Colorado HIE Cuts Costs To Attract Physician Network

8 Health Information Exchanges Lead The Way

The Integrated Physician Network (iPN), a large, multi-specialty association of independent practices affiliated with Centura Health, has finally agreed to join the Colorado Regional Health Information Organization (CORHIO). iPN agreed to do this only after CORHIO reduced its annual charge to connect to health information exchange from an estimated $150,000 to about $43,000. Also, implementation fees have been waived for the rest of this year.

While strengthening CORHIO, iPN's deal with the health information exchange (HIE) shows the challenges confronting HIEs as they try to connect providers across communities and regions.

Last year, iPN, which includes more than 200 physicians, balked at joining COHRIO because of the cost involved. Back then, the HIE was charging $85 per provider per month, plus implementation and training fees that started at $2,500 per practice, Ako Quammie, director of information systems for iPN, told InformationWeek Healthcare. In addition, physicians had to pay their EHR vendors for writing interfaces to COHRIO.

A number of providers complained about the HIE's charges, Quammie said, and COHRIO reduced them across the board. Meanwhile, iPN had already linked together its own physicians, all of whom use the same EHR. Since iPN required only one interface with CORHIO, iPN's leaders convinced CORHIO that its rate should reflect the economies of scale that iPN was providing.

Because of its affiliation with the 13-hospital Centura healthcare system, iPN already had electronic links with most of the providers that belong to CORHIO in the Front Range area of Colorado. But by joining CORHIO, Quammie said, iPN will also now have access to data from community hospitals in Boulder and Longmont, Colo., as well as a few other hospitals in central Colorado.

[ Looking for a PACS platform to replace an outdated system? See 9 Must-See Picture Archiving/Communication Systems. ]

"Initially, we'll see most of the influx from Boulder Community Hospital, which is geographically close to the bulk of iPN practices," Quammie noted.

iPN members will receive COHRIO data in their EHRs but will not be able to send information to other providers through the HIE, at least for now. So the main value of the HIE to iPN members will be the ability to receive hospital, lab, and imaging reports from providers outside of their network, Quammie said. "Say a primary care physician's patient ends up at an ER in Colorado Springs. If that hospital is connected to CORHIO, the doctor will receive a discharge summary and information on that patient visit."

COHRIO plans to introduce a secure clinical messaging service that will allow its members to exchange clinical summaries and other information, Quammie noted. The CORHIO website indicates that such a service is in the works, and the iPN announcement states, "In the future, the HIE is scheduled to be upgraded to include additional data types and functionality."

Larry Wolk, MD, CORHIO's CEO, was unavailable for comment at press time. But he said in a press release, "We're delighted that the health care providers of iPN will soon have real-time access to more comprehensive and complete patient information, enabling them to provide higher quality, more timely and cost-effective health care. Because their patients' data will be seamlessly accessible from their EHR application, it will save the providers' time too. It's a 'win-win' solution for everyone."

However, Quammie still wonders what effect the HIE will have on the cost of care. "CORHIO is definitely going to help the dissemination of healthcare information. The question that's always on my mind is about the cost savings afforded by having an HIE in place. Will having this traffic light that everyone connects to actually save money?"

What have been shown to cut costs, according to Quammie, are models like the patient-centered medical home, which focuses on changing how care is delivered at the practice level. HIEs provide a quicker way of obtaining data, he said, but they don't actually do the work of healthcare transformation.

iPN itself, he said, is committed to quality improvement. Since 2004, when it was launched as an entity to help physicians acquire a common EHR at an affordable cost, the network has compiled quality data from its providers. Recently, Bridges to Excellence, an employer-sponsored pay for performance program, certified iPN for excellence in diabetes management. iPN supplied all of the requisite data, Quammie said, without requiring its physicians to do any additional work.

InformationWeek Healthcare brought together eight top IT execs to discuss BYOD, Meaningful Use, accountable care, and other contentious issues. Also in the new, all-digital CIO Roundtable issue: Why use IT systems to help cut medical costs if physicians ignore the cost of the care they provide? (Free with registration.)