By Joy Duling, Executive Director of Central Illinois Health Information Exchange (CIHIE)
Two years ago, June 5 probably seemed like just an ordinary day to most people in Central Illinois. However, for the team at Central Illinois Health Information Exchange (abbreviated CIHIE and pronounced “See-High”), that was a day that forever changed health care in our community. On that day, for the very first time, patients experienced a new opportunity to make their patient records from one office electronically available to other offices, not just within the same hospital affiliation, but seamlessly to any participating medical office.
That may not sound like a monumental accomplishment. After all, you can stick your debit card into any ATM machine in the world and access your financial accounts. Your money gets where you need it when you need it. Yet, for countless patients every day, easy access and portability of medical records is an entirely different experience. Medical records do not show up where needed, when needed, and the result is costly. Delayed appointments, duplicated tests, missed diagnoses, and dangerous medication conflicts happen when information is missing.
June 5, 2012 was the day things started to change.
The Old Way Doesn’t Work
It is no secret that the health care industry is keenly competitive. Patients represent market share and, traditionally, a health care facility benefits when they can keep you purchasing services from them. One of the ways that facilities have historically done this is by making it easier to do business with them and harder to do business with their competitors. From a purely business perspective, it was not in a facility’s interest to make it easy for you to pick up your health care record and go elsewhere.
Today, health care providers are finding themselves faced with a different world. Patients expect portability. Insurance companies and other payers are shifting to payment models that intentionally emphasize value over volume. In other words, the expectation is for a positive outcome and a health care provider is supposed to take the most efficient path to get to the positive outcome. When they are able to do that, they’ll see more profit. Every time a test or procedure is duplicative or care is poorly coordinated, they’ll see some of that potential profit slip away. At least, theoretically, that’s the way the models are supposed to work.
New payment models are not without their critics, but in general, everyone agrees that the old way doesn’t work. When health care operates more effectively and efficiently, everyone benefits — patients and providers.
HIE: A Critical Success Factor
Secure, electronic health information exchange is already proving to be a critical success factor for organizations that are facing these new payment models. For example, effectively treating a patient’s heart condition is a little easier if you can look up recent test results while the patient is sitting in the exam room in front of you.
Sure, you could fax a request for records to the other office and wait for the results to come back, but that may mean that you can’t effectively treat the patient today. If you do start treatment today, you may find out that the treatment has already been tried. Or that this patient forgot to tell you something that was of critical importance that makes this particular treatment inappropriate for him or her.
With electronic health information exchange available a physician or an authorized member of the clinical team is able to find the patient’s records from another participating office within just a few keyboard strokes. This means that the patient doesn’t have to take off work to come back for another appointment and the health care provider is able to confidently recommend the most effective course of treatment. Everyone wins.
Across the country, health care organizations are acknowledging this necessity of HIE participation. In May, the Office of National Coordinator for Health Information Technology published a brief highlighting the emergence of data exchange.
According to the brief:
- More than 60 percent of hospitals exchanged data with providers outside of their networks in 2013.
- The majority of hospitals electronically exchanged data with ambulatory providers outside of their system, a 58 percent increase since 2008.
- Forty percent of hospitals exchanged health information with hospitals outside of their system, up 167 percent from 2008.
The increase in data exchange activity is no surprise when you view the trend within the context of the new emerging payment models. An organization that is not capable of coordinating care efficiently and effectively with community partners would be at a significant disadvantage.
Beyond Central Illinois
In the first two years of operation, CIHIE has grown from a handful of charter members to more than 35 participating organizations, including 17 hospitals spanning the counties surrounding Peoria, Bloomington-Normal, Decatur, and Rockford. Thirty-two long-term care facilities, including skilled nursing and assisted living facilities, are connected, making Central Illinois one of the first places in the country to include long-term care connectivity.
In May, connectivity was achieved with health information exchanges serving other geographies of Illinois, including Lincoln Land Health Information Exchange (LLHIE) in Springfield, Illinois; Health Exchange Partners (IHEP) in Metro East St. Louis; and MetroChicago Health Information Exchange (MCHIE) in Chicago. This joint effort connects 63 hospitals and covers more than 92 percent of Illinois’ population.
Going forward, the CIHIE team is working with participating organizations to identify other community partners that should be included in the exchange and types of data that are proving to be most advantageous. While CIHIE is already the most connected exchange operating in Illinois, efforts will continue to ensure that statewide and even interstate connectivity is achieved.
To learn more about Central Illinois Health Information Exchange and the benefits for patients, you can visit www.cihie.org. CIHIE is a nonprofit organization, established in 2009 by health care providers across the region to enable the secure electronic transmission of patient health care records between participating offices.
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