Saturday, March 29, 2008

State grant to start health information exchange

Yesterday Governor David Patterson announced the award of $105 million to 19 health information exchange (HIE) projects across New York State. This includes an award for the HIE being planned for Onondaga County. The local grant will be announced Monday (March 31) at a press conference in which I will participate.

The project in Onondaga County[1] will join with one in Broome County to develop an electronic information exchange in Central New York that will make available patients’ radiology, laboratory, and prescription data among physician offices, laboratories, pharmacies and hospital emergency departments. A study showed that such an HIE has the potential to reduce medical errors, to reduce unnecessary tests, and to improve care delivery in Central New York.

A recent article in the Harvard Business Review (HBR)[2] called such regional health information organizations (or RHIOs) “a promising new type of health care organization,” but asked “can these new entities…survive?” A handful of RHIOs are currently working in the US, and there are “some 100 or 200 more in development.” A number of such organizations are starting in New York, thanks to seed money provided by state government under its HEAL[3] grant program.

RHIOs are important because, despite all the computers used in health care, patient health information systems do not talk with one another. The RHIO that is planned for Central New York would allow patient data, including test results and prescription information, to be available through the Internet among hospitals and medical offices.

If there are big advantages to RHIOs, there are also big obstacles, as I have discussed. RHIOs need large capital investments to get started. They require cooperation among hospitals, labs, doctors, public agencies. They must have systems for assuring confidentiality, and they must overcome the lack of industry-wide technical standards.[4]

The local sponsor[5] of the RHIO is working on a business plan that will use the savings generated by the exchange to fund its ongoing operating costs through health insurance companies. That means the health insurance companies, hospitals, and doctors business will all have to agree on the business plan and will all have to forge agreements with the RHIO to make it a reality.

Yesterday’s HEAL grant awards is a promising start for this project. But it is a beginning, not the end.

Those of us who provide health care – and those who pay for it – will have a lot more work to do to make such a health information exchange a reality. And now is the time to start.

[1] The Onondaga County project is sponsored by the Health Advancement Collaborative of Central New York, of which I am the Secretary.
[2] Adler-Milstein, Julie and Jha, Ashish, “Fledgling Firms Offer Hope on Health Costs,” Harvard Business Review, March 2008, pp. 26-28
[3] Health Care Efficiency and Affordability Law for New Yorkers (HEAL NY)
[4] Adler-Milstein and Jha.
[5] Health Advancement Collaborative of Central New York.

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