Dan Paoletti is CEO of the Ohio Health Information Partnership (OHIP), a Columbus-based services organization that runs CliniSync, Ohio’s statewide health information exchange (HIE). OHIP’s services encompass not only CliniSync, but also its status as the regional extension center (REC) for its region, a state-designated entity that nonetheless is set up as a privately run 501c3 organization.
A small number of statewide HIEs are flourishing, among them HIEs in Maine, Michigan, and Colorado. OHIP’s CliniSync is another flourishing statewide HIE. Part of OHIP’s success lies in how it was created, Paoletti says. “We were created in the late summer of 2009 by the administration at that time,” he explains. “We spent the first two years planning, developing, and getting the technology in place. In other words, we spent a good two years at a very low budget cycle, with only a couple of employees, trying to get everything arranged. We really started our implementations in 2011, and our first hospital went live in December 2011.” Now, he notes, 143 hospitals across Ohio—all but about 20 in the state—are working with CliniSync, and 73 have gone live in data-sharing. What’s more, 600 practices representing over 3,000 physicians not already connected to CliniSync via their participating hospitals, are also participating.
Three elements in particular have helped OHIP to thrive: providing results delivery, DIRECT messaging for clinicians, and enabling the sharing of continuity of care documents (CCDs). “Results delivery is important, even though it’s very basic,” Paoletti says. “But you’re talking about potentially $60,000 to $100,000 per primary care physician in ancillary revenue, and that’s money that is up for grabs or moving. And us being a delivery mechanism for the community hospitals not only saves them money, but allows them to grow their ancillary services.” Indeed, OHIP is now racking up between 1 and 2 million transactions a month solely through results exchange.
Because of the success of OHIP/CliniSync, Paoletti was one of several HIE senior executives interviewed for the January/February issue of HCI, in the Top Ten Tech Trends cover story package.
Editor-in-Chief Mark Hagland spoke to Paoletti late last autumn. Below are further excerpts from that interview.
When did CliniSync go live with exchanging clinical data?
Our first hospital went live in December 2011.
How many hospitals and how many physician practices are live now?
We have 143 hospitals contracted with us, and 73 are live. Out of those 73, 53 are actually moving data into the community; the other 20 are in production—within a few weeks [December 2014], the other 20 will be. And then we have another 70 that are in implementation, with the expectation that all of those will be live by the end of April. Another 10 or 20 will go live [in 2015].
What percentage of hospitals in the state is that?
We have about 172 acute-care hospitals in the state. And out of those 172, there are 20 some that work with a regional HIE, HealthBridge in the Cincinnati area. So there are really only 20 in the state not actively participating in an HIE and that represents two health systems that are going through some major EHR upgrades, etc. So in the next year or so, everybody in the state will have some connectivity to an HIE.
And how many physicians in practice are currently connected?
About 600 practices, representing over 3,000 physicians. That doesn’t include the 8,000 hospital-employed physicians. They’re already included. The other important piece is that we also have 270 long-term care facilities that are contracted, and we’re working on our first set of payer contracts, with four payers now.
What is the volume of data being exchanged right now?
Our business model is several layers. One of the most important things we do is results delivery. And that’s important even though it’s very basic, but you’re talking one primary care physician—and that can mean $60,000-$100,000 in annual ancillary revenue. It’s money that is up for grabs or moving. So us being a delivery mechanism for the community hospitals not only saves them money but allows them to grow their ancillary services. So we have between 1 and 2 million transactions a month just with results exchange. But the most important thing is not the number of transactions, it’s the number of results we’re delivering.
The other thing we do is DIRECT messaging. We’re a health information service provider. We also provide the REC services for 77 counties; we’re also the biggest REC in the country. We’ve helped 5,800 providers attest to meaningful use so far, and our goal is 6,000—we think we will get there by the end of February.
Meaningful use support is huge, but the transition of care is what we see as key to helping transform healthcare. So that CCDA [consolidated clinical document architecture] and transition of care measure in meaningful use—we’ve tried to propel that across the U.S. We’re building a physician directory in Ohio, and what we’ve been able to build, we have over 12,000 directory addresses in our phone book right now, and our goal is to be one of the most connected states when it comes to DIRECT capabilities, and that’s important in getting long-term care facilities. So we make sure the CCDs move back and forth. We also have a community health record being rolled out so data can follow the patient. That requires consent, but we’ve been able to make it all work.
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