Like many states, New Jersey is on a quest to improve healthcare quality and lower costs. Prodded by the HITECH Act, four individual health information exchange (HIE) projects are in various stages of deployment throughout the state, creating the infrastructure that will allow providers to securely exchange electronic health information.
One of the more recent and larger efforts is HealthecITi-NJ, which consists of a network of eight Newark-area hospitals that share a common desire to achieve meaningful-use compliance, improve quality and coordinate healthcare to achieve measurable health outcomes for their patients, a large portion of whom are uninsured or underinsured. It's a lofty goal that technology alone cannot achieve. Many issues and considerations factor into an HIE's success, including governance structure, stakeholder participation, competing interest concerns, financial feasibility, data sharing agreements and privacy and security.
The network anticipates it will have the ability to reduce care costs by increasing access to health information across many community stakeholders — including federally qualified health centers (FQHC), ambulance services, home healthcare providers, nursing homes, long-term-care facilities and primary care offices — which will reduce the duplication of medical and related services.
How it works
One of the few HIE efforts to receive Office of the National Coordinator (ONC) funding, HealthecITi-NJ is using its first installment to pay for the hardware and connectivity software. Expanding upon an existing pilot HIE currently operating at Newark Beth Israel Medical Center and its caregiver network, HealthecITi-NJ is deploying IGI Health's ORBIT platform consisting of HIE applications including: Clinical Exchange, Physician Portal, Patient Portal and Meaningful-Use Reporting for Healthcare.
Among the HIE's key components, the network will include application interfaces with the New Jersey Immunization Information System (NJIIS), allowing users to retrieve patient immunization records, as well as the New Jersey Medicaid Medication Information System (NJMMIS) that provides access to prescription history records. Providers will use a secure web interface to query NJMMIS to view a patient's recently prescribed medications, allowing caregivers to make better-informed medical decisions.
The software also will retrieve and display lab and radiology results from Newark Beth Israel's EHR system, providing a summary of results as well as more detailed information about a particular lab test or image. Additionally, it will furnish hospitalization details and emergency department (ED) notes via a hospital interface. Providers can retrieve and view a summary of their patients' visits with additional episodic information available upon request. Once additional funding is available, similar interfaces will be built for the remaining facilities in HealthecITi-NJ.
New Jersey has a mandated process for transferring patients between licensed facilities. The final regulations have mandated implementation of a universal transfer form to be adopted with an effective date of October 30, 2011. There are 1,900 healthcare facilities and programs licensed by the NJ DHSS that will be required to use this form for patients who are transferred between settings. The HIE solution will facilitate this activity by automating the universal transfer forms and allowing each organization to pre-populate portions of the form, saving time and expense. With the technology, clinicians will be able to send and receive secure messages with colleagues and even patients, while patient search and user dashboard features permit networked facilities to view patients' demographic data shared by the HIE or from information entered into the patient portal. With the portal, patients will have access to the approved clinical data and a means to communicate with their physicians.
Benefits for the community
HealthecITi-NJ will provide the greater Newark region with an interoperable clinical data-sharing mechanism designed to reach the entire caregiver community and underserved populations. Additionally, the effort will focus on improving workflows and reducing healthcare costs associated with duplicate tests, time involved in recovering missing patient information, resources required to mail paper-based patient charts and manual phone communications involved in the referral process or to follow up on test results.
But that's just the tip of the iceberg. When all of New Jersey's HIEs come online, the state's healthcare leaders envision a “network of networks” that links the four individual HIEs, allowing healthcare organizations to disseminate clinical and administrative information around the state or even nationally when necessary. The next great challenge will be to create a sustainability model that will ensure ongoing operation of the HIEs. Without it, access to widespread clinical data will be severely hampered, effectively defeating ongoing efforts to provide safer, more efficient and equitable patient-centered care.
About the author
Lee Barrett is president and CEO of IGI Health (Piscataway, N.J.), a leading provider of health IT connectivity solutions to enhance HIEs, ACOs, payers, providers, EMRs and health information networks. For more information on IGI Health solutions: www.igihealth.com
