Catholic Health Initiatives is partnering with Orion Health to build an enterprise-wide HIE that will enable physicians and clinicians to access patient records across its 100 facilities in 19 states. Once connected, CHI plans to link to statewide HIEs in states where its 76 hospitals are located.

The second largest Catholic healthcare system in the U.S. will deploy Orion Health HIE to support its $1.5 billion OneCare program, which will create a shared, universal patient record documenting its more than 400,000 hospital admissions and nearly five million physician office visits annually.

Once the HIE is live across CHI’s 76 hospitals, 40 long-term and assisted care facilities, two community health-services organizations, two accredited nursing colleges and numerous home health agencies, by June 2015, the hospital system plans to expand and connect to statewide HIEs in states where its facilities are based. CHI is also looking to eventually connect to the Nationwide Health Information Network.

The OneCare Program, which predated the HITECH Act and was called the Clinical Information Technology program, was created to increase patient safety and improve clinical quality and the patient experience. It was expanded to cover meaningful use Stages 1 and 2. More importantly, OneCare is positioning CHI to be able to conduct population and disease management and take on shared risk – all of the components of accountable care organizations (ACOs) , according to Michael O’Rourke, senior vice president and CIO for CHI.

CHI, which is headquartered in Englewood, Colo., is involved in pilots in three major healthcare markets – Des Moines, Iowa; Kentucky and Nebraska – in which local relationships with other healthcare organizations are being leveraged to create an ACO. The Des Moines pilot is establishing a disease registry and determining the best way to manage this new model of care. CHI is identifying the market dynamics that offer a venue for testing the new models, O’Rourke said.

“As we go forward, even though the provision of care is instrumental to the patient, running the business is going to be generated on the intelligence, the information we gather – information about patients, populations, diseases, how they’re being managed, whether they’re improving or not improving, and how we compare to others who are doing the same work so we can get the best practices,” he said.

Electronic health records and HIE are the infrastructure to provide the intelligence to manage disease states and populations, and take on risk, which is where the market is going, according to O’Rourke.

Currently, CHI is going as “quickly as possible” to stand up the infrastructure across its facilities. O’Rourke said that CHI is in the “same place as everyone else” in terms of creating medical homes and ACOs. “We’re all still feeling our way. You have to put the fundamentals in place and then start to test out some of these different models,” he said.

CHI expects to be able to take the infrastructure – Orion Health HIE, which is powered by Orion Health Rhapsody Integration Engine and also includes Orion Health Clinical Data Repository and Clinical Portal – and easily “snap” it onto each of the statewide HIEs, regardless of their models, in order to eliminate having to reinvent the wheel for each connection.

“This is the situation for the whole industry where you have to crawl before you walk before you run,” he said. “If we can get our markets to where we can manage our populations, then that will in and of itself give us the learning and understanding and the technology and architecture principles so that we can move information and help to manage broader populations.”

While EHRs have been around for some 20 years, what has been lacking is the ability to pull disparate information from different sites of care, bring it all together into one record and be able to manage populations with that information, according to O’Rourke.

“This is pretty exciting – from the standpoint of this product, technology, and service – that now we’re ready to move this industry to someplace well beyond what people thought we could get to,” he said.