CHIME StateNet is releasing guiding principles that it has developed as foundational operating guidelines for regional extension centers (RECs) and health information exchanges (HIEs).
The federal government is funding RECs and HIEs as part of the push to help providers implement electronic health records and then more easily share electronic data. Separate workgroups within CHIME StateNet developed the guiding principles for each because of the overriding belief that collaboration among all parties gives RECs and HIEs the best opportunity for success.
CHIME StateNet is comprised of healthcare chief information officers representing each of the 50 states and the District of Columbia. StateNet was created by the College for Healthcare Information Management Executives (CHIME) last year for the purposes of gathering and communicating relevant in-state health IT developments, including HIE formation and sharing information on best practices within and across states.
The Department of Health and Human Services has established 62 regional extension centers around the country, while funding has been provided for dozens for health information exchanges, which are seeking to enable providers to more easily exchange clinical information. Additionally, the Office of the National Coordinator for Health Information Technology (ONC) has approved 27 state health IT plans that detail statewide initiatives; plans for the remaining states are in various stages of approval.
Both sets of principles have been presented to the Office of the National Coordinator for Health IT, which has been receptive to the recommendations, said Sharon Canner, CHIME’s senior director of advocacy. “ONC continues to seek out CIOs for their expertise in these areas,” she said.
In terms of HIEs, CHIME StateNet is offering guidance because the organization believes that consistency across states and regions is essential for effective exchange of health information. Healthcare CIOs play pivotal roles in enabling the collection and exchange of health information.
“Health information exchange has the potential to bring great benefits, but strong coordination will be required to ensure that limited funds are used optimally to create an environment that supports secure and efficient exchange of vital health information,” said Indranil “Neal” Ganguly, vice president and CIO at CentraState Healthcare System, Freehold, N.J., and chair of the workgroup that produced the HIE principles.
Some of CHIME StateNet’s recommendations for HIEs include:
• Adoption of best practice models with common themes across states--patient identification, provider directories, consent management, privacy provisions, data standards and other common services--with standardization where possible to minimize redundant activities and optimize use of public funds;
• Where possible, recognizing defined and exclusive geographic regions for health information exchange at the State level, and in the case of regions that cross State lines, by agreement between States.
• Coordinating Regional Extension Center activities with the approved State HIE plan to ensure that resources are used effectively, guarding against any conflicts as part of the evaluation of and sustainability of the plan.
• Establishing public/private awareness campaign to raise awareness of HIEs’ benefits for patients.
• Enabling an efficient workflow based on semantic interoperability to allow exchanged data to be normalized by the caregiver’s preferred application, easing adoption and effective use.
• Adopting a standard methodology for the patient identification process that would apply across all HIEs.
• Adopting a standard procedure for correcting errors with a suitable audit trail to address the challenges of both federated and centralized HIE models.
• Creating a statewide inventory of HIE environments to identify all potential stakeholders and to assure that sustainable funding is applied equitably and tax dollars efficiently utilized to encourage a well defined State HIE infrastructure.
• Ensuring that governance model(s) include representation for all participants.
In regards to RECs, the CHIME StateNet principles highlight the role that the extension centers can play in helping small providers and critical access hospitals implement electronic health records and participate in the exchange of health information.
As guiding principles for RECs, CHIME StateNet recommendations include:
• Working with established healthcare delivery organizations;
• Maximizing federal funding through collaboration among all parties;
• Harmonizing state law requirements to assure consistency across state boundaries;
• Leveraging local healthcare community expertise on EHR adoption;
• Working with organizations that have established patient identification methods to leverage lessons learned;
• Ensuring small physician practices and other target provider populations receive the necessary assistance for sustainable longer term business models;
• Providing guidance on best practice governance models to ensure all participants have representation.
“Many CHIME members have extensive EHR implementation experience, and regional extension centers can collaborate with these CIOs as they assist providers, critical access hospitals and rural hospitals with EHR implementation and utilization,” said Randy McCleese, vice president of information systems and CIO at St. Claire Regional Medical Center, Morehead, Ky., and head of the workgroup that developed the REC guidelines.
