The Massachusetts Health Data Consortium (MHDC) recently hosted an event titled “Health Information Exchange (HIE) focuses on the mobilization of healthcare information electronically across organizations within a region or community. HIE provides the capability to electronically move clinical information between disparate health... More: The Key to Integration & Accountability Sheraton Norwood Four Points.” The event was hosted in Boston and assembled leaders from the Health Information Exchange (HIE) community to share ideas on the growth and maturity of HIEs.
Kicking off the event was Ray Campbell, CEO and Executive Director of MHDC, who talked briefly about the evolving structure of HIEs into layers. These layers fulfill differing needs at the community, regional, and state levels. Ray referred to these layers as complimentary, and used this as the lead-in to introduce John Halamka, MD, CIO, CareGroup Healthcare, who discussed the state-wide layer in Massachusetts.
Dr. Halamka is a distinguished blogger in healthcare IT, and delivered a dynamic presentation. He compared the state-wide mission to that of a public utility. The goal is to make sure that every provider is connected. And in a fun sort of way, just to emphasize that this was not a slow stodgy public utility of the old, he emphasized that this would be a “cloud-based, modular, appliance driven technology stack”.
The roadmap for the Massachusetts Statewide HIE program was broken into three phases to incrementally expand the capabilities to the healthcare community. The phases were outlined as follows:
- Phase 1: Information Highway – Get everyone connected!
- Phase 2: Analytics and Population Health – Use the data to improve healthcare.
- Phase 3: Search and Retrieve – Allow for more advanced communications.
Dr. Halamka pointed out that the The Direct Project was launched by the ONC within Health and Human Services (HHS) on March 1, 2010. It was initially called NHIN Direct. The object of the Direct Project is to replace the use of faxes, phones, and paper transactions with a simple and... More standards will be mandated. These standards are built around the pushing of data, using either secure e-mail or point-to-point web services. To simplify things, organizations will have one secure e-mail.
He also discussed the ‘Last Mile Program’ which engages vendors to modify their structure to incorporate standards within the application. Dr. Halamka indicated that most vendors have been receptive. This will be immensely valuable to the providers in eliminating multiple applications to share data.
In an attempt to ease privacy concerns, the state will not host the HIE but rather it will be hosted by a separate commercial entity. The cost and complexity of an HIE infrastructure can be high. In an effort to plan for sustainability, Massachusetts struck an agreement with Medicaid to cover 80% of the costs. The remainder of the fees are subscription based, rather than transaction, with the idea being to encourage transactions.
In all, it was refreshing to hear of a well thought out approach that aimed at addressing so many of the concerns commonly discussed regarding large statewide HIEs. From the simplified Phase 1 approach, to the vendor involvement, to the plans for sustainability, it will be interesting to watch whether the Massachusetts HIE can set the stage as the model for a top-layer, utility-like HIE that is cloud-based, modular, with an appliance driven technology stack.
For more information on HIEs, read:Health Information Exchange