A standards-based HIE solution rolled out initially in the emergency departments helps Geisinger Health System to satisfy upcoming meaningful-use requirements and adapt to meet future needs.

Serving nearly 3 million patients across 31 counties in central and northeast Pennsylvania, Keystone Health Information Exchange (KeyHIE) connects founding participant Geisinger Health System with five other regional hospitals — linking a total of seven hospitals and 41 practices. In efforts to grow the system's value and overall adoption over time, members of the KeyHIE governance group designed the HIE to roll out in phases.

During the first phase, KeyHIE's initial research revealed that emergency department (ED) physicians primarily needed access to history and physicals; problems, medications and allergies; and discharge summaries. The ED is often the place where the least information is available about a patient, and speed is a critical factor in providing the best care. KeyHIE's first-phase goal was to provide critical patient information to local ED teams at the point of care — the right information at the right time and place. However, KeyHIE was faced with the challenge of connecting disparate electronic medical record (EMR) systems supporting the participating hospitals' EDs.

Leveraging industry standards

KeyHIE selected GE Healthcare's eHealth Solutions to power the HIE and support its future plans to connect additional hospitals, skilled nursing facilities, long-term care settings, affiliated physician practices and home health providers. The GE Healthcare system enables KeyHIE to leverage existing healthcare information technology (HIT) investments and industry standards to connect the disparate health information systems and provide a comprehensive, patient-focused information source.

Physicians at participating facilities can access HIE data within their normal EMR workflow, and in some cases, import data directly into their EMR. The solution also provides a web-based clinical dashboard that links patient encounters from multiple EMRs and allows providers who do not have an EMR to access data from external organizations.

Meeting current and future needs

Through the HIE, participating physicians are now able to easily view patients' problems, allergies, medications, history, physical documents, discharge summaries and radiology reports. Early research looking at radiology reports and ED visits showed:

  • Twenty percent of hospital radiology tests are duplicates (a conservative estimate). By leveraging shared information in KeyHIE to reduce half of the current duplicate radiology tests, potential annual savings are more than $5 million.
  • The potential annual savings from more efficient ED processing is estimated to be as much as $1.6 million based on studies performed in Indianapolis.
  • There is a positive impact to providing rapid and secure access to previously unavailable patient information in EDs.
  • There is improved quality of care and care coordination through increased information flow and transparency.
  • By providing hospital information to outpatient clinicians via access to discharge summaries, KeyHIE has reduced the time delay and potential for miscommunication that occurs when physician offices receive only paper discharge summaries.

With a standards-based HIE solution in place, the KeyHIE community is now well positioned to satisfy upcoming meaningful-use requirements and adapt to meet future needs. Since the initial launch of the HIE, KeyHIE has been awarded a $2.3 million grant from the Agency for Research Healthcare and Quality (AHRQ) to extend the KeyHIE community to additional regional hospitals, long-term care facilities, home health organizations and physician practices. In addition to attracting stakeholders, the five-year AHRQ grant is helping to make new clinical applications and document types available within the HIE. 

Geisinger Health System also recently received a Beacon Community award, which builds on KeyHIE's connectivity. The Beacon Community project is focused on utilizing the medical home model to better coordinate care. Focusing on patients with chronic conditions, the Beacon Community project works with KeyHIE to make HIT-supported care coordination available to a community of more than 250,000 residents. KeyHIE empowers care managers with easy cross-team communication and auto-generated notifications of patient encounters to provide effective treatment across the continuum, reducing re-admission rates and total cost of care.

About the author

Jim Younkin is an IT director at Geisinger Health System and director for Keystone Health Information Exchange. For more information on KeyHIE: www.keyhie.org.