David C. Kendrich MD, Chair, Department of Medical Informatics at the University of Oklahoma and CEO for “My HealthAccess Network”, www.myhealthaccessnetwork.net, a non-profit HIE serving more than four million patients in the state, presented testimony at the Senate Health, Education, Labor & Pensions Committee hearing held July 23rd to discuss health information technology.
As Dr. Kendrich explained, “My HealthAccess Network connects 275 organizations, including doctors, hospitals, pharmacies, tribal health systems, payers, employers, home health, hospice, long term care, state and local agencies and others.”
My HealthAccess technology has reduced wait times for access to specialty care by two thirds, been successful in preventing admissions and readmissions, and limiting unnecessary ER visits for asthma, COPD, CHF, and in general, has significantly reduced the total cost of care for transitioned patients in the Medicaid population.
Also, My HealthAccess Network has served as the convening organization and data aggregator for the Oklahoma implementation of a CMMI pilot project called the “Comprehensive Primary Care” (CPC) Initiative including local commercial payers as well as Medicare and Medicaid in the state. In its first year, Oklahoma’s 65 CPC practices have reduced Medicare costs by seven percent.
In California, a major problem is affecting California’s Emergency Medical Services Authority’s www.emsa.ca.gov Health Information Exchange. The state found that in 2009, when the federal government began providing funding to encourage the implementation of EHRs, Emergency Medical Services (EMS) were not recognized in that process.
Although 70 percent of EMS systems in the state use an electronic patient care record, the EMS system as a whole has not been able to securely send, receive, find, and use relevant patient information among and between different healthcare entities.
There are several challenges to sharing data, including funding and a lack of collaboration between vendors, providers, hospitals, and health information organizations. Even the data collection language EMS uses to report to the National EMS Information System is not directly compatible with the language used by the rest of the healthcare system for EHRs.
In another part of the country, the Kentucky Health Information Exchange (KHIE) http://khie.ky.gov has 759 signed participation agreements, represents 3,029 locations, and has a total of 1.087 provider locations submitting live data and exchanging information.
Today, ninety percent of acute care hospitals in KY are live on KHIE, $195.6 million has been paid to Medicaid providers in KY, $334.2 million has been paid to Medicare providers, and KHIE averages over 250,000 queries per week.
The news from the state is that a state legislative regulation was recently adopted in Kentucky related to the Health Information Exchange. The regulation requires laboratory results to be reported electronically to the Exchange.
To get into the queue and on board to KHIE for electronic laboratory reporting, providers must:
- Have signed a participation agreement and a disease surveillance addendum with KHIE
- Have laboratory feeds, reference lab orders, and results fully mapped to Logical Observation Identifiers Names and Codes and Systematized Nomenclature of Medicine with the exception of HIV and AIDS associated laboratory reports
- Establish that all-inclusive laboratory data feed contain HL7 2.5.1 ELR Standard Unsolicited Observation or Unsolicited Lab Observation messages from a 2014 certified EHE system
- Have an established all-inclusive admit, discharge, and transfer feed
These requirements aim to simplify hospital responsibilities, ensure ongoing compliance with state regulations on meaningful use, help adhere to the KHIE methodological framework, and prevent inadvertent submission of conditions that are prohibited from being delivered to Kentucky’s National Electronic Disease Surveillance System.