newest expansions for CIHIE is the involvement of more than 30 long-term care facilities from across the region. Through a short-term grant funded by the State of Illinois, CIHIE became one of the first HIEs in the country to include skilled nursing and long-term care rehabilitation facilities. Care coordination between hospitals and other settings is an essential part of keeping patients on the path to wellness and preventing readmissions.
Arthur Home, located in Arthur, Illinois, was among the initial participants. Like many skilled nursing facilities, it currently uses paper charts and hopes to move to electronic medical records in the future. Utilization of CIHIE to query records from referring hospitals represents a step in that direction. As part of the admission screening process, a query can be conducted to determine how long a patient has been in the hospital, as well as diagnoses and recent laboratory results. All of this information is essential in determining if the nursing home can accept the patient and fulfill their needs.
Connecting to Physician Practices
Recently, OSF Healthcare became one of the first CIHIE members to announce that transitional care summaries would now be sent via CIHIE to any physician practice that didn’t already have the capability of receiving these summaries electronically. By logging into CIHIE’s secure portal, authorized designees from the practice can access the summaries and communicate with the referring provider regarding the patient’s subsequent care.
Other healthcare providers are expected to take similar steps as it becomes increasingly important to be able to communicate electronically across organizational boundaries. In situations like this, CIHIE bridges a gap that exists in the region between providers that have advanced electronic medical records software and those that do not.
Connecting Beyond Central Illinois
While the majority of record sharing needs to happen locally, it’s not unusual for a patient to seek a consultation outside the region. In order to support care coordination in these situations, CIHIE has established secure messaging capabilities (called direct messaging) with several other Illinois-based exchanges, including:
- Lincoln Land Health Information Exchange (LLHIE), Springfield;
- Illinois Health Exchange Partners (ILHEP), Metro East St. Louis and Southern Illinois; and
- MetroChicago Health Information Exchange (MCHIE), Chicago.
When this connectivity was initially launched in April 2014, the four regional exchanges included 63 hospitals and geographically covered 92 percent of the Illinois patient population. As all of these exchanges have continued to grow, the coverage today is likely much higher. Participating providers in any of the regional exchanges can securely send and receive summary care records, referrals, discharge notes and other documentation relevant to patient care. In the final quarter of 2014, CIHIE’s direct messaging reach included more than 2,700 physicians from across the state.
What the Future Holds
During 2015, CIHIE will be expanding into the Quad Cities and Champaign communities, as well as continuing to upgrade and enhance the data being sent by current participants. As their respective software systems become more sophisticated, the records that can be shared will become richer and more complete.
Also notable is the plan to engage with other types of healthcare providers, such as home health and hospice care. These new sharing partners bring additional perspectives and care coordination opportunities that will be meaningful for both patients and healthcare providers. iBi