The Office of the National Coordinator for Health Information Technology has approved the Louisiana Health Care Quality Forum's (LHCQF) strategic and operational plan for the Louisiana Health Information Exchange (LaHIE), paving the way for the organization to move forward quickly in its efforts to develop a statewide health information network.

The LHCQF, a non-profit entity that is the state's point organization for initiatives to improve health care quality, received a $10.6 million federal grant through the HITECH Act in March 2010, as well as a grant to run the state's regional extension center.

LHCQF issued a request for proposal in December so, with the ONC's go-ahead, officials are now free to pursue the original implementation schedule. Jenny Smith, HIE program manager for LHCQF, said that she and other officials have already begun reviewing proposals and will select a vendor and a technical infrastructure by mid-April and begin building the new system in May.

The overarching technology model for the LaHIE is decentralized and will leverage existing HIEs, including the Louisiana Rural Health Information Exchange (LaRHIX) and the Louisiana Southwest Health Information Exchange (LaSWIX), Medicaid systems and numerous hospital, provider group and public health IT initiatives.

"We have included representatives of key stakeholders across the state to make sure that we build upon efforts that are already in place," Smith said. "We will leverage what we can and we won't replace anything that doesn't need to be replaced."

Smith noted that the LHCQF is open to technology solutions and ideas from vendors, but the LaHIE will initially include four key components: a master patient index, a record locater service, a provider directory and an enterprise service bus (ESB) to facilitate secure messaging in a standard data format.

The rollout will occur in phases over time, Smith said. The initial work will focus on the development of short-term use cases involving secure point-to-point messaging to help providers achieve meaningful use quickly and on the creation of an Emergency Department Visit Registry.

The latter, which will be implemented by the end of September, will exchange a subset of Admit, Discharge and Transfer (ADT) data.

"Hospitals will be able to immediately identify who the patient was, where they've been recently and what their chief complaint is," Smith explained. "It's considered most valuable to hospitals in urban settings" because, unlike in rural areas, patients have the option of being seen in several nearby emergency departments.

The LaHIE, including a fully developed master patient index and provider directory, is expected to go live in mid-2012. Beyond that, the HIE will evolve to also feature clinical decision support tools and consumer-facing applications, such as personal health records (PHRs).

Currently, Louisiana has an electronic health record (EHR) adoption rate of 17 percent, but Smith says that LHCQF officials are confident that those numbers will increase at a significant rate now that the LaHIE is on its way to reality.

"We're in a very unique position because we're not only managing the creation of the state's HIE, we're also running the Regional Extension Center for Louisiana and assisting providers with EHR purchases and implementation," she said. "So it will be very easy to coordinate and align those efforts."

"When my counterpart is out in physician offices getting them up to speed on EHRs and achieving meaningful use, there will be very easy handoff to then say, "˜Okay, now you're at a point where you can begin exchanging information and connecting to the LaHIE," Smith said. "That will be a major advantage to everyone's efforts."