Maine HIE Charts its Course After a Healthy Start

Culver: We’ve decided to change out having 3M serve as the prime contractor, and are in the process of taking out the 3M software that was in place. We’ve added two new vendors, Initiate [the Chicago-based Initiate Systems, recently acquired by IBM] to support our master provider and master patient index and we added [the Denver-based] Health Language Inc. to support our data dictionary and terminology coding needs. We’re very big on standardization and coding. So, all of the lab results are coded to SnoMed CT. Orion Health [Santa Monica, Calif.] stayed in place.

HCI: What did Orion provide that 3M didn’t?

Culver: In addition to serving the areas they did during the demonstration phase, and that was primarily the front-end with Rhapsody [Orion Health Rhapsody Integration Engine] as the interface engine and the backend with Concerto [Orion Health Concerto Physician Portal] as the presentation layer in the back [that leads] into the EMRs. They are now going to be responsible for the clinical data repository, which 3M had previously been responsible for. Clearly, 3M has a good product, but it’s getting a little old in some respects and pricing became a major issue.

HCI: Does Orion have any other U.S. HIEs deployed?

Culver: They’ve got a bunch in the queue that they are negotiating, but we’re kind their flagship in the U.S. They just won Singapore, which is no small feat. They’re in a bunch of provinces in Canada, New Zealand and a couple of states in Australia.

HCI: Is the HIE platform a federated or central repository?

Culver: It’s a central repository model. That was by design in 2005; you just can’t do public health reporting without that structure. That’s just a testament to all the work we’ve done developing trust. Because at the heart of the clinical data repository model is a trust model. The organizations participating are very much competitors, and in 2005 they made two very critical decisions that allow the clinical data repository model to even work. First, they decided to comingle their data. Secondly, they decided to stop competing with patient data. There was a lot of consensus building going on. Maine’s a very collaborative state; there’s a pragmatism in the state that’s pretty obvious. I think the organizations recognized that they’re becoming very visible targets because they’re expensive and large, and they needed to do some things to clearly impact the quality and cost of care. We became a very viable project.

HCI: What were some of the other lessons learned from the demonstration period?