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Nationwide health information exchange network is expanding

Surescripts gives participants the ability to send and receive data with any other network member across the U.S. by using a secure messaging system.

By — Posted Aug. 26, 2013

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Efforts to create a national health information exchange network got a boost with the announcement that 19 state health information exchanges, health information service providers and electronic health record system vendors will join the Surescripts network.

The new partnerships represent one of the largest gains for Surescripts, which began as an e-prescribing network but expanded to facilitate other types of data exchange. Participation in the network will allow physicians to exchange information with other health care facilities and physicians locally and across the nation.

Using a secure messaging protocol called Direct, physicians can request and securely send clinical messages containing data such as test results, medication histories and care summaries to and from other physicians with whom they have a relationship. The protocol was developed by the Direct Project group convened by the Health and Human Services Office of the National Coordinator for Health Information Technology as a way of allowing the exchange of information regardless of the type of EHR system or health information exchange technology. It allows disparate systems to “talk” to one another in a secure method compliant with the Health Insurance Portability and Accountability Act.

“This is something that has been a challenge in the medical work force for some time, which is the use of email services to move information about patients. Whether it’s to a referring physician or to support coordination of care, this service allows HealthInfoNet to bring forth a low-cost solution to these practices,” said Shaun Alfreds, chief operating officer of HealthInfoNet, Maine’s statewide health information exchange. HealthInfoNet recently joined the Surescripts network.

Use of the network allows physicians to satisfy the data exchange requirements under the meaningful use incentive program without necessarily joining an HIE. They would just need to use an EHR equipped with Direct capabilities.

Struggles for physician HIE buy-in

Participation in health insurance exchanges among small physician practices has lagged behind that of hospitals and large health care organizations. One challenge has been conveying the financial benefits of joining to physicians.

The National Opinion Research Center at the University of Chicago prepared a report for the ONC in February that looked at HIE participation. The report found that participation among large practices (with 20 or more physicians) was 65% compared with 55% of small practices. Small-practice physicians said their focus was on using EHRs to improve efficiencies, and they reported limited use of the systems for the exchange of information.

The report found that the most immediate uses of HIEs among small practices were to exchange clinical care summary information with local hospitals, and to exchange referrals and consults with specialists.

Another challenge with gaining physician interest in HIE is the perceived impact it will have on work flow. Jeff Miller, senior vice president and general manager of clinical interoperability for Surescripts, said the company addressed work flow when it launched its e-prescribing solution. What made the e-prescribing network so successful, he said, was that it was integrated into the physician’s existing work flow. “We don’t believe in a side-car approach,” he said.

This same approach “can be applied to other clinical work flows,” he said. “And that is the overarching strategy and goal of the organization, which is to take this big build and apply it to a broader set of clinical problems and clinical work flows learned in doing the medication-based work flows for e-prescribing.”

Between 70,000 and 80,000 clinical practitioners have access to the Surescripts HIE, Miller said. The company hopes that clinicians who are familiar with Surescripts because of its e-prescribing network will look to them for their data exchange needs as well.

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External links

“E-Prescribing progress reports,” Surescripts (link)

“Evaluation of the State Health Information Exchange Cooperative Agreement Program: Physician Experiences and Perceptions of Health Information Exchange,” NORC at the University of Chicago, February (link)

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