Q&A: Regional HIE takes a best-of-breed approach
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CMIO: What information is currently being exchanged through CareSpark?
Documents being exchanged consist of a complete CCD document, immunization, radiology, lab reports and medication history. CareSpark has worked on the NHIN [Nationwide Health Information Network] on the national level on multiple projects. Current national projects include a PQRI [Physician Quality Review Initiative] project, working with a local organization and one EMR vendor to show how quality review reports can be transmitted electronically to the Centers for Medicare & Medicaid Services (CMS), and the provider can receive feedback from CMS on how they’re doing as far as meeting guidelines. That’s been a very aggressive project that started in July, and should be complete in the fall.
We were also one of the awardees working on a Social Security Administration (SSA) project to show how disability determination can be done electronically. Patients will sign release to show where information from the organization can be sent to Social Security in an electronic format through CareSpark.
The other pilot project we are just getting under way is with the [Department of Veterans Affairs (VA)]: We’ll be working with a local technology company to show how, using NHIN Direct, we can get information from our medical organizations back to VA.
CMIO: What HIE technologies are you using?
We use best-of-breed systems, and do not have just one vendor. For the provider registry and master patient index, we use Initiate software and Oracle databases. We may be the only HIE that offers Master Patient Option Preference, which allows organizations that do not have the ability to have patient consent reporting in their system [to use] our consent module to indicate patient preferences. That software was developed for us by CGI.
CMIO: What is CareSpark doing to ensure its sustainability?
We’re doing market analysis with our local organizations to see what services we can offer. We are looking at secure messaging, where we can provide provider-to-provider communications, we can do results delivery, we can do medication reconciliation, all through secure messaging. So that’s one of the sustainability models we’re looking at.
Also if the SSA and PQRI projects succeed, we see that that could be a benefit that CareSpark could offer to its providers, [with] some type of transaction fee for service.
Currently we’re funded by grants, along with donations. Large organizations and hospitals in the Tri-Cities area [comprising Kingsport and Johnson City, Tenn., and the twin cities of Bristol, Tenn., and Bristol, Va.] see what a benefit CareSpark is, and they provide donations to us while we’re going through this transition phase to see what our sustainability model is. We have a service called ActiveHealth—we provide decision support to employers, to our providers. It’s a service some of the larger employers in the Tri-Cities [area] pay for.
CMIO: As an interstate health information exchange, how has CareSpark dealt with the challenges of regional exchange?
There are some challenges, even with the Regional Extension Centers—CareSpark is contracted with the Tennessee Regional Extension Center to bring meaningful use to providers, but we haven’t actually gotten the Virginia contract negotiated. Each state is working on a different level.
[However,] we do have the first state-to-state exchange: We are receiving immunizations from state of Tennessee and state of Virginia thru CareSpark. That’s Phase One. In Phase Two, [we’ll be able] to notify Tennessee that a patient has had an immunization through Virginia. In Phase Three, we will able to provide the update back to Tennessee. We can show the [possibilities of] state-to-state exchange and how it can benefit [care]. This is just one of the many projects we could do, even with medication reconciliation.