October 16, 2009

An Interim Approach To Sharing Patient Information Within Safety Net Providers

Filed under: Uncategorized — HankMayers @ 5:47 pm

It is generally known that the patients that  are served within the health care ‘saftey net’ are very mobile.  This, of course,  plays havoc with providing continuity of care. And enhancing the ability of the primary care physician (PCP) to deliver such care is one of the cornerstones of most versions of Health Care Reform being debated in the US Congress. Similarly, the safety net has a great need for the kinds of information sharing that goes to the heart of the objectives that lie behind the federal ‘meaningful use’ criteria in the recent ARRA Stimulus legislation.

In the health care safety net, one finds a wide array of providers: publically-funded hospitals, charitable hospitals (especially their emergency departments), federally-qualified clinics, rural health clinics, rural hospitals, nurse-managed clinics, private inner city clinics, etc. Many of these organizations are beginning to invest in various kinds of HIT (such as EMRs, e-prescribing, etc). The federal HRSA funding is a major provider of such funding, but its provider scope has been somewhat limited until quite recently. While the ARRA and its stimulus funds has not ignored this constituency, there is still is a need for a lot more clarity on how they can secure funds through related channels such as the states’ share of the stimulus program and the HITECH provisions of ARRA.

In the meanwhile, the inter-networking capability inherent in the NHIN/HIE funding would seem to be a very high priority/opportunity for the safety net providers. For this is the technology that promises to link them together in a way that will allow any PCP serving these very mobile patients to always have the full picture when a patient is presented. Until ED usage by this constituency can be deflected to other abulatory providers, ED units will be equally grateful to have this information at their finger tips.  It seems that a big question is: What data sharing arrangements can be made via the HIE  for little or no addtional costs to the safety net providers while this sector tries to secure funding for EMR technology?  For instance, the comprehensive EHR, that is expected to be continually updated inside of the HIE with summary information from care transactions, would seem to provide a valuable ‘minimum data set’ that could be used and updated by safety net providers. This would serve as their “EMR-Lite” until such time as they secure sufficient funding to embark  on a fuller EMR implementation.

This could serve as a high-priority objective for the HIE planning that is part of the current wave of state applications for federal HIE funding under HITECH. The recent federal guidelines relative to the regional extension centers (RITECH) already are placing an emphasis on services to safety net providers and the medically underserved. How about a similar expectation for the HIEs? This could come together quite nicely.

Comments anyone?

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