Pilot expected to boost clinical decision-making

PORTLAND, ME – HealthInfoNet, Maine’s statewide health information exchange (HIE) has achieved another first with the recent launch of image sharing. The pilot project puts both images and words at the fingertips of providers across the largely rural state.

Working with Dell, HealthInfoNet will create what its executives say is the nation’s first statewide medical image archive. It’s one way to help doctors, nurses and other healthcare providers make the right decisions for their patients. That the offering is financially sustainable is likely to garner the attention of HIEs across the nation.

"This is totally a cloud-based offering, which will be a subscription model, where we will charge on a per-study basis to put the studies in the archive, and have the ability to pass forward those images to anywhere they are needed – have the ability to provide business continuity and even disaster recovery if needed," explains Jerry Edson, former CIO at Maine Medical Center and now consultant for the HIE.

HealthInfoNet already provides image reports, but with the new archiving system it will be able to offer up the images themselves. It’s "something providers have asked for and told us will better support their treatment decision-making," says Todd Rogow, director of information technology at HealthInfoNet. [NewsMaker interview with Rogow, Page 28]

The pilot will last through the summer, "to be sure that everybody can touch it, feel it," says Edson. "They can be confident that it’s working the way that it needs to work. In the fall, we will move from the initial participants of the pilot to the statewide rollout."

In addition to leveraging the HIE, the service prepares Maine’s providers for sharing images through the NwHIN Direct and Connect systems, Rogow notes. It also supports the development of accountable care organizations and other shared-risk models.

"As the concept of ACO starts to come into place," he says, "a service like this fits very well and is very needed."

An estimated 1.8 million medical images (X-rays, mammograms, CT scans, MRIs etc.) are generated in Maine each year, totaling more than 45 terabytes of data. The organizations participating in the pilot generate 1.4 million of those images.

Today, the images are stored in a number of electronic archives at separate locations and mostly shared between non-affiliated providers by copying the images to CDs.

By consolidating the images into a single archive, HealthInfoNet estimates that Maine’s providers stand to save $6 million over seven years through reduced storage and transport costs.

"When a patient has an X-ray or MRI at a facility outside our system, it can take days for their doctor at Maine Medical Center, for example, to get a copy of that image," says Barry Blumenfeld, MD, CIO at MaineHealth.

"This new service will save time for our providers and their patients. With instant access to a patient’s images, medical staff can treat them much faster and the patient won’t have to take the time to pick up and deliver CDs."

There are several additional benefits of having images stored in one place, say HealthInfoNet officials. First, easier access to past image studies should lead to fewer repeat tests, meaning less cost and less radiation exposure for patients. Also, HealthInfoNet will be able to link each image with a single patient identifier through its HIE Master Person Index, making it easier for providers to search for all of a patient's prior images when needed to track changes over time. For example, a radiologist wants to see all of a woman’s past mammograms, not just her most recent, to better detect changes in her breast tissue.

To build and operate the new cloud-based archive, HealthInfoNet selected Dell through what Rogow says was a rigorous RFP process that involved vetting by both Maine clinicians and health information technology professionals. Dell manages one of the world’s largest cloud-based clinical archives through its Unified Clinical Archive solution, with more than 71 million clinical studies, nearly 5 billion diagnostic imaging objects and supporting more than 800 clinical sites.

HealthInfoNet, Dell and the pilot group of Maine healthcare organizations will work together over the summer to confirm the system design and integrate the service with existing PACS systems and the HIE.

HealthInfoNet expects to end the pilot phase in the fall and expand the service statewide by 2013.

Besides making records readily accessible, says Jim Champagne, executive director, Dell Healthcare Services, Dell executives are proud that they were able to build a model that is self-sustainable financially.
"You don’t have to go out for a bunch of grants in order for that to be self-sustaining," he says. "We’re offering here to the providers not only the tools to exchange, but also a cost-effective archive and cost-effective disaster recovery solution around it that makes sense financially from cost of ownership.”

Dell operates two data centers – one in Connecticut and one on the West Coast. Champagne says Dell has more than 10,000 interfaces to connect with the PACS in the marketplace today. Dell has worked with small regional facilities and IDNs that share information across multiple collaborative hospitals, "but nothing at the level that we’re seeing in this partnership across the entire state," says Champagne.