Some excerpts from the article:

A growing federally sanctioned healthcare community is starting to take hold, sharing information across agencies, healthcare providers and other external partners using CONNECT software to link to the Nationwide Health Information Network (NHIN).

“This nationwide network infrastructure is really winning as a way to link all kinds of healthcare organizations to the federal agencies involved in healthcare provision”, said Smith.

The entire article can be read here, and is available in the latest edition of Federal Computer Week.

Health Information Technology (HIT) is frequently associated with efficiencies and cost reduction / avoidance plans. Electronic Health Records (EHR) technologies will serve as the foundation for a creating a number of these efficiencies.  However, these technologies will not attain the efficiencies desired if providers do not adopt EHR technologies and use them as a part of their clinical workflow.  Only by significantly increasing provider adoption rates can these efficiencies be realized.

HIT and EHR adoption will be driven by the willingness of physicians and other health care providers to adopt and use new technologies.  In many ways, this makes HIT and EHR adoption a large-scale change management project.  Success is dependent on the acceptance, adoption, and use of EHRs and HIT technologies by healthcare providers at all levels. Experience teaches us that this level of education is important to the implementation process whenever action is required at the stakeholder level.

Perhaps the biggest problem facing providers and hindering the rapid adoption of EHR technology is a change in workflow or a change in the way a clinician delivers care. Workers like some level of routine in their daily tasks and predictably in work flow processes. Whenever change is introduced into the workplace, it disrupts the normal flow of work and may cause people to resist.  Even when workers understand the rationale for the change and may even agree with it logically, emotionally they will remain skeptical.  Frequently, workers are not shown how the change impacts them directly.  Will I be able to perform the new work tasks as well as I could the old tasks? If I don’t perform as well, will that impact the results of my work?  These and other questions may cause people to resist or even fight the introduction of EHR technology.

It is important to address these concerns and offer solutions.  Adoption of EHR and HIT technologies will be much easier if strategies are utilized to address and overcome stakeholder concerns early in the process.

A Medical Home can have a significant impact on patients, especially patients with a chronic (or multiple) conditions, as well as the patient’s family. Healthcare organizations need suitable technology solutions to enable the secure sharing of patient information across organizational boundaries, to automate workflows, to comply with regulations, and to manage patients with chronic conditions outside the acute care setting.  Enter the Medical Home, or Patient-Centered Medical Home.

But what is a Medical Home exactly? As defined by The National Committee on Quality Assurance (NCQA), “The Patient Centered Medical Home is a health care setting that facilitates partnerships between individual patients, and their personal physicians, and when appropriate, the patient’s family. Care is facilitated by registries, information technology, health information exchange and other means to assure that patients get the indicated care when and where they need and want it in a culturally and linguistically appropriate manner.”

Living with multiple or chronic conditions can be difficult for patients.  Patients and providers need quick and easy access to health information to better understand and manage chronic conditions. Provider organizations are committed to helping patients live a happier and healthier life by helping them manage these chronic conditions outside the acute care setting. With chronic care delivery being fragmented by patients visiting multiple care providers at different locations, it is a challenge to deliver the right care to patients.  Lack of current, relevant patient information across the different care facilities also adds to the challenge.

A Medical Home can help providers manage patients with specific conditions, manage chronic diseases, coordinate multiple caregivers, and help collect quality information.  A Medical Home can track patients across care settings and over time to improve patient outcomes and quality.

A Medical Home can be deployed as a separate service for individual projects, or integrated with other, existing services and Health Information Exchanges.   In fact, Medical Homes can be fully integrated and supported by the Nationwide Health Information Network, or NHIN.  Therefore, Medical Homes should be considered in a provider’s HIT roadmap, as well as the roadmap of services and integrated/supported offerings by a Health Information Exchange.

Next month, we will dive deeper into Medical Homes, use-cases, and goals of the interoperable Medical Home.

There have been a lot of discussions and questions about the role and alignment of State Agencies in and with Health Information Exchange, and HIE initiatives.  Specifically, there have been some questions around the role of State Agencies and the specific use cases for HIEs with State Agencies.

Its our belief that State Agencies must play a part in the HIE, and provide valuable services and offerings to and for the HIE.  Some examples of use cases include the utilization of a State-based Immunization Registry system that could be integrated with the HIE to provide immunization history.  Another use case could be the integration of the HIE with the Public Health reporting infrastructure, and provide event reporting to Federal Agencies such as the CDC.  The State Medicaid Agency could provide administrative transaction support (claims, eligibility, etc), as well other services (such as medical history to improve quality of care to Medicaid patients, etc),  to the HIE and associated providers.

With the convergence of technologies, administrative and clinical data, and the ever growing adoption of EHR technology, State Agencies provide valuable services and data to and from the HIE, and interoperable State Agency connectivity should be included in the HIE’s strategic plan, roadmap and future.

Make sure you visit the MITA/CMS group and showcase, see these new, exciting administrative transactions and learn about the impact of moving Medicare and Medicaid (as well as private payer) administrative transactions to the Nationwide Health Information Network, or NHIN.

Stop by and say hello to Seonho and Chris — and see you in Portland!

An article in the Minneapolis St. Paul Business Journal about MEDNET’s growth over the past few years

An upcoming article in the August Federal Computer Weekly, focused on the adoption of the NHIN CONNECT Software by MEDNET, the impact of NHIN, and the adoption of NHIN by Health Information Exchanges nationwide.

As the Health Information Exchange  market evolves and expands, we continue to hear questions about what offering is right (or wrong) for a specific provider, system, and HIE, as well as what offerings the HIE should (or should not) offer to assist with Meaningful Use.

Many HIEs seem to be in different places in regards to their role on the path to Meaningful Use…should the HIE provide all the tools for providers to achieve Meaningful Use?  Should the HIE provide optional services to assist providers in becoming meaningful users?

What about the HIE providing EMRs, applications, services, etc.? Or is the HIE merely an ‘on-ramp’ for connectivity and reporting, with  Meaningful Use compliance belonging only to the provider?

We have seen many different models for HIE, including the HIE focusing on providing applications and services for complete Meaningful Use compliance, to the HIE providing some options for connectivity and a few applications or services to assist in Meaningful Use.

The latest information we have is that HIEs need to focus on providing three core functions in 2011 for providers: ePrescribing, Structured Lab Results and Sharing Patient Care Summaries.

While there can be more global goals and focus for the HIE in 2011, these three key services should be addressed by the HIEs to help drive not only HIE adoption and HIE sustainability, but also the path to Meaningful Use.

In an ideal world, empowered patients should be able to manage their healthcare on-line, through a Personal Health Record. A Personal Health Record (PHR) is the newer term for systems that allow patients to manage their own health information on-line. The goal of PHRs is to allow patients to directly communicate with a multitude of providers and disparate clinical systems, creating a more efficient marketplace and driving value in healthcare.

Connecting PHRs via Health Information Exchanges (HIEs):

Some PHRs are connected to clinical (or EMR) systems run by a provider (called tethered), while other (un-tethered) PHRs are independent of any particular provider/clinical system.  For example, Google Health and Microsoft’s HealthVault are un-tethered systems and provide ways to connect to many different, existing provider clinical systems, while EMR vendors sell an electronic medical record system that includes a PHR option, which is directly tied, or tethered into only that specific EMR system.

Many people believe that Health Information Exchanges, or HIE, should be able to help bridge the connectivity/tethered PHR gap, and see HIEs as having the ability to simplify the connectivity between PHRs and EMRs and clinical systems.

Within an HIE, a patient is usually registered within the HIE’s Master Patient Index.  Connecting the patient’s PHR to their clinical information (within an HIE) involves connecting and linking the Master Patient Index record to the specific account the patient has setup within their PHR.  Utilizing the Nationwide Health Information Network (NHIN) to connect the HIE nationally, the patient could then use a PHR to connect locally and nationally.  Connecting nationally with their PHR is important for patients applying for Federal programs and benefits, such as Medicare or Social Security Benefits.

By connecting HIEs and PHRs using these new standards like NHIN, we can simplify access to services by the patient, allow better more uniform access on-line, and speed up access to government services and benefits.

In our work with Health Information Exchanges across the country, we are often asked about overall HIE value propositions and the impact therein.  A strong value proposition can energize and engage key stakeholders into and for a project, such as an HIE.  The value proposition is the statement that describes why an organization would willingly participate in a venture such as a Health Information Exchange (HIE).  The value proposition is a clearly defined statement that is designed to demonstrate a proposed service offering that will solve a problem in such a way that the value to the participating organization is greater than not participating.

Why is the development of a strong value proposition important? An optimal value proposition will provide strong reasons why a potential healthcare stakeholder will want to be included in the HIE Project.  In order to achieve project objectives, the value proposition needs to be clear, concise and compelling.  By identifying stakeholder needs through  research and analysis, it is possible to develop clear and concise value propositions for each stakeholder that reflects their specific needs.  When the stakeholders’ return on investment (ROI) is measured over time, the tangible results that participants can reasonably expect from participating in the HIE can be quantified and reported.

The value proposition is important because it is a key component of any financial sustainability model.  Linking an organization’s value proposition to an achievable ROI is key to keeping the organization engaged throughout the creation and implementation of the HIE.  Developing an ROI for each participant and continually reporting on it during the HIE formation process will serve as a reminder of the value the HIE will provide to each stakeholder when fully functional.