HealthAlliance Hospital and Fallon Clinic are the first two healthcare organizations to go live with SAFEHealth (Secure Architecture For Exchanging Health Information), a regional health information exchange based in Worcester, Mass.

When Fallon Clinic patients at HealthAlliance Hospital's emergency department give their consent, ED physicians can access their medical charts from the clinic in real time. Armed with relevant clinical data, ED physicians can deliver care in a timely, cost-effective manner.

 "Our basic belief is the use of technology can significantly improve patient safety," said Val Slayton, the CMO of HealthAlliance. "Our doctors need information on the patient at the point of care to impact clinical decisions."

Fallon Clinic, and partners Fallon Community Health Plan and the UMass Memorial Health Care System, developed SAFEHealth with a $1.5 million grant from the Agency for Healthcare Research and Quality and internally donated resources.

In this HIE model, a federated proxy edge server sits within each participating healthcare organization's four walls, said Larry Garber, MD, medical director for informatics at Fallon Clinic.

The clinic preloaded two years' worth of clinical notes along with new data from its electronic health record system, keeping the proxy edge server up to date. Only copies of clinical data that the healthcare organization is willing to share are on the server.

Through the registry process, the system checks whether a consent form was signed and what data can be shared. "This is all happening in the background," Garber said. "It fits into the workflow."

Patient consent can also occur at registration. "We get consent when and where it's most relevant," Garber said.

Once the consent is entered into the consent portal, physicians have access to the data. Whatever workflow occurs during the patient's stay, identical copies of the data flows into both EHR systems at the hospital and clinic, he said.

Fallon Clinic wrote the software using the Microsoft .NET framework. It provides the software free. The only cost to participating healthcare organizations is the purchase of Microsoft's SQL server and its license.