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Health Information Exchange

Grassroots approach builds connected health community

Physician retention, practice survival, quality of care fuel decision. By Rebecca Armato


o date, the buzz surrounding effective health information exchange (HIE) has more or less been centered on academic medical centers, inte- grated delivery networks (IDNs) and independent entities, such as regional health information organizations (RHIOs) that have been engineered for the sole purpose of sharing data.

Rebecca Armato is executive director of physician and interoperability services at Huntington Memorial Hospital. For more on

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But, from Huntington Me- morial Hospital’s perspective, there is a strategic element missing from this approach: a community hospital and physician-led collaboration with the patient as the focal point. In 2009, leadership at the 635-bed, not-for-profit

hospital recognized the importance of building a more ef- fi cient, connected healthcare community to continue its commitment of continuously improving the delivery of high- quality patient care now and for future generations. To achieve this, it turned to physicians and other clinicians on the front lines of patient care to fi nd out what strategy might make the most sense for all involved. Acknowledging that genuine health information communication occurs between private practice-based physicians who practice in different settings, Huntington Memorial Hospital consequently adopted a grassroots approach to building healthcare connectivity for the community it served.

The hospital is deeply committed to its “right care, right place, right time” mission and believes this can be actualized by making all relevant health information quickly and securely available at the point of care, irrespective of organization, geography, technology, device or care setting. Determined to more effectively deliver care to the residents of the com- munity, Huntington leadership felt a responsibility to engage physicians and invest in connecting hospital-based and offi ce- based care environments. Huntington knew this was possible with the help of new technologies – with all-important physi- cian buy-in – but only if those technologies worked together in a platform supporting interoperability.

16 September 2011

Physician retention, practice survival, quality of care fuel decision

Three primary considerations drove Huntington’s efforts from the start: the desire to support physicians, the need to retain physicians in the community and an imperative to deliver cost-effective, high-quality care. Located in Pasadena, Calif., right in the backyard of several acclaimed medical centers, and in a market that had a higher cost of living and lower reimbursement rate than much of the rest of the country, Huntington was acutely aware that physicians had choices, including being tempted to move their practice elsewhere or retire under the complexities the healthcare industry faced. But leadership likewise realized that physicians would be less inclined to leave medicine, or the community, if the hospital could help them by placing current, comprehensive patient information in their hands within their normal workfl ow at the point of service. Prior to 2009, the choice for community providers to view hospital- generated patient information or results was between mail, fax or physically logging into the hospital’s information sys- tem. All of these efforts were labor intensive, time consuming and outside of effi cient workfl ows. Leveraging information technology to create collaboration between all care settings serves to improve quality and lower the cost of providing and receiving care. The right technology and infrastructure could place lab results, imaging studies, ED reports, discharge summaries and other information into physicians’ hands quicker, so they could begin to deliver care faster. By informing the clinical decision-making process with greater amounts of relevant information instantaneously, physicians would be better equipped to diagnose and treat appropriately, thereby achieving improved outcomes.

Community physician buy-in facilitates universal participation Leadership knew that physician engagement and buy-in was vital and began its development process by undertaking a market assessment of local physician practices – inviting physicians’ opinions, seeking information about existing technologies (how easily and comprehensively they were


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