AHRQ issues progress report on data-sharing projects
The results of a five-year, $5 million Agency for Healthcare Research and Quality (AHRQ) State and Regional Demonstration (SRD) in Health IT are in: all six award recipients developed data sharing at the regional or state level.
In 2004, AHRQ awarded SRD contracts to organizations in Colorado, Indiana, Rhode Island, Tennessee and Utah, and added a sixth contract to Delaware in 2005. All six SRDs completed a common set of data-sharing deliverables, but developed a variety of approaches with different technical, business and governance models, according to AHRQ.
Projects and achievements include:
Colorado Regional Health Information Organization (CORHIO) began as a nonprofit organization building a prototype federated data exchange among Denver Health, Kaiser Permanente of Colorado, The Children’s Hospital and University of Colorado Hospital. CORHIO and its partners went live with a one-year data exchange demonstration on Dec. 1, 2008. The system offered authorized emergency department (ED) practitioners at three sites and call center employees at one site access to the most common radiology reports, laboratory results, prescribed and dispensed medication information, registration information, electrocardiogram images and/or reports, and problem lists aggregated from all sites. CORHIO’s achievements include the development of a useful enterprise Master Patient Index (MPI) and a robust set of policies that can be applied to future HIE efforts.
Delaware Health Information Network (DHIN) was created to foster development of a statewide health information and electronic data interchange network for public and private use. In 2007, DHIN became the first operational statewide clinical HIE. Four of Delaware’s hospital systems currently provide data through the DHIN (a fifth will be added this fall), along with LabCorp, Quest Diagnostics and Doctors Pathology Services. DHIN partners provide more than 85 percent of laboratory tests and 81 percent of hospital admissions performed in the state. Since going live, DHIN has added new data types (e.g., transcribed reports) and new functions (e.g., medication history). As of July, DHIN’s users included 65 percent of the state’s healthcare providers working at more than 230 practices. DHIN is transitioning to a nonprofit, public/private governance structure that will support ongoing operations and the expansion of services.
Indiana Network for Patient Care (INPC) was created by Regenstrief Institute prior to the SRD program to provide clinical information at the point of care for treating patients in the ED. For the SRD project, Regenstrief Institute brought on new data sharing partners, provided interfaces for laboratory and pathology data, and expanded its activities beyond Indianapolis. INPC processes an average of 2.5 million HL7 messages per week, and captures data from more than 50 hospitals, plus physician practices, public health departments, laboratories, radiology centers, pharmacies, pharmacy benefit managers (via SureScripts), payors, convenience clinics (those attached to a pharmacy) and long-term care facilities. INPC now includes more than three billion coded results, 526 million encounters and more than 53 million text reports.
Rhode Island: currentcare:The R.I. Department of Health (HEALTH) received the SRD contract to develop a statewide exchange. The HIE, known as currentcare, has been a collaborative effort between HEALTH and the Rhode Island Quality Institute (RIQI). RIQI, which became the state-designated health information organization in 2008, has led project governance, and received contractual and operational responsibility for currentcare in July. The project’s goals are to design, develop, test, deploy and evaluate an initial health information network to support secure exchange of health information, beginning with laboratory results and medication history information. One of this project’s most important achievements is the development of a broad set of governance, management and operating policies, which are integral to ensuring compliance with the R.I. HIE Act of 2008. The act stipulates health information privacy and confidentiality protections for currentcare.
Tennessee: MidSouth eHealth Alliance was formed as a policy-setting body to govern the HIE in Memphis, sponsored by the State of Tennessee and managed by Vanderbilt University in its first four years. Control of the exchange has been transferred from Vanderbilt and the state to the MidSouth eHealth Alliance. Data services have migrated to Informatics Corporation of America. The exchange began serving clinicians in May 2006. As of March, data from 14 hospitals (inpatient and outpatient), 14 primary care safety-net clinics, and the University of Tennessee Medical Group are available to several hundred clinicians working in 14 EDs, 14 primary care clinics and in hospitals. Data include patient registration data, encounter codes and clinical data including laboratory results, diagnostic imaging reports, cardiac study reports, discharge summaries and dictated ED notes, among other data. Clinical data, particularly hospital discharge summaries, are most widely used.
Utah Health Information Network (UHIN) partners include physicians, hospitals, laboratories, payors, local health departments and health centers. The UHIN project initially involved enhancing the gateway for administrative exchange to build clinical information exchange. Ultimately, UHIN and its stakeholders purchased a platform to facilitate clinical exchange, which they call the Clinical Health Information Exchange (cHIE). The cHIE has a modest EMR, an MPI, results delivery, e-prescribing and virtual health records query functionality. UHIN is enrolling data sources and building support among healthcare providers for cHIE. As of June, laboratory data are being supplied by two data sources while seven clinics are connected to the cHIE. UHIN has developed a patient consent policy for use with the cHIE.
In 2004, AHRQ awarded SRD contracts to organizations in Colorado, Indiana, Rhode Island, Tennessee and Utah, and added a sixth contract to Delaware in 2005. All six SRDs completed a common set of data-sharing deliverables, but developed a variety of approaches with different technical, business and governance models, according to AHRQ.
Projects and achievements include:
Colorado Regional Health Information Organization (CORHIO) began as a nonprofit organization building a prototype federated data exchange among Denver Health, Kaiser Permanente of Colorado, The Children’s Hospital and University of Colorado Hospital. CORHIO and its partners went live with a one-year data exchange demonstration on Dec. 1, 2008. The system offered authorized emergency department (ED) practitioners at three sites and call center employees at one site access to the most common radiology reports, laboratory results, prescribed and dispensed medication information, registration information, electrocardiogram images and/or reports, and problem lists aggregated from all sites. CORHIO’s achievements include the development of a useful enterprise Master Patient Index (MPI) and a robust set of policies that can be applied to future HIE efforts.
Delaware Health Information Network (DHIN) was created to foster development of a statewide health information and electronic data interchange network for public and private use. In 2007, DHIN became the first operational statewide clinical HIE. Four of Delaware’s hospital systems currently provide data through the DHIN (a fifth will be added this fall), along with LabCorp, Quest Diagnostics and Doctors Pathology Services. DHIN partners provide more than 85 percent of laboratory tests and 81 percent of hospital admissions performed in the state. Since going live, DHIN has added new data types (e.g., transcribed reports) and new functions (e.g., medication history). As of July, DHIN’s users included 65 percent of the state’s healthcare providers working at more than 230 practices. DHIN is transitioning to a nonprofit, public/private governance structure that will support ongoing operations and the expansion of services.
Indiana Network for Patient Care (INPC) was created by Regenstrief Institute prior to the SRD program to provide clinical information at the point of care for treating patients in the ED. For the SRD project, Regenstrief Institute brought on new data sharing partners, provided interfaces for laboratory and pathology data, and expanded its activities beyond Indianapolis. INPC processes an average of 2.5 million HL7 messages per week, and captures data from more than 50 hospitals, plus physician practices, public health departments, laboratories, radiology centers, pharmacies, pharmacy benefit managers (via SureScripts), payors, convenience clinics (those attached to a pharmacy) and long-term care facilities. INPC now includes more than three billion coded results, 526 million encounters and more than 53 million text reports.
Rhode Island: currentcare:The R.I. Department of Health (HEALTH) received the SRD contract to develop a statewide exchange. The HIE, known as currentcare, has been a collaborative effort between HEALTH and the Rhode Island Quality Institute (RIQI). RIQI, which became the state-designated health information organization in 2008, has led project governance, and received contractual and operational responsibility for currentcare in July. The project’s goals are to design, develop, test, deploy and evaluate an initial health information network to support secure exchange of health information, beginning with laboratory results and medication history information. One of this project’s most important achievements is the development of a broad set of governance, management and operating policies, which are integral to ensuring compliance with the R.I. HIE Act of 2008. The act stipulates health information privacy and confidentiality protections for currentcare.
Tennessee: MidSouth eHealth Alliance was formed as a policy-setting body to govern the HIE in Memphis, sponsored by the State of Tennessee and managed by Vanderbilt University in its first four years. Control of the exchange has been transferred from Vanderbilt and the state to the MidSouth eHealth Alliance. Data services have migrated to Informatics Corporation of America. The exchange began serving clinicians in May 2006. As of March, data from 14 hospitals (inpatient and outpatient), 14 primary care safety-net clinics, and the University of Tennessee Medical Group are available to several hundred clinicians working in 14 EDs, 14 primary care clinics and in hospitals. Data include patient registration data, encounter codes and clinical data including laboratory results, diagnostic imaging reports, cardiac study reports, discharge summaries and dictated ED notes, among other data. Clinical data, particularly hospital discharge summaries, are most widely used.
Utah Health Information Network (UHIN) partners include physicians, hospitals, laboratories, payors, local health departments and health centers. The UHIN project initially involved enhancing the gateway for administrative exchange to build clinical information exchange. Ultimately, UHIN and its stakeholders purchased a platform to facilitate clinical exchange, which they call the Clinical Health Information Exchange (cHIE). The cHIE has a modest EMR, an MPI, results delivery, e-prescribing and virtual health records query functionality. UHIN is enrolling data sources and building support among healthcare providers for cHIE. As of June, laboratory data are being supplied by two data sources while seven clinics are connected to the cHIE. UHIN has developed a patient consent policy for use with the cHIE.