Over the past month, Colorado has successfully demonstrated its ability to share patient data securely among four health and hospital systems across the state.
Within two years, the Colorado Regional Health Information Organization, or CORHIO, plans to connect additional regional and enterprise systems by expanding its clinical messaging capability to those systems, said executive director Phyllis Albritton.
The goal of the December "go-live" was to establish a point-of-care inquiry system, but having clinical messaging, which includes e-prescribing and access to lab data, will provide a complete health information exchange environment, she said.
Established in 2007 and with a 20-person board comprising multi-stakeholders, the nonprofit organization resulted from the convergence of two projects. A grant by the Agency for Healthcare Research and Quality enabled the University of Colorado to develop a regional demonstration project, which culminated in the December 1st health information exchange launch. Another grant enabled community outreach and understanding of the benefits of health information exchange.
"It was useful to have everyone at the table from the beginning," Albritton said. Gov. Bill Ritter has been "very supportive" of CORHIO, she said. Much of the funding and investments thus far have come from federal and state grants, foundations, including $2 million from the Colorado Health Foundation, and other stakeholders, including the regional and national payers in the state.
Colorado is unique in that its population is relatively healthy and young, but it has pockets of healthcare issues such as diabetes and infant mortality, Albritton said. On top of that, the state's many rural and frontier regions suffer from a shortage of healthcare providers, with its 10,000 physicians practicing in small groups versus large, multi-specialty groups.
Health information exchange can allow people to stay in their communities, she said. "It also becomes valuable to everyone," she said, because of its ability to enable specialists outside of the system to provide support.
With the demonstration successful, CORHIO will look to move beyond the "very sophisticated, very vertical integrated systems" in the pilot and facilitate health information exchange to the general population, said Albritton.
The next steps, beginning in 2009, are to work with the state's local successful exchanges such as Quality Health Network in Grand Junction, and help provide integration and interoperability, as well as robustness within their own framework, Albritton said. One of the projects will be creating interoperability among immunization registries across all systems, she said.
The Dec. 1 rollout to The Children's Hospital, Denver Health and Hospital Authority, University of Colorado Hospital and Kaiser Permanente Colorado is enabling emergency department clinicians to make better clinical decisions by querying the system during a patient presentation. In one instance, an ED physician avoided duplicative testing, thanks to accessing the patient's data from another visit to another hospital, resulting in a $2,000 savings, said Albritton.
In another situation, the ED physician accessed data on a patient and found that instead of the self-reported two medications the patient was actually taking a total of seven medications, she said. "It made a huge difference in how that patient was medically managed," she said.
A formal evaluation is underway to establish the business model for sustainability and the metrics and mechanisms to measure the system's success, but these and other anecdotes show that CORHIO has already demonstrated improved patient safety and clinical decision making, said Albritton.
