Advances in HIE technology and performance could prove beneficial to clinical laboratories and anatomic pathology groups
Even before most clinical laboratories have substantial experience with a full-function health information exchange (HIE) serving their region, one HIE expert is predicting that the next generation of HIEs is soon to arrive and will deliver more functionality.
“We’re maturing from HIE 1.0 to HIE 2.0,” declared Micky Tripathi. “We’re in a new world now.” Tripathi is in a position to know. He is CEO of the Massachusetts eHealth Collaborative. He also participates on the boards and/or steering committees of the Information Exchange Workgroup of the HIT Policy Committee, the eHealth Initiative, and the New England Health Exchange Network (NEHEN).
HIE 2.0 Would Benefit Clinical Pathology Laboratories
Such a development would be significant for the clinical laboratory industry and anatomic pathology profession. That’s because medical laboratory test data makes up the largest proportion of an individual patient’s permanent health record. Thus, as HIEs become more capable of collecting medical laboratory test data and making it available to physicians, providers, payers, and patients, this will open the door for pathologists and clinical lab managers to find new ways that their lab organization can deliver greater value.
Tripathi made his prediction during a “State of the HIE” speech he delivered on January 29, 2013, at a joint conference of the HIT Policy and Standards Committees. He is excited about how a many new technology advances and cultural trends are coming together in ways that enable more capabilities in the generation he calls HIE 2.0.
Consumers Have Greater Expectations about Accessing Quality Care
In Tripathi’s view, this transformation is being driven by advances in such technologies as broadband, cloud computing, cheaper storage, and mobile devices. Reinforcing these developments are changes in consumers’ care expectations and younger providers’ relationship with health-specific IT. As a result, Tripathi sees the HIE moving towards decentralization while generating and meeting consumer demand for access to their own records. These statements were reported in a story published in Government Health IT.
One example of a fast-moving, successful HIE is found in the Hudson River Valley. It is Healthcare Information Xchange New York (HIXNY), a network serving 23 hospitals in 16 Upstate New York counties. HIXNY recently achieved a 94% affirmative consent rate for sharing patient information.
This Albany-area network was established back in 1995. (That was in the days of CHINs—Community Health Information Networks.) But the ramp up of HIXNY’s electronic exchange capabilities happened rapidly, said network CEO Mark McKinney.
“We had one CCD document in October of 2011,” he recalled in the Government Health IT article. “In May of 2012 we had 250,00 and in July 325,000.” As of February 2013, more than 1.4 million CCDs have been pushed to the HIXNY HIE, which now has 2.3 million records in its master patient index.
So far, physicians are mostly responsible for momentum of the advanced the functionality of HIXNY. “We’ve shown physicians the future, to some extent, and now that they see the potential they want more,” observed Kallanna Manjunath, MD, CPE, in an interview with Government Health IT. Manjunath is Chief Medical Officer at Whitney M. Young Jr. Health Center, an Albany community hospital and HIXNY participant.
Manjunath went on to say that many physicians now depend on the network for up-to-date patient information. They complain when hospitals fail to submit discharge information or specialists do not share data from consults.
However, Manjunath noted that patients are essential to the success of an HIE. “In my view this really has to be driven by patients,” he advised. “If the consumers demand [use and access to the HIE] of more doctors, more hospitals, more specialists; it will become necessary for them to do it. We want the public to speak up because it’s also in their best interest [for physicians] to have the most updated information for treatment.”
Ushering in a New Era Partly Driven by Patient Demand
Patient engagement was also considered important by Tripathi. In describing HIE 2.0 to Government Health IT, he explained that, in the coming era of HIE 2.0, patient demand will trigger increased sharing of health records.
Tripathi also noted that healthcare organizations are attempting to meet interoperability needs with whatever tools are available, while staying within existing business, legal and technical restraints. The consensus among HIE operators is to not wait on the government to adopt policies that enable a nationwide exchange. Instead, there is a market-driven energy of what Tripathi described as “let’s try to fit whatever we do within the current paradigm that we have and sometimes that means the technology gets out ahead of policy.”
Tripathi further pointed out the influence that the younger generations will have in shaping these developments. He noted that the HIE reformation will advance as younger, tech-savvy physicians and medical students take over of the reins of patient care from the retiring crop of doctors, whom tend to avoid all things technological, including email with patients, like a plague.
HIE 2.0 Has Potential to Benefit Clinical Labs and Pathology Groups
Pathologist and laboratory administrators should welcome the advent of HIE 2.0. If it becomes reality, it may be the final stage of journey, which included community health information networks (CHINs) in the 1990s, then regional health information organizations (RHIOs) in the early 2000s. Should HIEs prove to be the winning model for the concept of a regional health information repository, then we may finally see the day when there is efficient, accurate lab test ordering and lab test result reporting.