Health Information Exchange moves closer to reality in Nevada

Supporters of a system that will allow hospitals, physicians and others in Nevada to share patient information in real time across digital networks are confident they've found the right technology to get the job done.

Now they need to get often-competitive, often strongly opinionated hospital executives, physicians and others in the health care industry to break down the walls that have kept them from sharing information in the past.

HealthInsight Nevada, a Las Vegas-based nonprofit that spearheads efforts to improve the quality of health care delivery in Nevada, this month launched its community-based health information exchange in the state.

A health information exchange more typically known simply as an HIE allows medical providers to share the information in their electronic health records system.

The information might include patient referrals, lab results, radiology reports, notes on prescriptions or hospital discharge summaries.

Patients are required to authorize the swap of data, and protection of patient privacy is a very big part of the initiative.

Supporters are enthusiastic about the potential benefits.

Accurate information delivered more quickly to health care providers will improve care, says Chris Bosse, vice president of government relations for Renown Health in Reno.

Renown, along with Catholic Healthcare West, the parent of Saint Mary's Regional Medical Center, is among the founding members of the HealthInsight HIE.

Axolotl Corp. of San Jose won the contract from HealthInsight to establish the technical infrastructure of the HIE that will serve Nevada.

The company operates the statewide HIE systems in Utah, Idaho, Nebraska and Maryland, along with several regional systems.

That experience, HealthInsight executives say, was a key factor in their selection in April of Axolotl to handle the Nevada project.

A potentially more challenging part getting everyone on the same page, and divvying up the costs lies ahead.

On its Web page explaining the project, HealthInsight rather blandly notes, "HealthInsight is currently working with stakeholders to establish its governance model and fee structure."

And the nonprofit adds, "Fees are determined based on the principles of benefits received and a common understanding of what is fair and reasonable."

Rachel Papka, health information exchange manager with HealthInsight, acknowledges that creation of the HIE will require demolition of walls between healthcare competitors. HealthInsight, she says, won't be driving the bulldozer that knocks down the walls.

"This is about allowing everyone to have a voice," Papka says.

"We at HealthInsight can't lay down the business model."

When Axolotl sponsored a forum on HIE systems late last year, participants said that winning the support of individual physicians is a critical element to the success of any regional network. Doctors will come on board only after they're convinced that the system will bring them value without adding significantly to their costs.

Lest this sound like a recipe for endless meetings, Renown's Bosse says the founders of the HIE have committed themselves to creation of its initial framework within two or three months. They're sufficiently committed to the concept, Bosse says, to move quickly.

Pilot-project exchanges of data might be happening as early as September, HealthInsight executives say, and well-developed system that includes hospitals as well as physician groups, labs and other providers is likely to be in place by the end of 2012.

HealthInsight is working with an initiative to improve broadband access to rural Nevada so that the HIE system is available beyond the metropolitan areas of the state.

Ultimately, federal officials want to link individual HIE systems into regional networks and into a Nationwide Health Information Network.