Health Information Exchange: To be sustainable, solve a business problem

Jim Bodenbender offers some advice on how to develop and maintain a sustainable health information exchange system.

About 31 percent of "meaningful use" guidelines relate to healthcare information exchange (HIE). With the calendar marching forward toward deadlines, why are so many health information organizations (HIO) failing?
Jim Bodenbender. Not all are failing. Some that have failed were developed solely with grants and weren't able to find the business model to keep going. Others have not only been able to sustain operations, but have actually expanded in terms of constituents, content, and geography. A recent study published in the Journal of the American Medical Informatics Association suggested that those who exhibit viability share some characteristics, including financial support from participants and a wide variety of participants sharing a narrow set of data.

Additionally, there is evidence that collaborative healthcare communities that start by first trying to solve a business problem can find they have done so by creating a vibrant health information exchange.

What do you mean by "solve a business problem?"
JB. An example is Saint Luke's Health System in Kansas City. In 2007, CIO Deborah 'Debe' Gash had a problem to solve. The organization's affiliated physicians complained about the amount of paper and phone calls their practices had to deal with from the hospital. Debe was looking for solutions in an area where few physicians were adopting technological tools.

Debe turned to RelayHealth SaaS-based tools to solve her problem, and branded the solution as Saint Luke's CareLink. They started with messaging tools that allowed physicians to securely communicate with their patients. Later, they implemented results management tools that allowed them to share clinical information electronically. This information includes hospital reports (radiology, H&P, Discharge Summary, and many other reports) and lab results. Debe's business problem was solved. Her hospitals are able to share information with their community physicians electronically, even with those who do not use electronic health records.

Jump forward a couple of years to the release of the draft meaningful use guidelines. Debe found that in solving her business problem, she had created a de facto health information exchange. Saint Luke's and their affiliated physicians are well positioned for meeting meaningful use guidelines. Additionally, she is reaching out to other health systems in her market to formalize an HIO. The RelayHealth solution is well suited for competitors to share patient information across organizations.

Why is RelayHealth advantageous for competing health systems to use?
JB. Some non-adopting hospitals have expressed concerns that their competitors would be able to analyze global information and determine, for example, that a competitor is currently focusing on their cardiac service line. With the RelayHealth security model, patient information is only made available on a need-to-know basis and only if the patient has given access permission. So if John Smith is visiting Dr. Jones, the doctor can see all of John's information - but no aggregate data. This solves the problem of making available to all healthcare providers a complete picture of a patient's care, but without the concerns that competitive information will be released in the process.

How does this relate to a more expansive healthcare information organization?
JB. We're finding that early adopters of RelayHealth tools are acting as HIO champions in their communities, encouraging competitors and other health systems to participate, and formally adopting an HIO structure.

Can you give me an example of this?
JB. Sure. Linda Reed is the CIO of Atlantic Health in New Jersey. Her hospitals and community physicians began sharing data through RelayHealth in 2007. Linda then reached out to other healthcare systems in the area. They recently applied for - and received - grant funding to form a formal regional health information organization (RHIO) called Jersey Health Connect. Again, a visionary CIO was solving a business problem - in this case, helping her hospitals and affiliated physicians to automate processes in pursuit of efficiencies and improved care. The result is a formal group that's connected from central to northern New Jersey and well positioned for inclusion in the National Health Information Network.

Jim Bodenbender serves as President for RelayHealth Connectivity Solutions. He joined McKesson in 2004 as Vice President of Business Performance Solutions before assuming his current role in 2006. Bodenbender has more than 25 years of experience in information systems and services with both start-up and large public companies and has an extensive background in domestic and international sales, marketing, M&A, operations, and finance. He holds an accounting degree from Bowling Green State University.