Maine’s culture is to “get things done” – and when it comes to improving the quality of care through IT, the state has positioned itself well, said its director of the Office of the State Coordinator for HIT, James Leonard.
The Office of the National Coordinator granted Maine $6.6 million to create a statewide health information exchange by 2015. At a recent regional extension center educational forum, Leonard said 72 percent of those funds support the exchange, while the remaining funds are being used for updating privacy and security issues around personal health information.
Leonard said PHI issues are being addressed by a work group created by Maine’s HIT Steering Committee. One issue they’re addressing is how HIV patients can benefit from the exchange, since state law currently doesn’t include conditions such as HIV.
Having HIV records as part of the exchange could be life-saving, said Jill Devereaux, RN, a health population nurse at Martin’s Point Health Care in Portland, Maine. She was part of a project in Louisiana that involved deploying an EMR for HIV patients in seven clinics. Not long after this project went live, Hurricane Katrina hit.
“It saved a lot of lives to have those patients’ medication lists,” Devereaux said. “You don't know the unexpected benefits you will find.”
Leonard said one of the goals of the exchange is to coordinate public health information and identify patterns for early warning – something he said would have been helpful last year in dealing with H1N1 cases.
Leonard offered an example of what the exchange aims to achieve. When the Department of Health and Human Services takes a child into protective services, he said, no medical records accompany that child to a foster family, including such data as an immunization history. This may seem like something small in the scheme of things, he said, but for a child who has already been through a traumatic experience, this can be especially difficult.
“The exchange will bring children’s records in state custody in front of providers who are treating them. These are the kinds of outcomes, goals that we hope that the HIE and HIT plan in our state will achieve,” said Leonard.
Maine’s state health information exchange, HealthInfoNet, is already operational, something few states can claim, said its COO, Shaun Alfreds. He said there is about a 40 percent adoption rate of EMRs in the state (the national average is around 20 percent), and 70 percent of practices in the state are affiliated with larger health systems, the largest of whom are participating in the HIE.
HealthInfoNet offers a centralized model, said Alfreds, that takes information from providers and ensures it meets national standards before sending it back out. Information on 780,000 of Maine’s roughly 2 million residents is located in this repository, he said.
The goal is to have all 30 hospitals in Maine and 80 percent of all ambulatory care providers connected by 2014, he said.
HealthInfoNet also serves as the state’s regional extension center, which was created to help providers achieve meaningful use of HIT. Vendors supporting providers enrolled with MEREC are eligible for up to $3,550 per provider. As part of the REC’s service, it is negotiating discounted prices for EMRs.
“We are trying to get the lowest cost out to providers for EMRs. The vendor has to demonstrate that they are the lowest price in the market and if they go lower with some other organization or REC, that we will get that price,” said Alfreds.
