Interest stirs in health info exchange

July 2, 2010
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Flint-based McLaren Health Care Corp. has joined five West Michigan hospitals as a member of Michigan Health Connect , a nonprofit  working to create a digital network to provide patient information for health care providers.

“Our provider network extends over 29 counties and includes more than 9,000 physicians,” McLaren President and CEO Philip A. Incarnati said in a press release. “For us, Michigan Health Connect represented an HIE solution that can accommodate the geographic footprint of our system and avoid the duplication associated with participation in multiple regional HIEs.”

MHC Executive Director Doug Dietzman said the organization, founded in March, is gaining attention from other health care institutions in the state.

“We are talking with others. We aren’t really marketing,” Dietzman said. “People are hearing about what we’re doing through relationships or things going on at the state level. We’ve had people kind of come to us and ask for presentations or to understand better what we’re doing. So most of the conversations that we’re having or entertaining have come from that standpoint.

“We do not have in our strategic plan or anything in our plan about growth to be aggressive or really to go out at all and try and market ourselves.” 

Possible expansion of Michigan Health Connect services is due mostly to hospital consolidation that has made corporate siblings of facilities across the state, Dietzman said. “To the extent that organizations that are participating have facilities in various parts of the state, and from what I understand and what the expectation is, that all those organizations and all those hospitals would be kind of participating with us, as well,” he said.

Regional health information exchanges, or RHIOs, have been under development in Michigan for several years. Once fueled by state grants that have since dried up, RHIOs have had to change tactics, and in several cases, hospitals have taken the funding lead.

Regional organizations are working on developing systems that eventually would aggregate data from all of a patient’s health care providers to provide a comprehensive medical record at the computer keyboard, said John Hazelwinkel, project manager for Michigan State University’s Institute for Health Care Studies.

Development is furthest along in the Upper Peninsula, he said, using a system developed by Marquette General Hospital. The Capital Area RHIO launched earlier this year in Clinton, Ingham and Eaton counties. Others are in various stages of development, including two in southeastern Michigan, one in Jackson County and one involving three doctors’ practices in Ann Arbor.

“Local networks are limited in either scale or scope,” Hazewinkel said. “The scope of the Capital Area is extensive, but the scale is smaller. Michigan Health Connect has the large scale, but the scope of services is small, although they hope to grow.”

Dietzman said that representatives of the various RHIOs meet regularly.

Michigan Health Connect relies on Medicity’s Novo Grid to provide test results and order laboratory and radiology tests to more than 460 physician practices and community hospitals. That information, previously sent by fax machine, is delivered either directly into electronic medical records or via the World Wide Web.

“The organizations that have come together initially have been focused on Medicity’s Grid platform — so, clinical data exchange, kind of transaction based,” he said. “We’ll be moving toward the end of this, I think, with some planning in the aggregation of data. The clinical viewer would start to aggregate data and provide a portal view into what we know about patients from across the community for access in emergency departments and physician offices, that sort of thing.”

Other RHIOs are using different companies to implement their health information exchanges, including Axoltl and Covisint, a unit of Detroit-based CompuWare, Hazewinkel said.

Dr. Greg Forzley, medical director of informatics for Saint Mary’s Health Care, chairs both the Michigan State Medical Society and the Michigan Health Information Technology Commission. He said the Michigan Health Information Network, which the commission oversees, is laying out a statewide plan. Its initiatives include creation of the digital infrastructure that would support communication between local health information exchanges, leverage aggregated information for public health, and iron out interstate issues between RHIOs at state borders, for example.

Michigan Health Information Network received a $15 million federal grant, Forzley said. Hazewinkel said that despite the stimulus package’s financial support for expansion of computerization in health care, convincing doctors and other providers that the service is worth the money is a challenge.

In April, the Social Security Administration awarded a $2.9 million grant to the South East Michigan Health Information Exchange to automate the process of filing disability claims in Metro Detroit. The SSA is expanding on the success shown in demonstration projects in Massachusetts and Virginia in using electronic medical records to reduce application processing time from an average of 457 days to six hours. The grant was part of $17.4 million awarded to 15 health care providers and health information exchanges nationwide.

A press release from SEMHIE indicates that it intends to use the SSA disability claims infrastructure to create an HIE for southeastern Michigan and link into the Nationwide Health Information Network. Henry Ford Health System and Oakwood Healthcare System are the two major partners in SEMHIE.

“It’s one of the clearest business cases,” Hazewinkel said. “One of the things we are always struggling with is how to justify ongoing payments and the business case. The disability thing is a home run.”

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