From the first planning meeting in mid-2009 for the Peoria, Ill.-based Central Illinois Health Information Exchange (CIHIE), participants were asked to “take off their nametags” and talk about the exchange from the patient’s point of view.

“We really tackled it from the patient perspective, setting aside the competitive differences and looking from the consumer perspective,” says Joy Duling, executive director of CIHIE. “When we all take off our nametags at the end of the day, we are all patients, parents of patients, and children of patients.”

This approach to planning allowed the participants in the 20-county area of Illinois (in the Peoria, Bloomington, Champaign, and Decatur areas) to be the first regional health information exchange in Illinois to go live with secure, automated data exchange of patient records. Another big advantage was that planning was led by Quality Quest for Health, a Peoria-based nonprofit community alliance, which pulled stakeholders together to agree to not compete on patient data.  

Another contributing factor to the patient-centered approach of CIHIE is likely the background of its executive director, Joy Duling. Even though Duling professes she’s neither a technology nor a healthcare expert (her background is in human services project management), she does have a deep connection to health information exchange.


Joy Duling

After being diagnosed with thyroid cancer, not only did Duling see her primary care provider and get lab work down at one hospital, she had her first surgery at a second hospital. When her insurance changed, she had a second surgery at a third hospital, where she saw a different surgeon and endocrinologist. “I am completely convinced that at no time did any of those healthcare professionals ever see my complete record all together in one place,” she says. “So I came into this project feeling a real personal passion for bringing this into being for central Illinois.”

CIHIE has 11 charter members who committed seed money to the HIE and to be early adopters. In addition to hospitals, charter members include a Federally Qualified Health Center (FQHC), behavioral health care center, a rehabilitation center, and a medical school.

CIHIE went live last month with four CIHIE hospital members that pooled data within the exchange: Methodist Medical Center of Illinois, Peoria; Decatur Memorial Hospital, Decatur; St. Mary’s Hospital, Decatur; and St. Mary’s Hospital, Streator. Over the next three months, clinicians at participating organizations will be trained regarding use of the exchange to locate patient records. Two more hospitals will come online later this summer.

“We are completely funded now by our subscription fees, so our top priority has to be taking the current functionality and rolling it out to as many adopters as we can,” says Duling. “We had to figure out how to go out with a service offering that is big enough that is meaningful and feels worthwhile that other organizations will invest in, so we knew in our initial service offering, we had to go big or go home.”

All organizations that connect sign an equitable participation policy and commit to sharing six data points: demographics, medications, allergies, problem lists, diagnostic results, and immunizations in a hybrid federated exchange. Duling says a future data point will include diagnostic images. Providers access the exchange through allcharts software solution provided by the Nashville, Tenn.-based ICA, either through a portal or via their EHR. This private exchange will ultimately be able to connect with other regional and national exchanges.