Health Information Exchange Planned For D.C.'s Medicaid Patients

The nation's capital is launching a new health information exchange to improve care for Medicaid patients while reducing costs by weeding out fraud and inefficiency.

The Department of Health Care Finance, or DHCF, is Washington, D.C.'s Medicaid agency that pays for the medical care of about 150,000 low-income beneficiaries, including the city's homeless population. With the help of federal funding, DHCF has awarded a $7 million contract to MedPlus, the health IT subsidiary of Quest Diagnostics, to implement the new health information exchange, dubbed Patient Data Hub.

MedPlus will provide services and technologies--including its Centergy Clinical Portal and Data Exchange Engine--to securely collect, store, manage, and integrate clinical data from multiple care sites. The Centergy products also will give clinicians a centralized view of the data.

The data hub's pilot program will let clinicians in selected D.C. hospitals and clinics access and share data pertaining to Medicaid patients, including information on their medication histories, lab results, and allergies, as well as demographic data. Much of this data initially will come from admissions, discharge, and transfer records, generated by in-patient facilities, such as hospitals, said MedPlus president Richard Mahoney.

MedPlus also will provide predictive modeling software to let DHCF identify Medicaid patients at a high risk for developing complications from chronic conditions like diabetes. Eventually, those tools also will be used to alert physicians to care patients need to prevent complications that could require costly hospitalization and other treatments, Mahoney said. For instance, it would alert doctors when a diabetic patient is overdue for a glucose test or foot exam.

In addition to improving care, the data hub will also curb costs by weeding out unnecessary and redundant tests, a DHCF spokeswoman said. The system is also expected to deter billing and other fraud.

Many of D.C.'s Medicaid patients are transient and homeless, according to the spokeswoman. If a homeless patient gets care at one clinic and later shows up at another, doctors at the second clinic will sometimes unknowingly order tests that were already performed. Patient Data Hub will let doctors know what lab test results and other data is available for a patient from previous visits to D.C. facilities.

That sort of data access can also red-flag potential complications and save lives, said Mahoney.

For instance, results of a recent lab test ordered by one physician might show a blood measurement indicating potential renal problems in a patient. This information guides a subsequent doctor treating the patient to prescribe medications that won't damage the patient's kidneys, Mahoney said.

Patient Data Hub will give D.C.'s "most vulnerable residents one less thing to worry about, while simultaneously providing efficiencies in care that will help to improve the quality of healthcare delivered," said Dr. Julie Hudman, director of the DHCF in a statement to InformationWeek.

While the initial focus of the program is on Medicaid patients, it could be used for other patients in the future, the spokeswoman said. MedPlus technologies and services have been part of other regional health information exchanges, including ones in Ohio and New York City, said Mahoney.