Health Information Exchanges

Computerworld - This version of this story originally appeared in Computerworld's print edition.

A national electronic health record exchange is far from a reality, but a few local health care exchanges have emerged in the U.S. These allow member provider organizations to share electronic health record data, giving physicians a unified view of a patient's medical history.

The Massachusetts Health Data Consortium has organized a regional health information sharing initiative called MA-SHARE (for "Simplifying Health Care Among Regional Entities"). MA-SHARE has created two exchanges. The first was an e-prescribing gateway between two Boston-area hospitals. The second enables several providers to share patient discharge and emergency room summaries. The cost savings from eliminating paper handling, storage and routing have been enough for member hospitals to consider funding the project on an ongoing basis, says John Halamka, CEO of MA-SHARE.

The key to success has been grant funding and contributions from large health care organizations. Such local information-exchange efforts may ultimately succeed, but a national health information exchange can't be funded by local stakeholders, Halamka says.

The Regenstrief Institute's electronic medical records system aggregates data on 6 million patients from 34 providers and allows a doctor to view all data for a given patient in a single, virtual record. Rather than forcing each provider to change its data format, the institute provides the middleware to convert everything into a common format.

The Regenstrief Institute contributes $2.8 million of the annual $19.5 million budget; the balance is largely funded by federal grants, although some funding comes from local health care institutions. The organization has also procured ongoing funding for related services. For example, the exchange creates a repository of health data that the institute has mined to create a system for alerting public health officials to disease outbreaks.

But getting health care providers to lay their dollars on the line has been a tough sell, says medical informatics researcher Shaun Grannis. "They're just beginning to understand the value of a system like this," he says.