While most of the government push for healthcare automation is coming from federal sources, state governments such as Massachusetts and Minnesota have been pioneers in developing health IT mandates. And increasingly states are banding together to encourage software vendors to address their needs.
For instance, what started as an effort by New York State to identity the gaps that exist between EHR vendors and its regional health information organizations (RHIOs) has grown into a multistate effort involving nine ambulatory EHR vendors and 11 states representing approximately 40 percent of the U.S. population.
The states’ goal is to use their collective buying power to create a marketplace in which the interfaces between EHRs and health information exchange systems are standardized across multiple states, said Rick Shoup, director of the Massachusetts eHealth Institute and the commonwealth’s health IT coordinator, in a recent interview.
The members of the Multi-State/Multi-Vendor EHR/HIE Interoperability Workgroup recognized that there are barriers that prevent plug-and-play standards for EHR-to-HIE connections. Each new instance of an HIE launched presents a custom connection for EHR vendors that introduces unnecessary costs into the healthcare system, its leaders note.
“We realized that working with vendors one-on-one was time-intensive and difficult,” said Rachel Block, New York’s deputy commissioner for health IT. “So we went to a multistate collaborative to facilitate the definition of what we need in things like basic lookup, routing and provider directories.”
According to a recent presentation by Shoup, the workgroup has developed a list of priorities in terms of implementation guides/specifications to work on:
- Send and receive individual patient records with other healthcare providers inter/intra state (utilize Entity-Level Provider Directory (ELPD) and Individual-level Provider Directory (ILPD) for routing information) (NwHIN direct and/or traditional IHE methods);
- Query and retrieve patient records across disparate health systems (utilize message/record routing, consent management, Master Patient Index, and Identity Management);
- Import initial patient history without requiring patient to fill out “the clipboard” and avoid manual hand entering of information into EHR system (utilize Master Patient Directory and Patient History Service);
- Look up medication history for a patient (utilize Medication History Service);
- Public Health/Quality Reporting capabilities; and
- Check insurance eligibility for a patient (utilize a claims eligibility service).
Rick Shoup, the health IT coordinator for Massachusetts, which was one of the first states to join New York in the effort, says the group has the opportunity to make a contribution in an area the Office of the National Coordinator for Health IT hadn’t tackled yet. “We have ONC’s blessing,” he adds. “We are ready to move toward the next level of specificity.”