Spotlight on “Health Information Exchange – an interview with Linda Stotsky of Ignis Systems.

Introduction
The American Recovery and Reinvestment Act (ARRA) appropriated and funded a special extension grant of $564 million to set up health information exchanges (HIE) throughout the United States.  States across the United States have begun planning their own versions of HIE. In the original schema, primary care providers were the main emphasis of these HIEs and only have just begun including specialists (such as optometrists). To include optometry within this crucial information exchange mechanism, state associations will need to ramp up their familiarity with the complexities of HIE, less it excludes optometry and thereby raise an arbitrary border for it to collaborate with other health care disciplines.

This installment of Tips4EyeDocs spotlights Linda Stotsky, a regular contributor on #HealthIT, #HIE and #HITsm via @EMRAnswers and @EMRLink on Twitter. She has 25 yeares of experience in Healthcare and Healthcare Information Technology (HIT). Her responsibilities include launching EMR (Electronic Medical Records), EHR (Electronic Health Record), eRX (electronic prescribing) and Lab (Laboratory)  projects across Tennessee. Ms. Stotsky rolled out the first “Payer based” HIE in the state of Tennessee. Since then,  she has integrated Electronic Lab Results with HIE’s, and managed CCD (Continuity of Care Document) Integration Projects with organizations such as KHIE, HXNY, LaRHIX and others. She is passionate about improving the secure delivery of health information, for point-of-care medical decision-making and improved patient outcomes. and has personal experience as a caregiver before starting her work EMRs and HIEs. Ms. Stotsky intimately understands the benefit of care coordination across the continuum as she walks as an advocate for patient safety and patient advocacy as #117 in  #thewalkinggallery (@ReginaHalliday on Twitter).

Ms. Stotsky now works for Ignis Systems (http://www.ignissystems.com) integrating clinical laboratory orders. radiology results and laboratory studies with physician and patients for their EMR and HIE.  She is intimately familiar with HIE because of Ignis’ platform of EMR to HIE integration. Contact Linda via Twitter with her user identities as follows:  @EMRAnswers  or as @EMRLink.

What is a health information exchange and how will it affect primary care providers? specialist providers?

The goal of HIE is to facilitate access to and retrieval of clinical data to provide safer and more timely, efficient, effective, and equitable patient-centered care. A Health Information Exchange is a repository of patient health information, across a wider “View”. The HIE aggregates information from multiple providers, hospitals, labs, and clinics within a specific state or region, providing a more complete and timely picture of a patients health. This “Snapshot” includes the latest labs, problems, diagnoses, medications,tests,allergies, and therapies across the care continuum. Providing this “Enhanced View” of the complete patient record enables attending physicians to capture a more comprehensive picture of ongoing health information at the point of care, allowing for better medical decision making and avoidance of medication allergies, errors, and duplicate therapies.

Primary care providers add much of this information to the health repository. Yet specialists are at a disadvantage in terms of gaining a complete picture of a patient’s health including medication reconciliation, allergies and lab reporting.  This is usually left to memory or “‘scraps of paper” with critical gapsin care. HIE’s can “fill these gaps” for specialist providers.  Their information is the critical component that is often times overlooked during transitions in care, or care coordination.

As an example, my mother had cataract surgery, and had an adverse reaction to the eye drops. This was never ” passed along” as part of her medical record. If I didnt carry this information on a scrap of paper, it was nonexistent.

Contribution and retreival from an HIE, enables care coordination where otherwise, there would be none. A more complete snapshot of medications and allergies is critical to all providers. decreasing adverse events for provider and for patient is the name of the game. In that respect, HIE is a ” Game changer” when its correct…

Do doctors need to be engaged with a health information exchange? What happens if they do not?

Engaging with a Health Information Exchange is beneficial to the physician .Treatment options are based on ongoing tests and services.The ability to view a patients most recent tests and services reduces costly duplications,which are expensive to a physicians bottom line revenue.

Medication reconciliation is accurate, providing a list of the patients medications, allergies and adverse reactions. Emergency Department physicians can reconcile medications quickly and reduce medical errors through access to a Health Information Exchange. On average, medication reconciliation from an HIE saves an average of 14 minutes during hospital admittance.

Alignment with a state or regional Health Information Exchange sets a service standard synonymous with increased patient outcomes and consumer satisfaction. However, there are obstacles to overcome. HIE integration must be tightly woven to align with existing work flow and practice challenges. Data transmission must be secure. Access must align with the electronic medical record. Overcoming the obstacles determines actual “Use ability” of the information retrieved.

If you could give 3 tips to a EMR vendor about getting ready for a health information exchange, what would you say?

1. Enable access to the HIE through Single Sign On of the Electronic Medical Record..

2. Be sure to integrate Lab result reporting with the patient record, and send to the HIE.

3  Capture,transmit and consume clinical health information securely, transparently, and through normal delivery standards (HL7, CCD, CDA)