The Minnesota Health Information Exchange has begun a pilot with the association Aging Services of Minnesota that will enable 12 long-term care organizations to access patient medication lists, lab histories, clinical care documents, benefit eligibility data and the state immunization registry via a Web connection.

However, officials do not expect the pilot to immediately result in a major expansion of the HIE's services to the long-term care industry.

"These institutions are not automated for the most part, which is kind of unfortunate," said Michael Ubl, executive director of the Minnesota HIE, noting that long-term care as a healthcare sector was left out of the incentive program for electronic health record systems in the 2009 HITECH Act.

For this reason, the pilot is focused initially on trying to understand workflows within various types of long-term care organizations"which include home-based care providers, assisted living centers and skilled nursing facilities"and how they would use HIE-enabled information.

"What we're trying to do with this is to conduct an assessment and a determination of the value proposition of those types of facilities being connected and exchanging information," Ubl says. Organizations only need a PC, browser and Internet connection to access the HIE for the pilot.

The HIE will study the first 12 pilot participants"which vary by type, size and geographic location"for 60 to 90 days and then begin working with additional subjects from within Aging Services of Minnesota, which has about 1,000 members serving more than 100,000 seniors.

Ubl expects the entire pilot to take a year. "If these were all the same sort of business operation, it would be different, but there is such a wide variety of organizations within the long-term care sector, and everybody does things a little bit differentlt, so it will take some time to study them and work with them and figure out their business and workflow models."

Despite being behind the technology curve at the moment, long-term care facilities are likely to ramp up their automation in the next few years and along with it, their participation in health information exchanges, Ubl says. And he sees long-term care as a key part of the successful use of health IT to improve patient care, improve efficiencies and cut costs.

Once the pilot is completed, "we're going to expand this rather rapidly so that when patients are being transferred out of an in-patient hospital setting to a rehabilitation or long-term care facility, the hospital will be able to electronically push the medical record information to the new facility ahead of time," Ubl says.

"And then if they have a complete set of the information that they need, they won't have to then call back to the hospital or some other provider to ask questions or clarify something about the patient's record. They'll have what they need to prepare for that patient's arrival and continue their care."