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Health Information Exchange

the ocean is not the way to go for an HIE. Starting with focused, achievable objectives and incrementally growing the number of use cases is most manageable. For instance, lifeIMAGE advocates an imaging HIE. A group of hospitals and their community physicians can all participate in sharing imaging results. “Technology is often not the barrier, but it is expensive to acquire the capabilities of a master patient index and sharing information from diverse origins and formats. Therefore, there is such a thing as buying too much HIE which leads to inability to support the minimum requirements for the long term. That’s why the lifeIMAGE solution is transaction based and allows facilities to pay for what they use, when they use it.”

Friedrich: “Anytime, Anywhere. Clinicians have to be able to access data from anywhere at anytime. Data needs to be viewed easily, with only Internet access and a browser required, versus only on a workstation where a piece of software has to be installed. The fl exibility to look at information anywhere a clinician may need it provides value not only to the clinician but to the patient as well. “Real-Time Data. Physicians need to be able to look at a patient summary and have access to information that is as current and up to date as possible. If a patient was in the Emergency Department and was told to follow up with his or her physician the following day, the corresponding clinician needs updated information to be able to provide the best care possible. If clinicians are working with data that is less than time sensitive because it is only uploaded once a week, for example, it provides much less of a value proposition for that patient’s immediate care. “What can the clinician end-users see? Not only is the type of data (medications, labs, radiology images, etc.) important to the clinical users, but the facilities from which they can see it is vital as well. Many HIEs are looking to implement a statewide system, but the likelihood of a patient who lives in one part of the state receiving care at a facility hours away are slim. Rather, a user who can see regional data will fi nd what he or she needs quickly and completely, which increases the likelihood that he or she will use the HIE over and over, which, of course, is the goal.”

Jones: “When considering HIE implementation, the end-user should: Clearly defi ne the purpose and value of HIE for the participating organizations. In other words, answer these questions: Why will we implement an HIE, who will use it and profi t from it, and what work fl ows and/or processes will be enhanced? Next,

10 July 2010

document and get buy-in from the key stakeholders on the purpose and expected value of the HIE. This ‘vision’ statement can then be used to inform the ‘how’ (the actual selection and implementation of a solution) and to evaluate the success of the HIE once installed. “Confront the issues of governance. This involves

more than control and management of the HIE. It also centers on issues of trust. Are the participating organizations and/or stakeholders willing to share patient information? What barriers exist to data exchange and how can they be removed? Once the shared data is identifi ed, determine whether its content and quality will be rich enough to bring value to the end-users. “Identify how the HIE will deliver new capabilities to the targeted end-users and whether these will be valued by them. Will the users embrace these features, believing that they enhance the clinical work fl ow? Two factors infl uence end-user adoption: intuitive, ease of use and the delivery of fi ltered, highly-relevant information. The best technology in the world cannot make up for awkward, hard-to-use functionality that is disconnected from a deep understanding of the clinical workfl ows. Engage the end-users to ensure that they are committed to the changes required. Based on their feedback, it’s possible to create a multi-staged implementation plan so that each stage brings value to the targeted user within a short period of time.”

Vengco: “Make sure to identify what data is the most useful to provide from the HIE out of the gate. While lab results may be fi ne as a fi rst step, for our institution, our clinicians stated that labs alone weren’t useful enough to make a trip to the HIE. So we added meds, problems, and allergies. That made it stickier. Think about the presentation of the data before you present any data. The CCD document structure can make for a wieldy work fl ow. Who’s going to pay for it? [Other concerns] won’t matter if the grant runs dry and there’s no funding.”

Kasal: “Sustainability plan for support (ongoing operations) and for the needed expansions that always surface in technology tools in healthcare. Solid understanding of expected customers of HIE – specifi cally knowledge of possible competing HIE initiatives, culture of community towards sharing of data, knowledge of technology platforms in place in planned region. Knowledge of infrastructure requirements of HIE technology and readiness of customer base for use of HIE.”

HEALTH MANAGEMENT TECHNOLOGY www.healthmgttech.com

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