Q&A: Connecting in Connecticut
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When did you start building this HIE?
We started working with Misys Open Source Solutions (MOSS) about a year ago, after we contracted with Allscripts for their physician EHR; Allscripts and Misys had merged at. Prior to that, we had been developing an open-source HIE for ourselves using in-house staff. The HIE components that we were developing matched very closely with what MOSS had been doing. When we had the chance to sit down with MOSS and compare notes, it just made a lot of sense to contract with them to develop the HIE, rather than us doing it on our own.
Where are you in the process?
The basic HIE components are completed. We’re in the middle of testing, and getting ready to deploy them in a statewide demonstration project, as well as use them for some of our own interconnectivity requirements.
We’re actually up and live with some of the transfers of data right now. But the formal delivery for the statewide demonstration project is the end of February. We will be able to demonstrate sharing records between hospitals, physicians and some of our federally qualified health centers [FQHCs].
Currently, what facilities are included in the HIE?
Right now we’ve got three hospitals scheduled to start sending data back and forth: Hartford Hospital, St. Francis Hospital and Medical Center in Hartford, and the Eastern Connecticut Health Network in Manchester. As far as FQHCs go, we’re looking at linking to the Community Health Centers in Connecticut. We are also interacting with ProHealth Physicians, a large primary group practice.
That’s the start. Our plan is to extend this to all hospitals in the Hartford area to begin with, but then to extend it throughout the state. About 25 out of 32 hospitals [in the state] are actively involved with this project, including Yale University, which is the largest health system in Connecticut. Most of the hospitals have signed on to the idea of using this as the statewide HIE.
Will the interoperability demonstration include all hospitals?
Not right away, but our plan is to start implementing them later this year, probably in the summertime, and it will take a while to hook everybody up. We’re hoping to have it all done by 2011.Our integration teams are now pretty expert now at being able to link hospital-based products into the HIE.
One challenge we will have is with the physicians offices, because there are a variety of different systems out there. We’re coming up with Allscripts linkages, but everybody will have to link up to this product, so there will be some challenges on the integration. But our expectation is that to be a certified product, the physician systems have to comply with the IHE standards in order to be accepted and those include the connectivity to the HIE. So we’re expecting to be able to do that, it’s just a question of how much work is going to be involved to bring all those practices up.
How important is an open-source solution for HIE, when interoperability is required for compliance with federal mandates?
The Nationwide Health Information Network, and the fact that it is using open-source technology, really led us to start our own in-house project. Given that, it was a natural for us to move over to Misys.
The things that drove us toward open source were primarily economic and ease of use. One of the problems, as we evaluated the HIE commercial marketplace, was that they really weren’t open products and they tended to be pretty expensive, particularly when you started looking at it in terms of a statewide program. Many of their pricing schemes involve a per-click charge or a per-transaction charge or a per-member charge, they tended to add up very quickly.
We found that the economics of an open-source solution made more sense.