St. Agnes Hospital in Baltimore, Md., recently launched a three-hospital health information exchange that officials say provides a cheaper, easier model for hospitals. 

St. Agnes Hospital has been exchanging patient information with Erickson Health Medical Group since June 2007 and in March 2009 the hospital also began exchanging data with LifeBridge Health.

While finding a business case is often problematic for health information exchanges and regional health information organizations, Baltimore's first HIE was born out of a need to reduce administrative cost and eliminate duplicative tests for patients who frequented the health systems.

Approximately 25 patients flowed back and forth between St. Agnes Hospital and Erickson Health, a large integrated healthcare and wellness system for older adults. The two entities needed an electronic system that not only enabled information exchange but fit into the existing workflows for 100 percent provider utilization, said Prem Urali, CEO and co-founder of HealthUnity.

St. Agnes Hospital and Erickson Health Medical Group launched their HIE with five transactions in 2007 and added a personal health record module using Microsoft HealthVault in the fourth quarter of 2008.

"If we can provide five services, we can deliver 80 percent of the value for providers," Urali said. What's most important to go live are the demographics for patient matching and a clinical use case such as secure messaging, record location, clinical summary exchange, results delivery and order routing, he said.

Because HealthUnity offers a services model, which includes monitoring the network, St. Agnes Hospital and Erickson Health Medical Group were able to split the upfront costs and yearly license fees, Urali said. The HIE is proving that a low-cost provider-to-provider communication system built on Microsoft technology can deliver high value without the technology integration issues that challenge many HIEs and RHIOs, he said.

While there's a need for a public utility to exchange health data, integration technology and services for this type of HIE model is a "very expensive proposition" for providers, said Jay Pathy, senior vice president and co-founder of HealthUnity.

A hosted HIE model provides a multi-tenant infrastructure for multiple stakeholders to exchange data through multiple networks, he said. This type of model makes exchanging healthcare data easier and cheaper, which will appeal to small, rural hospitals with limited budgets, Urali said.

With 15,000 HL7-standardized messages being generated daily for up to 40 patients in a fully automated process that requires no workflow change, the Baltimore HIE is proving to be a successful model. HealthUnity is looking to leverage that success as Maryland works to build its statewide network.