Hospitals work to revolutionize exchange of health information

Steve Tarter

In the computer age, the ability to share health information would appear to be the least of the reform challenges facing the nation's medical industry.

"But different hospitals don't speak to each other," said Dr. Stephen Hippler, a physician at OSF Saint Francis Medical Center in Peoria, Ill., who has been part of a group for the past two years that wants to change that.

Hippler is not talking about phone calls between health professionals, but rather a computer link. "We're trying to bridge an electronic gap. ... There has to be a way to share information," he said.

Thanks in part to billions of dollars in federal incentives (and, in a few years, federal penalties), Health Information Exchanges are being set up around the country to accelerate the spread of electronic health records.

Advantages include improving safety and the coordination of care, reducing medical errors and controlling health care costs, said Dr. Gail Amundson, president and CEO of Quality Quest for Health of Illinois, the group trying to establish a health information exchange for a 20-country area in central Illinois.

Although the benefits are numerous, change is never easy -- especially in something as complex as the present medical system, Amundson noted.

"In a best case scenario, (the exchange) could be up and running in a year," she said.

Tackling that organizational challenge has required a group effort involving almost 200 people that helped structure the plan Quality Quest submitted to the state, said Amundson.

Illinois, in turn, applied to the federal government for funding appropriations for HIE plans. A response is expected in another month, said Joy Duling, HIE project director.

Duling is optimistic about the chances for change. "In Peoria, I'm pleasantly surprised at how the concept has been embraced. The mood has been predominantly positive. I couldn't have said that 12 months ago," she said.

Huling cites progress being made in health exchange elsewhere. "Other states are doing it. We like what they're doing in Nebraska," she said of the Nebraska Health Information Initiative, one of the first statewide HIEs in the country.

Omaha physician Harris Frankel spoke about the development of the Nebraska exchange at an April conference at the Embassy Suites in East Peoria.

"The vast majority of health care information in the United States today exists as paper records that are difficult to share and prone to misinterpretation," said Frankel, noting Nebraska rolled out its electronic exchange in July 2009.

The move from paper to electronic health records amounts to a paradigm shift, said Dr. David Trachtenbarg, medical director of information technology at Methodist Medical Center. "Overall, electronic is better. That's the reason people are shifting. It's easier to analyze (electronic health records) to see what's going on with the patient," he said.

"A computer can generate a table or a graph at the touch of a button. Another advantage is in doing reporting. In the case of a recent drug recall, we had a list of every patient that used that drug. There's no way that would have been done on paper," Trachtenbarg said.

Although many hospitals have invested heavily in computerization, those systems tend to share with their own kind, said Dr. Robert White, OSF's chief medical officer of clinical informatics.

"We will soon be able to exchange common records across the OSF system," he said, referring to the seven hospitals in the OSF group.

No shortage of vendors exist to facilitate the exchange of electronic information by hospitals. While OSF uses an Epic computer system, Methodist and Proctor use systems developed by McKessons.

"Within the year, we will be able to exchange with other Epic users," said White.

But electronic records have to start somewhere, he said. "If you don't have a digital record inside, you're not going to exchange much outside," said White. "At OSF, we're focused on getting everybody on the same electronic platform."

Other hospitals say the same thing. "There needs to be an interchange of information. Eventually, we can expect the same seamless connectivity you see with an ATM machine. But it's a work in progress," said Trachtenbarg.

"Each organization needs to make sure they have their own house in order first before opening it up to other people," said Jenny Clyatt, director of health informatics and technology at Proctor Hospital.

After a six-month evaluation process, Proctor Hospital decided to develop a new computer system, she said. "The new system will take from 18 to 24 months to fully implement. We look to start the process in the third quarter of this year," said Clyatt, estimating the price tag as "multiple millions."

As Quality Quest project director, Huling is committed to promoting the exchange concept. But she has another perspective: "As one with health records sprinkled all over central Illinois," said Huling, adding that her own personal experience - being treated for thyroid cancer - has made her a proponent of electronic files.

"Information should flow through the system like blood through the blood system. It needs to go where the patient needs it to be," she said.

Although plenty of work lies ahead, Duling cites what is already known. "Lots of organizations across the country are already electronic and engaged in exchange. The biggest barriers center around competitive gains and losses," she said.

While pushing for greater access to health records on one hand, there's also a need to assure both consumers and healthcare practitioners that information is private and secure, said Duling.

Steve Tarter can be reached at