The Delaware Health Information Network, live since March 2007 and a participant in the Nationwide Health Information Network trial implementations, is now preparing for its next transition.
DHIN has received federal funding through NHIN and the Agency for Healthcare Research and Quality, state-appropriated funding that requires dollar-for-dollar matching in the private sector and grants from local health plans. Participating members pay based on their transaction volume.
DHIN is currently defining a long-term sustainability model, which is expected to be put into place in July 2010, according to Executive Director Gina Perez.
Launched in 1997 by the Delaware General Assembly, DHIN was originally intended to enable administrative transactions. While the network wasn't adopted by health plans, it found new life in 2003 by focusing on the electronic exchange of clinical data.
DHIN was created as a public/private model, with five government officials and 16 private sector individuals comprising the board of directors. The statewide health information network is also determining if its governance model will change – specifically, what the role of government will be, Perez said.
With its health IT partners Medicity and Perot Systems, DHIN provides lab results, radiology reports, admissions/discharge/transfers and medication history queries. Within six months, it will go live with medication history, transcribed reports, electronic order entry and radiology images, Perez said. It will also provide a 'lite' version of an electronic health record (EHR), called an EHR Primer, which sits between a paper-base system and a full EHR.
"We want to provide 'meaningful use' functionality for physicians who don't want to purchase a full-blown EHR," Perez said.
More than half of the state's physicians are using the DHIN network. More than 85 percent of all lab transactions completed for Delaware patients or in Delaware are sent through the system, and 80 percent of all hospitalizations are being reported through the system. Two additional hospitals and several small radiology and lab providers are currently discussing participation.
While DHIN is conducting a formal evaluation of provider satisfaction, post-training e-surveys reveal that 80 percent of respondents believe DHIN will improve their practice's efficiency and 84 percent believe DHIN will improve patient care, Perez said.
Perez credits many factors for DHIN's successes, including long-time commitment from the involved organizations and a strategic, stringent planning process based on consensus of the multi-stakeholders.
"Everybody was really clear on what it is we were accomplishing, how we were going to get there, and what work was needed to get done," she said. Each participant was required to sign a memorandum of agreement that outlines responsibilities, including designating a dedicated project manager to act as a liaison between DHIN and the organization for accountability.
"It's very important for HIEs getting started to take the time to develop a strong plan and to engage all of the stakeholders who will be affected by health information exchange and to build consensus and to get buy-in," she said. "This really is a community-based grassroots project, and it's very important to have that collaboration in the beginning."
