'The Road To Health Information Technology Interoperability In Eastern Massachusetts' by Sandra Fenwick

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Editor's note: this is the 2nd of 3 posts on goals outlined by the Eastern Massachusetts Healthcare Initiative (EMHI), a group of major hospitals, health insurers and universities in Greater Boston.

The American Recovery and Reinvestment Act of 2009 included extensive funding for health information technology programs. Funding includes $300 million to support regional health information exchange efforts and $17 billion in Medicaid and Medicare incentives for implementing “meaningful use” of certified electronic health records. This commitment to health information technology was reinforced by President Obama in his speech on health care reform to the American Medical Association this week.

As one of the first three major initiatives the Eastern Massachusetts Healthcare Initiative (EMHI) sought to tackle, health information technology interoperability holds hope for aligning care in a way that can reduce unnecessary tests, reconcile medications, and achieve other potentially cost-saving goals. More importantly, it can improve the quality of care.

To achieve this goal, EMHI completed a strategic plan phase, assisted by consultants at the Massachusetts Health Data Consortium that resulted in a recommendation that the group pursue a project around electronic communication of clinical data. Next, the collaborative entered into a scoping phase to examine what that work would mean for each EMHI organization, including determining individual institutional cost estimates based on the current sophistication of each of our organization’s health information technology systems.

We are now in a planning phase that will bring the group to the point of implementation of one area of this communication – visit and discharge summaries. Through the assistance of topic-specific workgroups, our consultants Computer Sciences Corporation, and our Advisory Committee, Chaired by Sandy Kurtz, Chief Operating Officer at Lahey Clinic, we are developing policies EMHI will use to move forward in this area – policies around participant rights and responsibilities, security, workflow, and developing a provider directory crucial to making this all work. We also have a workgroup developing an implementation guide that will assist participating organizations. In this endeavor, we are exploring the possibility of using the New England Healthcare Exchange Network, Inc. (NEHEN) as a gateway for such communication.

Each EMHI organization is currently determining whether to proceed with this program, with the intent to have a functioning HIE for clinical information exchange by the end of 2009. Given the current economic situation facing many health care organizations, this will not be an easy decision to make. However, there are reasons to seriously consider this first step towards effective interoperability.

First, we come back to the primary reason we pursued this goal in the first place – because it is the right thing to do to help improve the quality of care provided to our patients.

Second, in order to take advantage of federal stimulus money in this area, in the future hospitals will need to meet the criteria of “meaningful use.” Our electronic transfer of discharge summaries is a good first step towards that goal.

We are optimistic that this initiative can be expanded to include other health care organizations in the Commonwealth, and that it can serve to promote needed improvements in this important area. We believe that this could lay the foundation for a state-wide HIE so that we can improve communication and care among our patients and providers.

While health information technology interoperability is not the answer to all cost and quality problems in hospitals, it is a serious tool that can be used to reduce errors, improve quality, and ensure that our patients receive the best care possible. This goal is important for my hospital, Children’s Hospital Boston; it is important for all the organizations in our initiative, and it is important for all of us – as providers and patients.

Sandra Fenwick is President and Chief Operating Officer of Children’s Hospital Boston and member of the Eastern Massachusetts Healthcare Initiative’s Executive Committee

This program aired on June 17, 2009. The audio for this program is not available.