The Central Illinois Health Information Exchange (CIHIE) has contracted with the Informatics Corporation of America (ICA) to provide IT for a new health information exchange (HIE) to serve approximately 1.3 million people in the region.

Under the contract, ICA's CareAlign patient-centered information management platform will link to CIHIE's existing patient information systems, called AllCharts. CareAlign's ability to extract patient-specific data from multiple systems, while also enabling data exchange among systems, will help CIHIE give clinicians greater access to patient data. The CIHIE service area includes 27 hospitals, 20 health departments, 2,800 physicians, 280 pharmacies, 12 labs and imaging centers, and numerous ancillary healthcare providers across 20 counties in the Peoria, Bloomington, Champaign, and Decatur areas of Illinois.

With many of these organizations using a variety of health IT tools from vendors such as McKesson, Meditech, Epic, Medicity, and GE Healthcare, Gary Zegiestowsky, ICA's CEO, said the goal is to bring together as many of the pieces of a patient's record as possible so that healthcare providers can quickly access patients' medical information, avoid duplicating tests, prevent medication errors, and realize significant cost savings by utilizing the HIE.

"Our core interoperability engine is a secure cloud-based solution that provides for the aggregation of longitudinal patient information across participants, allows that information to be accessed through standards-based protocols, and supports direct "push-based" messaging among participants," Zegiestowsky said in an interview with InformationWeek Healthcare. He also said ICA will provide CIHIE with a secure clinical portal that will give participants who are not able to interact with the HIE through their clinical system the ability to access, share, and communicate patient information securely with other participants. CIHIE plans to host the clinical portal in an internal cloud-based model.

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In a statement that outlined what CIHIE expects to achieve, Joy Duling, interim executive director of CIHIE, said ICA's project initiation workflow methodology will help the exchange develop use-cases and identify measurable goals.

"CareAlign will provide us with core technology tools to achieve transformative changes to healthcare in the region, such as primary care medical home and informed care coordination teams," Duling said. "We also see the solution improving transitions of care from hospitals to the ambulatory setting, from emergency departments to follow-up care and supporting the transfer of trauma patients to trauma centers."

Like so many HIEs that seek to link several data systems at hospitals, pharmacies, physician practices, and other healthcare delivery organizations, Zegiestowsky said implementing an HIE at a time when many healthcare delivery organizations are adopting electronic health records (EHR), computerized physician order entry systems, and other health IT tools to achieve Meaningful Use presents both advantages and difficulties.

"To our advantage, organizations are painfully aware of the need for interconnectivity. However, planning for that interconnectivity is also like taking aim at a moving target as IT departments and EHR vendors are rolling out new versions of EHRs and other information systems," Zegiestowsky said.

He also noted that many healthcare organizations have been focused on exchanging information within the boundaries of their own organizations. The idea of a patient's data traveling with the patient, even if that means outside their own walls, has been a hurdle for some.

"There is often a fear that new technology won't be presented in a way that will be helpful to clinical workflow. Clinicians want assurance that the new system will not only be secure, portable, and accessible, but also contextual so that it helps them perform their job for the patient better," Zegiestowsky added.

CIHIE has signed up participants to begin immediate implementation of the exchange. These include: Advocate BroMenn Medical Center in Normal; Decatur Memorial Hospital; Easter Seals; Heartland Community Health Clinic; the Human Service Center, a subsidiary of Fayette Companies; Methodist Medical Center of Illinois; Proctor Hospital; OSF Saint Francis Medical Center; St. Mary's Hospital in Streator; St. Mary's Hospital in Decatur; and the University of Illinois College of Medicine at Peoria.

Implementation of ICA's software is currently underway at CIHIE charter member organizations and their clinicians are scheduled to begin utilizing the system in January 2012. As adoption increases, plans are to add other functionality and features to CIHIE such as a patient portal and clinical dashboards.

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