Sutter Health CMIO: HIE will allow access to unaffiliated providers

Sacramento-based Sutter Health’s newly launched integrated health information exchange (HIE) not only will link its own network of physicians and hospitals, but will allow outside entities to have access as well.

“The value of an HIE network effect, is that the more [providers] you have connected, the more value there is for the next entity that is connected,” Chris Jaeger, MD, CMIO at Sutter Health, told Clinical Innovation + Technology. He foresees a number of valuable developments from its implementation: improved quality of care; more transparency of data; fewer unnecessary tests and procedures; and reduced readmissions.

“In emergency situations, it’s critically important to have patient information,” he said, especially as patients themselves may be too delirious to convey their medical histories.

The HIE will help break down the more siloed, reactionary approach to care that is common today, he said. “The HIE will enable us to improve our cross-continuum quality of care, bringing care closer to where patients live—at home or in the community.”

Already Sutter’s EHR (Epic) connects five medical foundations and 17 hospital campuses. The system exchanges tens of thousands of records per month, Jaeger said, adding that Sutter Health is the largest single instance of Epic worldwide. The HIE expands beyond this level of connectivity. “It enhances ways to exchange information with other entities, including non-Epic entities and even those using paper, to more actively engage and offer more 360-degree views of patient medical histories.”

The HIE will aggregate data to propel population health management, which Jaeger said is becoming “increasingly important” with evolving payment models.

The implementation of the HIE will occur in phases during the next four to five years.

This summer, Sutter Health will begin deployment, with the first step involving basic data integration with the Sutter EHR as well as testing the exchange of inbound and outbound data to ensure quality. The next phase will connect the platform to that utilized by the visiting nurses and hospice arm. “That will allow visiting nurses and Epic using providers to share information and view important data across the care continuum,” said Jaeger.

In later phases, tools will be implemented so external entities can access the HIE in a view-only mode. Other entities that share care of patients will include aligned mental health professionals, independent practices, federally qualified health centers, retail clinics and other providers in the care continuum.

“It’s focused on the patient at the center of it, and that is what is best to empower patients and help them in their own care,” he said.

Jaeger himself is working with other stakeholders through the California Association of HIEs to develop a policy and trust sharing agreement to help strengthen HIEs in California. This common framework will help advance exchange by enabling Direct secure messaging to anyone within the trusted network, and this eventually will scale to the national level.

As such, Jaeger sees the evolution of HIEs not as a top-down process, but one that starts locally and organically and builds from there. “I think HIEs will scale through interconnections instead of one single connection,” he predicted.