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Building a Sustainable HIE Model in The Sunshine State

January 27, 2015
by Rajiv Leventhal
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As provider organizations across the U.S. continue to move forward with health information exchange (HIE), no one would deny that the successful exchange of health information comes with an array of challenges. Perhaps the biggest HIE implementation challenge is to create a model that is more than the exchange of information. It’s about leveraging that infrastructure to use insight and data to support clinical decision-making, improve care coordination, and make processes more efficient.

To this end, in Pensacola, Fla., Baptist Health Care is progressing with health information exchange in the state on a local level (the local HIE in Pensacola includes Baptist and Sacred Heart Health System) via the Harris Corporation, an international communications and information technology company based in Melbourne, Fla. Being in the town of Pensacola, rather than a big city such as Chicago, presents its own challenges and opportunities when it comes to data exchange, says Steven Sarros, vice president and CIO, Baptist Health Care.

Sarros will be part of a group panel discussion, "Optimizing Clinical Care through Data Exchange and Interoperable Systems" on Feb. 11 at the Institute for Health Technology Transformation’s (iHT2) Health IT Summit in Miami. Among the panel’s objectives will be to identify ways HIE is enabling meaningful use and clinical decision support, discuss strategies for sustainable HIE models, as well as the importance of governance, clinician workflow, and physician engagement within an HIE. Click here to register for the Miami Health IT Summit to see Stephan and plenty of others. (iHT2 is a sister organization to Healthcare Informatics under the corporate umbrella of the Vendome Group). Sarros also recently spoke with HCI Associate Editor Rajiv Leventhal to preview the panel as well as discuss health information exchange in Pensacola, and nationwide. Below are excerpts of that interview.

How is Baptist progressing with health information exchange?

We have had mixed results, mind you, but the biggest accomplishment has been made over the last year, using information exchange for our patient portal. We have put together our physician system in NextGen and our inpatient system in McKesson Horizon into the NextGen patient portal so patients see the data all in one place. Medical group doctors see it too, so they can correspond [appropriately]. Overall there has been relatively low usage, but at the same time, it’s something to point to, and will drive some success. In terms of managing the patient side, I think we are being progressive.

Regarding the physician side, we have been using the local HIE for quite a while. We have 80-100 doctors using it every month, with 600 or so patients getting better care because they’re on it. And this allows us to put all of our inpatient and ED data on the HIE alongside of our key competitor, Sacred Heart [Health System]. Physicians can see the record, so it’s all out there in the local HIE. And then we have the Allscripts product for data sharing and sending to our referrals, who also have access to the HIE, which has the Veterans Administration (VA) and Department of Defense (DoD) on it as well. There is a big military presence in Pensacola, and we are seeing more military patients online for both of them.

Steven Sarros

Does the competition factor with Sacred Heart Health System ever get in the way of the goal to share more data?

No, at the mission level, we want to improve care for all people and communities that we serve—that’s the last line of our mission. We didn’t want to make patient information a competitive roadblock; we established that with Sacred Heart. The HIE is essentially sustaining itself on subscriptions from Baptist and Sacred Heart. It’s a lean HIE, there’s not a lot of overhead with a solid infrastructure.

Is this HIE model sustainable long term?

I think it’s sustainable in the context that it’s low cost. I see the market is changing and hopefully they’ll keep up with it. Payers aren’t interested in this market historically, but now with CVS making a play nationwide, they are more relevant than just tourists needing to get a Band-Aid. So it’s sustainable if they are innovative and can adapt to the value proposition.

Big picture, where do we stand today when it comes to interoperability in healthcare?

My take is that we have done some pretty big things right here. The Horizon-to-NextGen interface with our patient portal is a good example where we have ability with CCDA or C32-type records to bring them in and parse them. We have flexibility in terms of whether we want to be discrete or PDF. Higher-end functions, such as APIs need to be written, but now, we’re able to accomplish some pretty big things with the standards today. It can only get easier, but the basics are there. You still have to parse through what doctors want in the record—other than medications, allergies, the last history of physicals, they don’t want all of it. It can be too much, and each doctor wants it a little different. But they will have to get more used to standard data sets versus having them technically.

But even as HIEs continue to grow, healthcare leaders within and outside HIE organizations see stumbling block after stumbling block facing the sector in the next few years. What, if anything, can address this?