Q&A: Build trust into the HIE process
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The WNC network has collaborated since 1995 on patient healthcare quality projects, and together developed a group purchasing organization, but implementing Data Link, an HIE connecting disparate systems at each facility, required a higher degree of trust.
What were some of the trust issues you faced in implementing an HIE?
Not only did hospitals have to trust the network to develop this HIE, which takes it out of their direct control, but they also had to trust how the network [would] work for them. We had to convince the hospitals to trust Medseek [WNC’s software vendor] to work with their providers.
All these hospitals, although they’re forward-thinking in collaboration, they’re still very protective because they are competitors.
How did you work through these issues?
The bulk of our time was spent on policy development for the HIE. We literally sat down with blank pieces of paper. There was nothing in existence at the time we started developing this: We were pretty much hammering these policies on our time with our own brains. It was a detailed process that took a while.
[We decided] there would be no central data repository to store clinical data; all data would be maintained in the hospitals’ EMRs. We utilized a hosting center for our patient record locator, Peak 10 Data Center Solutions, in Charlotte.
We developed the HIE to be completely patient-centric and as long as that’s occurring, people feel more comfortable knowing they can compete even though you’re sharing patient information. This is so patient-centric you couldn’t query this type of information and figure out how to get a competitive edge on someone else in the same industry.
We [built] the trust, lessened the risk and people were willing to move forward and learn how beneficial it was for them, and it became something people were very glad they moved forward with. … We are working to bring on about 370 ambulatory providers, and we hope to get that completed by summer. Some hospitals have affiliated providers, and they will connect them to their hospital hub.
What information is available through Data Link?
Currently, the key information [is] demographics, admission/discharge information, lab results, microbiology results, radiology reports, inpatient medication lists, discharge summaries, history and physicals, consultative notes, procedural notes and allergies. We would like to add images, because often a specialist would prefer to see actual images and EKGs. And, of course, ambulatory clinical data are not there yet, and we are hoping to bring in retail pharmacy lists on patients as well.