A Model for Sharing and Caring

By Held, Shari

THE INDIANA HEALTH Information Exchange (IHIE), whose mission is to use information technology to share clinical information among health care organizations, has attracted national attention since it was incorporated in February 2004.

“We knew it was going to be a very important entity if we were successful,” says Dr. J. Marc Overhage, president and CEO of the Indianapolisbased non-profit organization. “That also led us to be more careful, because we knew there would be a lot of people watching.”

IHIE deploys and creates services for health care entities based on technology developed by the Indianapolis-based Regenstrief Institute. IHIE’s first project, a clinical messaging system, has been highly successful.

Managing information. Health care providers utilizing the system send all their clinical data-lab results, x-ray results, doctor reports-to IHIE, which then distributes it to doctors and hospitals for a fee. Formerly, each organization faxed, mailed and/or couriered reports to each provider. it was a costly and inefficient system.

IHIE worked with five charter hospital systems in IndianapolisClarian Health Partners, Community Health Network, St. Francis Hospital and Health Centers, St. Vincent Health and Wishard Health Services-to implement its clinical messaging system.

“From the hospitals’ perspective, it is a huge win because it takes a manual labor-intensive process, automates it and puts that information out in a repository where the physicians’ offices can get it,” says Don Keller, director of finance for Alverno Information Services, a division of the Sisters of St. Francis Health Services. “We only have to send the information once, and IHIE takes care of the rest for us.” St. Francis is in the process of adding its Lafayette and Crawfordsville hospitals to the system.

The clinical messaging system is also a win for physicians. “Physicians with patients at multiple hospitals in the city have all their results, from all hospitals, in their mailbox at IHIE,” says Keller. “They only have to go to one spot. And the results are all in a standard format.”

Overhage estimates that out of the 4,000 providers in the local market, 3,800 are actively receiving clinical messages on a daily basis, and that number continues to increase as participants are added.

Ultimately it is the patient that will benefit from the clinical messaging system and future efforts in IHIE’s pipeline.

“Right now the [healthcare] system is specialist- and hospitalcentric,” says Daniel F. Evans Jr., CEO of Indianapolis- based Clarian Health Partners. “It needs to be patient-centric. If you get run over by a truck in Tipton… then Lifelined to Methodist, you want all your data to follow you. You want to assume the people at Methodist’s trauma center know you got run over by a truck in Tipton and that an x-ray or MRI was done locally and Methodist received the results before you arrived. That would be patient-centric. With health care, it’s a constant reinvention of the wheel. We don’t share common databases. That’s the breakthrough of IHIE.”

Garnering national recognition. All of this has put the national spotlight on IHIE, which has been referred to as “the most advanced regional health care information organization in the country” by health care analyst Wes Rishel of Gartner Inc., the leading provider of research and analysis on the global information technology industry.

In 2005 IHIE was awarded one of four government contracts to develop a prototype for a nationwide health information network. “Ninety percent of the technology used in that consortium under that contract is built on what Regenstrief Institute has developed and IHIE uses,” says Overhage. “The interest that has been stimulated, in part by IHIE’s success and by the prototype contract, is leading a lot of market energy and interest. I think it is very fair to say that Regenstrief and IHIE are right in the middle of that, and are working with a variety of communities around the country to expand the services and use of Regenstrief software. it is pretty clear that we are having a dramatic impact on where people head and how they get there.”

IHIE was selected to be one of six pilot sites across the country for a project for Medicare/Centers for Medicare & Medicaid Services. The purpose of the project is to help improve the quality and efficiency of care that Medicare beneficiaries receive. IHIE is also participating in two national, federally funded efforts to develop business models that others can borrow from for health information exchange.

“A lot of people are interested in what we are doing,” says Vince Caponi, CEO of Indianapolis-based St. Vincent Health, “but more important.

Indianapolis is one of the few places in the US. where the major providers of health care have decided to put aside their competitive differences and join in a process that has longterm benefits to everyone. We have also had the advantage to have the Regenstrief Institute here. So we already had a mechanism established. We had relationships established. And our ability to move in this direction was enhanced because of those previous relationships.”

Providing new services. IHIE has a long list of services it hopes to provide to health care agencies. The latest one is Quality Health 1st, a clinical reminder service for primary care physicians, which it plans to launch in the first quarter of 2007.

“It will help physicians work with health care providers and with patients to really begin the whole process of evidencebased medicine,” says Caponi. “That’s where, as you are treating the patient, you have available to you a longitudinal record that would have both clinical and financial information. The ultimate hope is that you would be treating patients both efficaciously and cost- effectively.”

Evans says the purpose of Quality Health 1st is to come up with common measurements of quality within the provider community in Indianapolis. “The idea is to have clinical messaging and electronic medical records as the cornerstones and quality transparency, where consumers know the cost and quality of care, so they can make health care decisions based on quality.”

Continuing the mission. Now that the Indianapolis metropolitan area is onboard with the system, or in the process, IHIE is setting its sites for the rest of the state. Its growth plan is to start in urban centers and expand outward to connect with the Indianapolis network.

Overhage says the other challenges the organization faces in moving ahead are finding high-quality people who are passionate about the mission to help IHIE grow and reining back on the temptation to launch new services too quickly. “We really have to balance that against executing well on the things that we are already deploying,” says Overhage.

Copyright Curtis Magazine Group, Inc. Jan 01, 2007

(c) 2007 Indiana Business Magazine. Provided by ProQuest Information and Learning. All rights Reserved.