California’s statewide health information exchange (HIE) is in transition again. But by the end of 2012, 75 percent of the Golden State’s counties will either have community-based operating HIEs or will be in the planning stages, according to the recently appointed state official tasked with taking over the program.

“Our mission has changed,” Pamela Lane, Deputy Secretary of Health Information Exchange for the California Health and Human Services Agency, told attendees at the sixth annual Redwood MedNet Conference – Connecting California to Improve Patient Care 2012. “We are about the business of HIE. We are not in state government to say no; we are there to get the barriers out of the way.”
 
Lane, who also heads the California Office of Health Information Integrity (CalOHII), which works in support of the CHHS’s HIE initiatives, acknowledged the challenges, which included limited staffing and other resources and finding a new partner when Cal eConnect recommended that it step down from its role of state-designated HIE partner. She highlighted, however, the steps her office has already taken.

“One of our commitments is not to slow down the programmatic work,” she said.

Despite the transition, the statewide HIE’s strategic and operational plan has been newly revised. The contract with the University of California at Davis Health System to take over as the new HIE partner is imminent.

HIE orderable kits – or HIE OK, as Lane dubbed them – will soon be available for distribution. The state partner and EHR vendors have been collaborating to develop HL7 standards-based interoperability module kits to help healthcare providers attain HIE capabilities.

California’s HIE goals include creating an interoperable EHR for the state’s foster children, of which 100 percent are in the Medi-Cal program, 80 percent have behavioral health issues and 90 percent take more than one medication.

“Imagine the benefits if we can create electronic medical records [for them],” Lane said.

Other goals are to reduce complications of stroke under the chronic care category and develop an emergency department use case around a catastrophic earthquake. “What can we do using HIE to continue providing care? We have a resource that can be a tremendous value,” she said.

Lane acknowledged the challenge of coming up with a patient consent solution. CalOHII has set up demonstration projects for empirical, outcomes-based alternatives to the opt-in/opt-out model. “We will not shove down your throats only one option for consent,” she said. Instead, her office will look to harmonize laws to make it easier for secure health information exchange.

“We are at a place where we can write a new chapter,” she said. “We learned a lot of lessons over the last three years.” Lane emphasized the renewed focus on the patient and their care.

While the job ahead will be difficult, Lane urged stakeholders to not falter, keep working hard and to continue to encourage one another. “It’s all about the patients,” she said.