Effort Underway to Link Safety Net Clinics with Health Information Exchanges

KANSAS CITY, Mo. – Regional healthcare officials say they are close to hiring a consultant to assist safety net providers establish a computer network aimed at providing better care while reducing costs.

Officials with the Regional Health Care Initiative (RHCI) are conducting final interviews with three companies that could help the safety net providers connect to patient-record-sharing networks known as health information exchanges.

The hope is to have the consultant working on the project by March 1, said Scott Lakin, RHCI executive director.

The plan is to have the work start in Wyandotte County, he said, then move into Johnson County and on to the Missouri side of the state line by mid-summer.

Project leaders continue to seek foundation funding for the $500,000 project. Lakin said they have raised about $100,000 so far.

Health reform advocates view health information exchanges as key components of the drive to provide better-coordinated patient care.

“We think the timing is perfect as far as getting these safety nets on board and on board quickly,” Lakin said of the project. “We think it lines up really well with the Affordable Care Act and some of the things regarding integration and patient-centered homes.”

By making patient records securely available electronically to all the providers a patient might see, advocates say, the exchanges could help reduce or eliminate duplicative tests and prescriptions.

As envisioned, the networks would connect across state lines so that at some point, for example, a doctor treating an accident victim in California could pull up the patient’s primary care records from Kansas.

Exchange operators are now working to ensure communication with bordering states.

Lakin said safety-net patients present a particular challenge.

“They are pretty mobile and they don’t always go to the same place for care,” he said, “so (an exchange) really emphasizes the advantages and the need to keep track of treatments, so you don’t double up on immunizations, you don’t double up on testing, and things like that.”

According to the request-for-proposals issued by the healthcare initiative, officials want the consultant to also help safety-net providers prepare for certain situations, such as a pregnant mother at risk of having a low-birth-weight baby or a patient with a chronic disease with the high potential for readmission to the hospital.

The three major exchanges serving the Kansas City area are: Kansas Health Information Network (KHIN), Lewis and Clark Information Exchange (LACIE), and Missouri Health Connection (MHC).

The operators vie for customers at the same time they cooperate to ensure patient information flows between their systems.

“We call ourselves collaborative competitors,” Mike Dittemore, LACIE executive director, told a group of safety-net providers at an informational meeting on Monday, where leaders of the three organizations made presentations to an RHCI committee.

KHIN and LACIE are the two health information organizations approved to exchange electronic patient records in Kansas. Both networks went live this summer.

KHIN has more than 200,000 patients in its system, and LACIE has records on about 300,000 patients, officials said.

Missouri Health Connection is the state-designated organization building the health information network throughout Missouri. Its board includes the head of the state Medicaid program along with the directors of the departments of Health and Senior Services and Social Services.

MHC is working with an initial group of five providers outside the Kansas City area. Chief Operating Officer Mindy Mazur said this group, which includes St. Louis-based BJC HealthCare, has nearly 40 percent of the inpatient beds in the state.

Mazur said the organization is actively recruiting clients in the Kansas City area.

She also said MHC took a significant step last month when it established connections with KHIN and the Nebraska Health Information Initiative to send secure messages between the three systems.

Lakin said the pace of agreements between major providers in the area and the exchanges has quickened lately.

Truman Medical Centers, for instance, is working with LACIE.

KHIN’s roster includes a number of safety-nets and public providers, such as the Health Partnership Clinic in Johnson County and the Johnson County Department of Health and Environment.

Saint Luke’s Health System and HCA Midwest Health System are among the major providers in the area that remain undecided.

In an email to KHI News Service, HCA Midwest’s vice president of physician systems, Paul Klehn, said the company already has an internal exchange that provides hospital records to its employed and affiliated physicians at no charge.

In addition to the drawback of having to pay to be part of one of the area exchanges, Klehn said, there are “significant security, privacy, and liability challenges in sharing private patient data through a community HIE.”

As the chair of the RHCI committee that convened Monday’s meeting, Marsha Morgan said she was encouraged by what she heard. She is chief operating officer for behavioral health at Truman Medical Centers.

She said she liked the competition among the exchanges.

“People will put together good products,” she said, “because they know there is someone else who would gladly take on the job.”

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