29 Jan Milwaukee EMR RHIO set to go live
Milwaukee, Wis. – An emergency department linking project that is the first priority of a local electronic patient data exchange effort is on track to go live in late February at three Milwaukee area hospitals, according to information provided during the annual membership meeting of the Wisconsin Health Information Exchange.
The ED Linking project, one of three priorities that also include laboratory results reporting and a regional medication reconciliation process, will aggregate data from hospitals and other sources of medical data and present it to emergency clinicians. The objective is to provide critical patient information to emergency departments to support better medical decision making in those care settings.
It will be launched at Wheaton Franciscan Healthcare – St. Francis, Columbia St. Mary’s Hospital, and Aurora Sinai Medical Center on Feb. 25. That will be followed by several weeks of employee training before it is used for patient care sometime in March. The information exchange, which serves nine counties in southeastern Wisconsin, eventually will expand ED Linking eventually would be expanded to 10 hospitals.
Kim Pemble, who has been hired as the organization’s first full-time executive director, said since the ED Linking system is getting data feeds from many sources, the work that must be done prior to Feb. 25 includes ensuring a good match of patient data. He also said changes in database structure mean that WHIE has to reload Medicaid data from the state, which is time consuming.
“We’re not starting from ground zero,” Pemble said. “Data is being loaded. We’re at least one or two steps up the staircase with data.”
Pemble, former vice president of information services and CIO of for Synergy Health, was brought on to help develop a new business model for the subsequent phases of the information exchange. He isn’t sure how long it will take to develop the business model, but said the organization has enough funding to remain stable for the next two years.
“I believe we’ll have a solid business plan in place by the end of this calendar year, but the goal is much sooner than that.”
WHIE started in 2004 as one of nine community projects nationwide to receive start-up funding, and it has received $5 million in financial commitments along the way. This figure includes a preparedness grant form state Division of Public Health, which is part of the Wisconsin Department of Health and Family Services, and $1.6 million of a $3.2 million Medicaid transformation grant to implement the ED linking program as its first information exchange effort. Among the in-kind donations, Microsoft has stepped forward with technical services and software for large-scale data sharing, and participating hospitals also have contributed funds.
A recent Harvard study reported that one-quarter of the nation’s 145 Regional Health Information Organizations are defunct and only 20 programs, at the time of the survey, had grown to a modest size and were exchanging at least some patient data.
Dr. Barry Chaiken, associate chief medical officer of BearingPoint and chairman of WTN’s 2008 Digital Healthcare Conference, and other healthcare professionals have called for a stronger public-private partnership to move RHIOs beyond government grants that tend to dry up and halt project momentum. Chaken said healthcare is unique in that improvements made by one stakeholder don’t necessarily benefit all stakeholders, and as a result stakeholders don’t have the same incentive to advance technology.
Asked whether the difficulty RHIOs are having would impact the development of that business model, Pemble said he’s looking forward to learn what other data exchange organizations have accomplished and to reviewing ones that are having challenges. He also said WHIE would look at one approach in particular, one in which providers are rewarded for the quality of healthcare services.
“I think pay-for-performance is something we’ll be looking at a lot, both for engaging the payers and the physician,” he said. “I think a large part of this is how we share information to address quality, patient safety, and the accuracy and timeliness of care delivery for patients. I think that’s what it boils down to.”
Setting the stage
Dr. Ed Barthell, a co-founder of WHIE, noted the exchange has established workflows at each of the pilot emergency departments. Data-sharing agreements also have been established with the three pilot hospitals and the exchange is looking to establish them with other hospitals.
“We’re working on end-user interfaces, what [computer] screens they would actually see, and we have to train the end-users, and very soon we will be taking care of patients using this system,” Barthell said.
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• Milwaukee takes another step in electronic patient data exchange
• Yasnoff: Wisconsin should invest in health record bank
• CIO Leadership Series: Kim Pemble, SynergyHealth
• WHIE receives state eHealth Initiative contract