Western Pennsylvania Gets Its First Health Information Exchange

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Nine hospitals and healthcare systems are coming together to form what they say is the first health information exchange in Western Pennsylvania.

Called ClinicalConnect, the exchange will incorporate an electronic master patient index (EMPI) to allow bidirectional transfer of patient summaries in the Continuity of Care Document (CCD) format, according to Jacque Dailey, VP of IT solutions for medical science, research, and patient-centered accountable care at the University of Pittsburgh Medical Center (UPMC).

UPMC, the largest healthcare provider in the region, is one of the founding partners in ClinicalConnect, which is being set up as an independent not-for-profit organization, Dailey said. Also participating in the launch are Altoona Regional Health System, Armstrong County Memorial Hospital, Butler Health System, Excela Health, Heritage Valley Health System, Jefferson Regional Medical Center, St. Clair Hospital, and The Washington Hospital.

Executives at UPMC and other founding members began discussing an HIE nearly two years ago, according to Dailey. It has taken about a year of actual work to formalize the business structure of ClinicalConnect and draft bylaws.

ClinicalConnect has chosen dbMotion to build an aggregation platform, using an EMPI developed by Initiate Systems, a company bought by IBM in 2010. UPMC is a major health IT development partner with IBM.

"That's actually the first, and I would say, our most important step," Dailey said of the EMPI. The inability to build a workable master patient index has been the Achilles' heel of many failed HIEs and regional health information organizations, a preferred term from the mid-2000s.

Another key ingredient in sustainability is user acceptance. "We are really paying attention to how the clinician views the information at the bedside," Dailey told InformationWeek Healthcare. She said that CIOs from the nine organizations have a conference call every Monday morning to "make sure clinicians are enabled by technology."

The plan is for each participating health system to embed the HIE into regular workflow. One way they accomplish that is by placing an icon on electronic health record (EHR) screens indicating that there is more information available on a specific patient. "Once a clinician has selected a patient's information, it's entirely appropriate to give them access to this additional information," Dailey said.

It will be up to each health system or hospital to integrate the CCD into its own EHR, and not all participants have EHRs in place yet. However, Dailey said that UPMC has used the Initiate EMPI for years, and that Heritage Valley Health System also has a working EMPI. "Many of the partner organizations now can exchange CCDs," Dailey added.

Within the next four to six months, ClinicalConnect will launch the network with a pilot between UPMC and Heritage Valley, which serves areas west and northwest of Pittsburgh. It will take about 18 months to get all nine founding organizations live, Dailey said.

The founders have contributed to ClinicalConnect's startup, and the HIE has set a budget for the next two years. Beyond that, however, funding is uncertain. "We still need to build the model to bring in additional partners," Dailey said. Those likely will include independent physician practices and skilled nursing facilities, she explained.

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