It4doctors in English /Marathi
News & Events

Shared Network Beginning To Help Doctors Get Patient Information Fast

03 March 2012
By Guy Boulton

Chris Decker, an emergency medicine physician, typically sees 22 to 24 patients in an eight–hour shift at Froedtert Hospital.

The Wisconsin Health Information Exchange influences the way he treats three or four of those patients.

That number is almost certain to increase in coming years.

The Wisconsin Health Information Exchange has set out to build a network that eventually would give doctors and other health care providers in southeastern Wisconsin quick access to a patient's basic medical history.

The exchange, started in 2008, is still in its earliest stages. But as more information is added each year, it will help doctors such as Decker make better decisions.

"That's what the exchange really is about – providing more information to inform decision–making," said Kim Pemble, executive director of the Wisconsin Health Information Exchange.

For now, the exchange provides only limited information, such as recent emergency department visits, on some patients. But even that limited information is useful.

Shared Network Beginning To Help Doctors Get Patient Information Fast Chris Decker (center), director of clinical services for Froedtert Hospital's emergency department, talks with physician Chris Mitros (left) and physician assistant Deb Marciniak. The Wisconsin Heath Information Exchange is helping doctors such as Decker make better decisions about patient care.

Surveys have found that when information is available from the exchange, it influences doctors' decisions 40% of the time.

The result can be better care and, at times, lower costs by reducing duplicative tests and unneeded care.

Pemble cites the example of a patient in his or her 30s who arrived at an emergency department with shortness of breath.

Information from the exchange showed that the patient was being treated for congestive heart failure, a rare disease for someone that age. As a result, the physician could make a quicker diagnosis.

The exchange initially has focused on hospital emergency departments, where physicians often must diagnose patients with little or no solid information on their medical histories.

It is being used at 13 hospitals, including all those in Milwaukee County except the Zablocki Veter ans Affairs Medical Center.

Other hospitals include Wheaton Franciscan Healthcare–Elmbrook Memorial and Columbia St. Mary's Hospital in Mequon. Wheaton Franciscan Healthcare–All Saints in Racine and Aurora Medical Center in Grafton will be added within a few months.

Outreach Community Health Centers also is using information from the exchange. And Sixteenth Street Community Health Center and Progressive Community Health Centers are scheduled to begin using it in the first half of this year.

Outside emergency departments, patients must give their consent for physicians and other health care providers to access their medical information.

Building on basic data

The Wisconsin Health Information Exchange can provide doctors and other health care providers with a history of a patient's visits to emergency departments. If the person is covered by Medicaid, information culled from claims data on recent doctor visits or hospital admissions as well as prescriptions is available.

There also is basic information on hospital admissions, including allergies and primary care physicians, for Aurora Health Care, Columbia St. Mary's Health System and Wheaton Franciscan Healthcare.

Columbia St. Mary's Health System and Wheaton Franciscan Healthcare also are sending information to the exchange on physician visits. And Sixteenth Street Community Health Center is sending a "continuity–of–care document" that includes a patient's medications, health problems, allergies and the physician notes.

Each bit of additional information increases the exchange's value, and that cumulative process is expected to continue.

"It has power today," said Joy Tapper, executive director of the Milwaukee Health Care Partnership, a coalition that includes the chief executives of the five health systems in Milwaukee County. "But its full potential won't be realized for several years."

The push to move from paper to electronic health records helps.

That's fairly far along in southeastern Wisconsin. But incentives included in the federal recovery act for hospitals and doctors have provided an additional prod.

The software for electronic health records must meet certain standards, known as "meaningful use," for hospitals and doctors to receive the incentives and to avoid potential penalties beginning in 2015. The standards are being phased in, and the most recent stage requires electronic health records to be able to exchange information, such as past diagnoses and test results.

The ultimate goal is a nationwide network. But that is easily a decade away.

A national survey done in December 2009 found that 80 exchanges were up and running and 82 were in the planning stages, according to a 2010 report from the Robert Wood Johnson Fund.

A more immediate goal is a statewide network. That effort is being led by the Wisconsin Statewide Health Information Network, an independent nonprofit organization that initially plans to create a network of networks.

The exchanges in southeastern Wisconsin, Madison, Eau Claire and Superior and Duluth, Minn., could be the initial building blocks.

Financial support

The biggest obstacle isn't technology. It's money.

The Wisconsin Health Information Exchange has a budget of $1.6 million for this year and four full–time employees.

The health systems in Milwaukee County are supporting the initiative financially as well as providing technical support. The exchange also has a federal grant, through the state Department of Health Services, for detecting disease outbreaks, one of the system's features.

But Pemble, the executive director, said, "We have to engage others in this initiative."

Humana is supporting the exchange financially. So, too, is iCare, a joint venture of Humana and the Milwaukee Center for Independence, which manages the care of people with complex medical problems covered by Medicaid. And Molina Healthcare, one of the four managed care organizations that contract with the state to administer the BadgerCare Plus program in southeastern Wisconsin, plans to help support the exchange.

"It's working very well," said Albert Tzeel, national medical director for Humana One, the Humana unit that sells insurance to individuals and their families. But he added, "There still is a lot of potential we haven't tapped."

For now, the Wisconsin Health Information Exchange will continue to add to its database, knowing that as more information becomes available through the exchange, more people will use it.

That networking effect works in its favor.

The long–term plan is for the exchange to pull information from electronic health records in hospitals and clinics throughout southeastern Wisconsin and eventually the state.

All this will take time. But 10 years from now, Decker, the emergency medicine physician at Froedtert Hospital, envisions the exchange having information on patients' medical histories, conditions, lab results and prescriptions.

"We'd have that information available at our fingertips to make the best decisions for patients," he said.

Disclaimer: The news story on this page is the copyright of the cited publication. This has been reproduced here for visitors to review, comment on and discuss. This is in keeping with the principle of ‘Fair dealing’ or ‘Fair use’. Visitors may click on the publication name, in the news story, to visit the original article as it appears on the publication’s website.