To Be the State HIE, Or Not To

McIlwain: We have a lot of value with this [HIE] by offering active medication history in real-time. We then found out that people wanted laboratory results, so we added that to it, plus other reports from hospitals. We established a value proposition that we’ve been using to include radiology reports in phase two. We are also about to start connecting to PACS [picture archiving and communication systems]. We’ve also added additional hospitals and physician offices that will be going live in the next month or so. When you have people come onboard and go-live, you have to train them to use the system, and we’ve accomplished that. We have more than 600 people trained on the system.

Part of the concern is the privacy and security of health information. We’ve developed a training packet on privacy and security issues related to the exchange that will be available on the Internet, as a short 15 minute course to be required to validate before being approved to use the system.

HCI: Did Medicity or MISCHIE set that up?

McIlwain: It’s going to the property of MISCHIE, but Medicity had a big hand in setting it up. So that’s an innovative thing. And we want to make sure everyone understands their role in privacy and security when they use this.

HCI: And can you tell me a little about the HIE platform itself? Is there a centralized repository for the data or is it a provider to provider network?

McIlwain: It’s a hybrid. It does contain a centralized database. But for example, Medicaid doesn’t like to store their data into our central data repository, so they can buy their own data repository. Or we have a record locator service, which is a federated model that we can reach out to them to get the information to put in our system. Some institutions don’t like to be on a central database, so we have the ability to reach out and get what we need. We feel like that’s the best model there is.

HCI: What is the governing structure of MSCHIE?

McIlwain: We [have] a governing board with 11 members. We tried to choose [a mix of] organizations and state agencies. It’s a public/private board, so it’s not just a state agency. It involves stakeholders too.

We formed a consumer committee, which has 22 consumer members throughout the area. They have been active and approved policies and approved an ‘opt-out’ procedure that all patients will be able to be put into the exchange, so they can ‘opt-out’ rather than ‘opt-in.’ We also have a committee with compliance and security officers of the hospital that will set up procedures for the coastal area.

We’re in the process of discussing if it should be a local nonprofit, more like a regional health organization, or not. Now we’re faced with the fact that we have stimulus money to create the Mississippi health information network, and it’s been recommended since we’ve had so much good success with the platform on the coast that it should just meld into the Mississippi health information network. And we are still trying to decide if that means that MSCHIE will become the state network or it will become a regional organization that joins the state network that uses Medicity platforms. We have to make a decision in the next few months.

The difficulty is sustainability after the grant is gone. It costs money to maintain and implement new services. We have had legislation to create the Mississippi health information network, and we’ve had approval for a governance body for that network. The thoughts is it’s probably going to be that MICHIE becomes a regional network, but we still don’t know what the ONC (the Office of the National Coordinator for Health Information Technology) is going to pay for and what they won’t and how do we work that into our project.

For example we have Biloxi Regional Medical Center, a large health system on the coast that belongs to a corporate entity HMA [Health Management Associates Inc.], they are very excited about this. They are going live in a month. They have 11 other hospitals in our state, so all it will take is a push of a button to put them in the exchange and they’ll be eligible for all the incentives.

All the hospitals along the coast will be live by the end of this year except Garden Park Medical Center, [in Gulfport, Miss.]. We already have about 36 physician clinics onboard, and we need another 100. By the end of the third year, we’ll have everyone connected that wants to. The coast has been a little bit more ahead on EHR adoption than the rest of the state.