Even as it finalizes plans for a statewide health information exchange, eHealth Connecticut has applied for federal stimulus funding to become a health information technology regional center.
The health information exchange ”“ HIE ”“ developed by eHealth Connecticut is scheduled to go live in February. It will initially be tested on a pilot basis among recipients of Medicaid funding.
“How great is it that we are starting health information exchange in (Connecticut) with the Medicaid population ”“ usually the last to benefit from innovation?” Ellen Andrews, executive director of the New Haven-based Connecticut Health Policy Project, wrote in a blog.
The exchange is designed to house all patient information in a single database from which health care providers could access as needed, in theory reducing the odds of medical errors, and eliminating the redundant efforts by different medical offices to take patient information, limiting administrative inefficiencies and errors. The system will provide doctors with performance reports in a bid to help them improve their results.
Establishment of a working health information exchange would mark the first concrete step since the Connecticut General Assembly overrode a Gov. M. Jodi Rell veto to establish SustiNet, a near-universal health insurance plan with a number of mechanisms intended to reduce costs as well.
In addition to a health information exchange, those steps include the use of so-called medical homes, a network of advisers to help coordinate care for insurance policyholders.
As of July this year, nearly 60 health information exchanges were operating nationally at local, state and regional levels, according to the Washington, D.C.-based eHealth Initiative, up from 40 a year earlier.
“We have a great opportunity to expand HIE efforts with the new funding coming out in 2009 and 2010 through the (American Recovery and Reinvestment Act),” said Jennifer Covich, interim CEO of the eHealth Initiative. “We need to take advantage of this moment in time, when health information technology and health information exchange enjoy broad support. We might not get another.”
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Count eHealth Connecticut among those chasing federal stimulus funding.
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If the application is successful, the federal government would provide $9 for every dollar furnished by eHealth Connecticut in the first two years to help doctors”™ offices make the transition, with the ratio reversed in the following two years.
Under the exchange taking shape, patients will be given the option to opt in when they arrive at a hospital or doctor”™s office for an appointment. For those that opt out, their medical information will not be able to be viewed by the system.
In a bid to ensure security of health information, the system will use sophisticated authentication and encryption systems, and will employ a 24-hour auditing schedule to monitor user activity.
The system features both a “pull” model in which doctors can access patient records at other offices, as well as a “push” paradigm in which physicians can send records to authorized recipients, such as in cases of referrals or hospital discharges.
Participants include hospitals, health centers that qualify for federal dollars and private physician groups in multiple communities. The system will not immediately be able to accommodate bandwidth-intensive radiological images, but plans are in place to allow for that and other applications.
Several elements of the statewide exchange became operational this month, including:
- a master index to identify patients;
- a document registry service to identify where electronic clinical records exist for specific patients;
- document repositories housing clinical records in structured data;
- capabilities to accept non-standard data feeds and convert them to standard documents;
- electronic prescription infrastructure, including services to route medication orders and refill requests between prescribing providers and pharmacies, and a capability to make eligibility, formulary and medication history information available;
- privacy policies and applications allowing patients to specify whether or not they want to participate;
- security applications to encrypt data and authenticate all users;
- interoperability standards specifying file and data formats;
- a “semantic broker” to translate the language and codes of a participating health IT system to the exchange standards; and
- a hosted data center.
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