Patients in Rhode Island will soon have a choice regarding whether they will allow their protected health information shared through a statewide health information exchange. The exchange will also allow their providers access to lab data and medication history.
The HIE—termed currentcare—is a secure electronic network created with a $5 million federal grant that the Rhode Island Department of Health received in September 2004 when Rhode Island was chosen as one of six states to receive funds from the Agency for Healthcare Research and Quality. Rhode Island subcontracted with the Rhode Island Quality Institute to provide governance for the initiative, the first phase of which is set to go live in the fall.
The exchange of electronic health information is at the forefront of health leaders' minds these days, particularly because the American Recovery and Reinvestment Act earmarks $300 million specifically for these types of developments. HIEs—the mobilization of healthcare information electronically across organizations or within a region, community or state—is one way of sharing data in this way.
"I think the government is really clear on how important the health information exchange component is to achieving our goal of safer, higher quality, and more efficient care," says Laura Adams, president of CEO of the Rhode Island Quality Institute, adding that currentcare plans to tap into the funds that would support a more robust capability for data exchange into and out of electronic medical records.
"Our plan is to interface all providers and sources of clinical data, such as labs, pharmacies, radiology centers, and hospitals into the system soon and as well as bring in data from physician's offices," Adams says. "Our funders have said we need to exchange data in and out of EMRs sooner rather than anticipated, so we're applying for the available stimulus funding. If we're able to get stimulus money, we can certainly ramp this up and shorten our timeline considerably."
currentcare is a Web-based application that allows physicians to sign in, be authenticated, and access laboratory information from three different labs in the state as well as information about medication history from retail pharmacies statewide. Provided the HIE receives stimulus funds, providers will have the ability to pull information out of the exchange and download it into their EMRs rather than having to read information through a Web viewer, Adams says.
Physician offices don't need an EMR to participate in the HIE, Adams says. "EMRs aren't interoperating with each other. It would involve numerous, expensive connections. Instead, they operate with a center into which all of the data flows versus everyone having to connect with everyone else."
In an effort to ensure the privacy and security of the PHI exchanged through the HIE, Rhode Island passed the Rhode Island Health Information Exchange Act of 2008 that took effect March 1, 2009. The legislation includes numerous explicit consumer safeguards, clear language that participation in the HIE is voluntary, strict penalties for misuse of the system, and created an HIE Advisory Commission that will make recommendations to the Rhode Island Department of Health regarding the use of confidential PHI used in the exchange.
Patients not only choose whether to participate in currentcare, but they also control which providers have access to the information as well as in what scenarios (i.e., emergency versus routine versus both) providers can access that information.
The Rhode Island Quality Institute recently started efforts to educate and enroll consumers in currentcare, which now has 2,300 members. Adams says it will continue to grow. "We think this will save lives. We think it's much more efficient that the current paper-based system, and that it reduces complications and the chances that people experience a medical error."