Many of the healthcare reform proposals put forth by Democrats are expected to carry with them high price tags. A bright spot that exists is potential savings from a requirement for doctors and hospitals to use health information technology, including electronic medical records, as a condition of participating in Medicare. Officials says that such a requirement could save the federal government $7 billion in the first five years and a total of $34 billion over 10 years, by reducing medical errors and avoiding unnecessary tests and procedures.
The Nationwide Health Information Network will become reality very soon when the Social Security Administration performs a preliminary test of the new system in February 2009. The NHIN's trial run will be used to determine benefits eligibility for the SSA's 2.6 million annual disability claims.
The NHIN's rollout—even in its limited form—is considered a major milestone because until now, the public-private "NHIN Cooperative" has only performed trial implementations based on fictitious patients. This test run will have the real-life benefit of greatly decreasing the time it takes to determine disability eligibility, says SSA Commissioner Michael Astrue. "This safe and secure method for receiving electronic medical records will allow us to improve our service to the public by cutting days, if not weeks, off the time it takes to make a disability decision," he said in a release.
The SSA is working with MedVirginia, the North Carolina Healthcare Information and Communications Alliance, and Kaiser Permanente to implement the NHIN. In early 2009, the first exchange of information will begin between Social Security and MedVirginia, with the assumption that if all goes well, the SSA will expand the trial to include North Carolina and Kaiser Permanente.
Work on getting the NHIN up and running has been frenzied since September 2007 when the Department of Health and Human Services awarded contracts totaling $22.5 million to nine health information exchanges to begin trial implementations of the Nationwide Health Information Network. During the fifth forum on the NHIN held in Washington on December 15-16, officials said they fully expect that the millions handed out in federal grants last year will soon begin to yield results as each of the nine HIEs gets up and running and begins to exchange actual health information with the medical community.
But even outside of that funding for those nine HIEs (which can be found here among the rest of the members of the coalition), other states are working hard to create their own HIEs.
Colorado recently announced it has become one of the first states in the nation to share electronic health information securely between hospitals and healthcare organizations at a statewide level. Currently, 500 emergency clinicians are being trained to use the system, which shares a host of health information across emergency departments at The Children's Hospital, Denver Health and Hospital Authority, and University of Colorado Hospital, as well as Kaiser Permanente Colorado. The CORHIO system, which began in 2004, was funded by a mix of federal and state agencies, as well as funding from several insurers.
Meanwhile, Idaho just announced that the Idaho Health Data Exchange will connect two hospitals and a physician group in January 2009 as part of a goal to have 100 physicians and three hospitals join the network by June 2009. That HIE was funded by the state and charges participating fees.
There is no doubt that this announcement from the NHIN coalition is big news. They will soon actually be exchanging actual information that will provide real-life benefits. And each step toward interoperability made by individual states gets us one step closer to that "network of networks" the Bush Administration envisioned occurring by 2014. Now, with President-elect Obama pledging to keep technology and healthcare reform at the forefront of his agenda, is it possible that the nation could reach that 2014 goal?
Based on talking to many of you, I remain doubtful. Yes, these are big steps, but it's going to take many, many more like them to reach the bigger picture of complete national interconnectedness.
Kathryn Mackenzie is technology editor of HealthLeaders magazine. She can be reached at kmackenzie@healthleadersmedia.com.
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