Delaware Health Information Network

Two of Nations Largest HIEs Electronically Share Patient Information across States

NASHVILLE, TN – March 19, 2013 – ICA, a leading provider of interoperability technology that enables care coordination and health information exchange (HIE), today announced that Delaware Health Information Network (DHIN) and Kansas Health Information Network (KHIN) have successfully validated national interoperability by facilitating the secure exchange of patient records between each organization via Direct messaging. Direct messaging, the new federal healthcare email system, was facilitated by the AlliedHIE Company and ICA, using ICA’s CareAlign® Direct Messaging and Exchange solutions.

The Direct Project provides HIPAA-compliant national infrastructure and interoperability through certified HISPs enabling healthcare professionals and providers to affordably and securely send clinical messages, hospital discharge summaries, radiology reports, lab results, immunization reports, CCDs and a wide variety of important, timely and critical patient information to instantly improve patient care and safety. Some of the nation’s largest and wisest healthcare organizations are using Direct messaging because it’s fast, secure, smart, affordable and HIPAA-compliant. Instead of months or years, new users are authenticated, on-boarded and trained to use Direct messaging in less than 24 hours.

“We are very pleased to validate national interoperability with KHIN and the Kansas medical community through Direct messaging. Our two dynamic states have business leaders, families, students and vacationers visiting each state and now we can quickly, confidently and securely exchange medical information when medical need warrants the same,” said Dr. Jan Lee, executive director of DHIN. “With our core HIE transactions approaching one million a month, Delaware remains committed to helping advance national interoperability and the Direct Project. It’s an important next step.”

“What is exciting about this connection is that patients no longer have to be concerned that their important medical records may not be available when they travel across the country,” said Laura McCrary, executive director of KHIN. “By electronically sharing secure messages between KHIN and DHIN, we have established the foundation for a new standard in patient care where critical health information is available electronically wherever our patients seek care. This is particularly important in our global society and for Kansans who travel extensively throughout our nation. KHIN is already connected to our surrounding states and is sharing health information across 30 Kansas health care systems with more than 3,000 medical professionals on our Direct messaging platform.”

“While many states and organizations are just getting started on the journey to HIE, health IT and Direct messaging, both Delaware and Kansas are already live with actively robust HIE systems,” said Kelly Lewis, President of AlliedHIE. “DHIN and KHIN are national leaders delivering information and use cases that immediately increase patient safety. Allied DirectTM is pleased to help facilitate affordable encrypted, mobile-ready, HIPAA-compliant email through our live HISP infrastructure services with the federal healthcare email system.”

“We are pleased to see our customers, DHIN, KHIN and AlliedHIE, successfully facilitate the secure exchange of patient information with each other via Direct messaging,” said Gary Zegiestowsky, President and CEO of ICA. “As a market leader in health information exchange and interoperability, we consider this a valuable opportunity to help grow the Direct Project and the many use cases that add immediate value, safety and cost-savings.”

The Direct Project, the new federal healthcare email system, and HISP infrastructure services are still in their infancy, like ISPs and email in 1991-1992. After 1992, Internet and email usage exponentially exploded through services like LinkedIn, Quicken, Facebook, You Tube and Google. Today, Direct messaging through HISPs provides an easy-to-use, affordable, HIPAA-compliant infrastructure that supports electronic exchange of health information among healthcare providers, regardless of their size, resources or technical capacity.

DHIN, The Delaware Health Information Network, is the first live, statewide health information network in the nation. Launched in 2007, today it serves all of Delaware’s acute care hospitals and 97% of the State’s medical providers. More than 9,000,000 clinical results and reports are posted on DHIN each year. Total patient records in the system now exceed 1.4 million including patients from all 50 states. For more information about DHIN visit www.DHIN.org or call 302-678-0220.  Please also visit us on Facebook, LinkedIn and Twitter (@DHIN_hie).

KHIN, The Kansas Health Information Network, serves almost 250,000 patients through connections with more than 30 hospitals and clinics. The KHIN mission is to improve health care quality, coordination and efficiency through the exchange of health information at the point of care utilizing a secure electronic network provided by a collaboration of health care organizations. KHIN is the first HIE to connect and feed data to the national disease outbreak surveillance system, according to CDC officials. Officials at BioSense, the CDC’s syndromic surveillance system, said that KHIN became the first HIE to begin contributing data. www.khinonline.org.

The AlliedHIE Company is a patient-centric, purpose-driven, point-of-care focused national health information exchange company with a mission to include and serve allied health organizations in order to connect our most vulnerable and at-risk patients. To lead America’s Health Information Exchange we are partnering with the nation’s premier Health IT firms, including ICA, www.icainformatics.com to deliver best in class Health IT services, critical security and aggregation services, and superior client support. Allied-DirectTM’s national commercial strategy to be the market-leading, best-in-class, HIPAA-compliant and fastest-growing Direct Email and HISP in the Federal Healthcare Email System. (www.alliedhie.com)

About ICA

Originating from clinical informatics solutions developed within Vanderbilt Medical Center, ICA’s state-of-the-art CareAlign® interoperability and informatics platform addresses and solves data and communication challenges for many healthcare entities, including hospitals, IPAs, IDNs, HIEs, payers and others. CareAlign delivers a flexible architecture to connect, collect, consume and intelligently distribute data through Direct, IHE, HL7, and custom methods for use in EHRs, third party applications, and ICA’s applications. CareAlignTM unites a wide range of information and supports analytic needs associated with population health management, transitions of care communication, re-admissions reduction, meaningful use requirements and PCMH/ACO operations. Visit www.icainformatics.com, and follow us on Twitter, ICA HITme Blog, Facebook, LinkedIn and YouTube.

Media Contact:

Dodge Communications for ICA Jeff Nessler; 770.576.2573
jnessler@dodgecommunications.com

Does Stage 2 Meaningful Use show lack of support for HIEs?

Kyle Murphy, PhD | March 11, 2013

At the same time that eligible professionals and hospitals have continued to pursue the meaningful use of certified EHR technology as part of the EHR Incentive Programs, numerous organizations (regional, statewide, and national) have worked to develop infrastructure capable of supporting health information exchange (HIE) and public health reporting.

As part of Stage 2 Meaningful Use, the Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health Information Technology (ONC) have taken aim at increasing the exchange of health information among healthcare organizations and providers. But according to one attendee of the ONC Town Hall during HIMSS13, some HIEs (i.e., the noun) are concerned that they will be negatively affected by misinterpretation and confusion surrounding the HIE requirements of Stage 2 Meaningful Use.

During the Q&A portion of the ONC Town Hall, Dr. Jan Lee, Executive Director of the Delaware Health Information Network, asked two questions of the panel that included the National Coordinator Farzad Mostashari, the second of which raised the concerns of HIEs heading into the next phase of meaningful use:

We need to create a really tight marketing message in Delaware to explain to Delaware providers how they can leverage the HIE that they already rely on to meet this requirement, and I have not been able to find anything that says when the provider is ready to attest that they have met this requirement. How will they indicate that they used the HIE? What’s I’m afraid of is that there’s going to be a lot of misinterpretation that is going to drive people away from the state HIE because it’s not clear to them how they account for that when they attest. I’ve been badgering our program officer about this in our biweekly calls until she doesn’t even want to talk to me anymore, but I haven’t gotten an answer yet. So I’m not giving up the microphone until I get the answer.

(For the record, Dr. Lee’s question was followed by laughter and applause from the audience.)

What Executive Director of DHIN brought to the attention of the panel and attendees were the three methods by which eligible providers could meet the transitions of care (ToC) and summary of care requirements for Stage 2 Meaningful Use via:

  1. CEHRT using Direct protocol
  2. CEHRT using SOAP-based/query standards, or
  3. non-CEHRT by engaging a partner (i.e., an HIE) of the Healtheway, formerly the Nationwide Health Information Network (NwHIN).

As Mostashari noted in response, no method was currently in place for aspiring meaningful users to show that they had achieved this requirement using an HIE. “It’s probably under development, and it’s helpful for us to hear that as one of the business requirements for this should be that it is as easy as possible to communicate to the providers attesting that this is an acceptable option instead of leaving it vague,” said the National Coordinator.

According to Dr. Lee, the push and support for EHR interoperability by the ONC and CMS has subsequently worked against ToC option 3 and HIEs in general. “I’ve spoken with some of my counterparts in other states who are feeling the same frustration that we feel like there’s a subtle devaluing of the HIE in encouraging interoperability standards among the EHR vendors,” explained Dr. Lee. “That the HIE organizations are really being devalued and the role that we play in aggregating data on behalf of an entire community, we frankly see that it’s at risk.”

The work of the HIEs and policies established by CMS and ONC are seemingly at odds. However, the National Coordinator made clear that the concern on the part of the HIEs is one of many increasingly challenging those tasked with charting a wide and flexible path toward the meaningful use of CEHRT going forward:

There’s a broader issue, which is we could not in meaningful use say, ‘You must use health information exchange organization.’ We didn’t do that, and I know that there are many on the HIE side who wish we had. What we said was there are going to be many ways in which information gets exchanged — it should be a verb, not a noun — and it’s all good. It has to be good. We have too complex a system and we have to have vendor-to-vendor transmission.

For those organizations relying on ONC funding needing to move toward sustainable operations and business models, the perceived lack of support for these exchanges in Stage 2 Meaningful Use represents yet another obstacle in the way of HIE sustainability. With less than seven months to go before eligible hospitals begin the next phase of meaningful use, clarification cannot come fast enough for HIEs.

Another First in the Electronic Transmission of Immunization Records: CVS/pharmacy and Nemours begin transmission of vaccination records through DHIN

DOVER, DE – February 28, 2012 – The Delaware Division of Public Health (DPH) immunization registry received a boost this week when a major pharmacy chain and Nemours began electronically transmitting vaccination data for the first time to DPH through the Delaware Health Information Network (DHIN).

CVS/pharmacy and Nemours recently began sending their daily immunization records to the DPH database using SFTP, secure file transfer protocol, in the system administered by DHIN. This streamlines what had been a manual monthly process, increasing both speed and accuracy.  It is the latest development in DHIN’s quest to provide timely health data to medical providers and ultimately to the public in Delaware.

“Having CVS/pharmacy and Nemours electronically transmitting its vaccination records greatly enhances the quality and the quantity of data in the registry,” said Dr. Karyl Rattay, DPH Director.  “DPH congratulate CVS, Nemours and DHIN for their leadership and vision. This is an important step in reducing costs, increasing efficiency, and protecting the children of Delaware from preventable illness.”

The State Immunization Registry was established in 1983 and provides an accessible record to physicians, emergency room staff, school nurses and parents. State law requires that immunizations be reported to the Division of Public Health by every healthcare provider. Until recently that was mostly a manual process.  As of February 28, 2013, over 21,000 immunization records have been transmitted through DHIN since the first phase of the process launched last October, with two private practices submitting their data.

“This is a major step for streamlining how immunization records are delivered to the Registry,” said Dr. Jan Lee, executive director of DHIN. “Hospitals and pharmacies are major conduits for immunizations, especially routine ones such as influenza and shingles, and we are pleased that our platform will deliver results more quickly with less work for pharmacists as well as physicians.”

The DPH immunization database now contains the records of close to a half million people. The purpose of the Registry is to make immunization records accessible to health care providers and ultimately the citizens of Delaware to help prevent vaccine-preventable diseases.

Nemours/Alfred I. duPont Hospital for Children began transmitting demographic information as well as Lab, Pathology and Radiology testing results to the DHIN database in October 2012. As of last week, the hospital and its primary care satellite offices are now sending their immunization data through DHIN to DPH.  “Nemours is dedicated to improving the lives of children and their families. Leveraging health information technology improves quality of care for Delaware’s kids,” said Stephen Lawless, MD, MBA, Vice President for Quality and Safety at Nemours/A.I. duPont Hospital for Children. “Using DHIN to transmit our immunization information to the DPH database is a more efficient use of resources and has benefits for our patients and families.”

“We are pleased to partner with the Delaware Health Information Network to automate the process of sending our vaccination data to the Immunization Registry in Delaware,” said Papatya Tankut, RPh, Vice President of Pharmacy Affairs at CVS Caremark. “Because of their accessibility, pharmacists are playing an increasingly important role in providing vaccinations. CVS pharmacists are available every day to administer many different vaccines to patients, including influenza, pneumonia, Tdap and hepatitis.”

The Delaware Health Information Network was created by the Delaware General Assembly in 1997 as a public-private partnership for the benefit of all citizens of Delaware to establish a statewide health information network and to address Delaware’s needs for timely, reliable and relevant healthcare information.  With all Delaware acute care hospitals and 97% of providers now participating, DHIN is sharing real-time clinical information to improve patient outcomes, eliminate the duplication of service and reduce the cost of healthcare.

About Nemours

Nemours (NAH-mors) is an internationally recognized children’s health system that owns and operates the Alfred I. duPont Hospital for Children in Wilmington, Delaware and the Nemours Children’s Hospital in Orlando, Florida along with major pediatric specialty clinics in Delaware, Florida, Pennsylvania and New Jersey.

Established as The Nemours Foundation through the legacy and philanthropy of Alfred I. du Pont, Nemours offers pediatric clinical care, research, education, advocacy and prevention programs to all families in the communities it serves. For more information, visit www.Nemours.org.

About CVS/pharmacy

CVS/pharmacy, the retail division of CVS Caremark Corporation, is America’s leading retail pharmacy with more than 7,400 CVS/pharmacy and Longs Drug stores. CVS/pharmacy is reinventing pharmacy to help people on their path to better health by providing the most accessible and personalized expertise, both in its stores and online at CVS.com. General information about CVS/pharmacy and CVS Caremark is available at https://info.cvscaremark.com.

Healthcare Information Technology Delivers Instant Access to Patient Data to Doctors and Hospitals: Using the DHIN and Cerner, United Medical LLC becomes a leader in data exchange

DOVER, DE – February 20, 2013 – Physicians need quick and direct access to their patients’ comprehensive health information and records. As patients see multiple physicians and receive care at different hospitals, it’s no wonder documenting and managing healthcare information is so complicated and time-consuming. To streamline workflow and have instant access to patient data, associates at United Medical LLC use the Delaware Healthcare Information Network (DHIN) along with Cerner Ambulatory solutions.

DHIN, the nation’s first and most mature state-wide health information exchange, has established an interface that provides a direct link to medical results for more than 1.4 million patients.  All of Delaware’s acute care hospitals participate in DHIN along with private laboratories and radiology firms.  Over 9 million clinical results are posted annually on DHIN and approximately 97% of Delaware’s practicing medical providers that order tests for patients are enrolled in DHIN.

Recently, DHIN announced that Cerner’s Electronic Medical Record (EMR) software has passed the DHIN certification process.  Cerner’s EMR software is used in 46 medical practices in Delaware – among the most widely used EMR vendor by healthcare providers in Delaware. The certification process takes several months and ensures that information is securely and appropriately transferred from DHIN directly in to the electronic patient record as it is maintained directly at the practice.  The process includes extensive testing and validation to ensure all information from DHIN is appearing correctly and in the intended location on the Cerner software.

“The Cerner – DHIN integration is unique. United Medical was instrumental in the facilitation of the interface for just under 50 practices and well over 100 physicians in our network.” Kemal Erkan, FACHE, CEO of United Medical, LLC expounds: “As we change the landscape of healthcare our physicians are realizing the financial savings of being part of a larger network of physicians.  We relieve the individual practices of the administrative and technical aspects of business allowing them more time to focus on the delivery of care.”

“We are very excited to welcome Cerner as one the growing number of EMR vendors that offer a direct integration with DHIN,” said Dr. Jan Lee, Executive Director of DHIN. “Practices using Cerner’s EMR now have a direct and secure interface to their patients’ medical results.  These integrations make it easier for doctors to see important information about their patients, expediting the decision-making process and ultimately providing better care to patients,” said Dr. Lee.

Cerner’s interface with the DHIN eliminates time consuming tasks that United Medical’s providers used to perform. Previously, United Medical clinicians would have to check every patient to see if they had results, if they had ordered results or if the patient had filled the result.  Instead of checking each patient individually, United Medical would log into the DHIN to check.

“With the Cerner interface, now those results come in directly to the provider’s inbox. Once the provider signs off, it shows that they’ve signed off on the Flow Sheet, and it’s coming in as discreet data not just a scanned image. It’s actually coming in as something that can be charted, something that can show the trends, something that can be shown in or out of the reference mark,” explains John Donnelly, Associate Director at United Medical. “So it’s an incredible interface and it has more of a benefit because of the shared patients.”

“The integration of patient data into our state-wide exchange and into EMR software makes it easier for healthcare providers to see all the information for one patient in a single place and in a format with which they are already very comfortable,” notes Dr. Lee. “This is great news for Delaware practices as Cerner has a high penetration in the Delaware medical community with nearly 10% of DHIN enrolled practices using their EMR product.”

About United Medical LLC

Founded in November 2005 by Kemal Erkan, United Medical is a turnkey solution for the medical industry and the largest private ambulatory health care network in Delaware.  As a full service company United Medical will work to increase the practice profitability by streamlining practice workflow and operations allowing the practice to focus on increasing quality of patient care. With a local network currently uniting more than 150 providers and 250,000 patients, United Medical is well on its way to changing the health care landscape in Delaware and the Mid-Atlantic region.

About Cerner

Cerner is contributing to the systemic change of health and care delivery. For more than 30 years Cerner has been executing its vision to make health care safer and more efficient. We started with the foundation of digitizing paper processes and now offer the most comprehensive array of information software, professional services, medical device integration, remote hosting and employer health and wellness services. Cerner systems are used by everyone from individual consumers, to single-doctor practices, hospitals, employers and entire countries. Taking what we’ve learned over more than three decades, Cerner is building on the knowledge that is in the system to support evidence-based clinical decisions, prevent medical errors and empower patients in their care.

About DHIN

DHIN, The Delaware Health Information Network, is the first live, statewide health information network in the nation.  Launched in 2007, today it serves all of Delaware’s acute care hospitals and 97% of the State’s medical providers.*  More than 9,000,000 clinical results and reports are posted on DHIN each year. Total patient records in the system now exceed 1.4 million including patients from all 50 states. For more information about DHIN visit www.DHIN.org or call 302-678-0220.  Please also visit us on Facebook, LinkedIn and Twitter (@DHIN_hie).

*Provider penetration calculation reflects the number of providers who make orders and are enrolled in DHIN (MD’s, DO’s, NP’s, PA’s and ED’s).  It does not include healthcare providers that do not make orders (e.g. Pathologists).  Total provider list compiled from multiple sources including the Medical Society of Delaware, University of Delaware, Delaware Blue Cross Blue Shield and the Delaware Division of Professional Regulation.

HIE in 2013: Climbing past the low-hanging fruit

Unlike western and central Pennsylvania, providers in greater Philadelphia are not linked by a health information exchange, perhaps because until recently there wasn’t a huge need for one among uber-competitive, highly-rated providers like the University of Pennsylvania Health System and Hahnemann University Hospital.

Now though, providers in and around Philadelphia are in the late stages of planning for HealthShare of Southeastern PA, developing governance and funding models and hoping to have a rough framework by February, said Michael Restuccia, University of Pennsylvania Health System CIO.

“Then we can push it forward from a use case perspective,” Restuccia said. About 20 hospitals are set to participate by 2014, with two use cases initially: medication history lists and discharge summary.

HIE: The industrialization of healthcare

With a new focus on, and in some cases requirements for, healthcare cost control and quality improvements, 2013 is likely to bring the formation of HIEs long coming — like one in greater Philadelphia — and the standardization and improvement of ones in existence. Indeed, some observers think HIEs, especially state-based exchanges, need to prove their value.

[See also: How Vermont is executing on its statewide HIE strategy]

In Philadelphia there’s “an aggregation of entities, which all have different cultures, and there’s a lot of competition,” said Hahnemann physician liaison Thompson Boyd, MD. That’s in large part why the region never developed an HIE, compared to western and central parts of the state, where the dominant providers, UPMC and Geisinger, created their own HIEs.

“We have been in negotiations with a common regional HIE for at least three to four years, and probably longer than that,” Boyd said. “Now we’re having people at the table who probably wouldn’t be found at the table a couple of years ago.”

The post-health reform landscape and financial pressures that have been simmering for a while are large drivers, he said. “The margins that we have are slimmer and we have to do better with less.”

“One of the most important issues we face right now is transitions of care,” Boyd continued. “When our patients leave the hospital, they either go home or to a skilled nursing facility or to a long-term care facility. Our ability to communicate with that receiving provider really needs to be enhanced.”

Philadelphia providers are starting to realize that “if they’re going to stay in business, they’re going to have to communicate with each other,” Boyd added. “The silos are going to have to be broken.”

Breaking down those silos while using HIE for business value is necessary for the “industrialization of healthcare,” Scott Lundstrom, group VP at the Massachusetts-based consultancy IDC Health Insights told Government Health IT during an interview.

“Healthcare is the last craft industry,” Lundstrom said. “We’re going through a process now where we can’t afford that anymore. The reality is we’re starting on a 20 year industrialization cycle, and we’re just in the formative days.”

HIXs, HIEs and the industrialization of healthcare

That means HIEs are going to have to develop use cases beyond just patient look-up services if they’re going to survive, and more than that, deliver value.

Lundstrom thinks a lot of state-based HIEs have a business model problem, in that they’re focusing largely on regulatory compliance and simple use cases, while missing the demand for more enterprising exchange and analytic services.

“Integrated delivery networks are using HIEs to create a single view of the patient across their payer and their provider business. Payers are using HIEs as the basis of their care management systems,” Lundstrom said.

HIEs already eyeing value-added services

A number of state-designated HIEs are offering exchange services that ensure a revenue stream and also bring clinical value.

The Delaware Health Information Network (DHIN) is creating business lines with insurers and the government, in addition to its exchange services for labs and providers. DHIN is currently floating ideas for new services and pilots — potentially doing hospital readmission analysis, for instance. The HIE is doing a five month medication history pilot service for providers, using federal funding to study medication history of patients in the DHIN system, which includes almost every Delaware resident and a few thousand from neighboring states.

Created by the state legislature as a private nonprofit in 1997, DHIN is aiming to generate 100 percent of its revenue from service fees during its current fiscal year, which ends in June.

[See also: 7 ways meaningful use grew deeper roots in 2012

“We’re expected to generate revenue and turn a profit,” Michael Sims, DHIN CFO, said. “Our goal is to be really self-sustaining.”

Other state-designated HIEs working to create a viable business model include HealthShare Montana and Maine HealthInfoNet, which is launching a statewide clinical-claims data warehouse.

In addition to provider exchange services, HealthShare Montana is using the i2b2 open source software as a basis for a statewide clinical repository and analytic software that William Reiter, MD, an internist and the HIE’s CMIO, hopes to use for comparative effectiveness treatment.

Reiter thinks the analytic potential of HIEs will get physicians much more interested in the meaningful use of health IT. When Reiter gives presentations to physicians around the state, “they’re fast asleep” when he talks about meaningful use criteria, he said in September. “They consider that more of an administrative rather than a physician thing. When we start talking about analytics, and when we pull up i2b2 and the docs see what they can do with it and how they can interrogate their own data, it’s almost like literally the audience goes wild.”

Indeed, Hahnemann’s Boyd said that Health Share of Southeastern PA’s “low hanging fruit is not doing the unnecessary duplication.”

“The whole idea of having rules and incredible amounts of data to be able to drive the physician and provider decision-making right at the patient level is going to be incredible,” Boyd explained, pointing to Mentioning HIMSS clinical business intelligence initiatives as one example. “Docs, physicians, providers love to look at data.”

Related coverage:

Q&A: Predicting a HIPAA cloud, BAA ‘tipping point’ come HIMSS13

HIE and the patient privacy conundrum

Crystal ball: 4 predictions for HIPAA and ICD-10 in 2013

ONC aims to crack barriers that slow HIE adoption in 2013

ACA to trigger state and local HIT spending splurge

Q&A: On the inevitability of an HIX delay

The state of HIE as 2012 comes to a close

– this was originally published on January 02, 2013 by Anthony Brino, Associate Editor, and can be read here: https://www.govhealthit.com/news/hie-2013-climbing-past-low-hanging-fruit

Nemours / Alfred I. duPont Hospital for Children Now “Live” On the Delaware Health Information Network

Increased access to data improves care for Delaware’s pediatric population

DOVER, DE – December 18, 2012 – The Delaware Health Information Network (DHIN) today announced that Nemours/Alfred I. duPont Hospital for Children in Wilmington is now making clinical results available to community healthcare providers through DHIN.

In making the announcement, Dr. Jan Lee, DHIN Executive Director said “We are very excited to welcome Nemours to DHIN. Now, real-time clinical information, including the results of all patient tests conducted at the duPont Hospital for Children, are posted on the Network. That ensures providers will have the most up-to-date clinical information and will improve the quality and safety of care provided to Delaware’s children.”

Launched in 2007, DHIN has grown to include 97% of Delaware’s health care providers who have access to a wide array of medical information from hospitals, laboratories, medical imaging providers and pharmacies. More than nine million clinical results and reports are posted on DHIN each year.

“Nemours has been leveraging health information technology for more than a decade to improve the quality of care for Delaware’s kids,” said Stephen Lawless, MD, MBA, Vice President for Quality and Safety at Nemours/A.I. duPont Hospital for Children.  “Making clinical information available through DHIN enhances communication among our clinicians, our referring physicians and our patients and families.”

With the recent addition of Nemours/Alfred I. duPont Hospital for Children and with Nanticoke Memorial Hospital set to begin sending data within weeks, all of Delaware’s acute care hospitals are now participating on the Delaware Health Information Network.

“In the last five years, hospitals, medical practices and laboratories throughout Delaware have come to depend on DHIN’s interactive database of medical information,” said Dr. Lee. “It is clearly improving patient care by providing timely and reliable patient medical information and has reduced costs by eliminating duplicate testing.  DHIN also provides medical specialists a comprehensive view of the patient upon referral from his/her primary physician, which saves time and improves efficiency” she said.

About Nemours

Nemours (NAH-mors) is an internationally recognized children’s health system that owns and operates the Alfred I. duPont Hospital for Children in Wilmington, Delaware and the Nemours Children’s Hospital in Orlando, Florida along with major pediatric specialty clinics in Delaware, Florida, Pennsylvania and New Jersey.

Established as The Nemours Foundation through the legacy and philanthropy of Alfred I. du Pont, Nemours offers pediatric clinical care, research, education, advocacy and prevention programs to all families in the communities it serves. For more information, visit www.Nemours.org.

About the Delaware Health Information Network (DHIN)

The Delaware Health Information Network is the first live, statewide health information network in the nation.  Launched in 2007, today it serves all of Delaware’s acute care hospitals and 97% of the State’s medical providers*. More than 9,000,000 clinical results and reports are posted on DHIN each year. Total patient records in the system now exceed 1.4 million including patients from all 50 states. For more information about DHIN visit www.DHIN.org or call 302-678-0220.  Please also visit us on Facebook, LinkedIn and Twitter (@DHIN_hie).

*Provider penetration calculation reflects the number of providers who make orders and are enrolled in DHIN (MD’s, OD’s, NP’s, PA’s and ED’s).  It does not include healthcare providers that do not make orders (e.g. Pathologists).  Total provider list compiled from multiple sources including the Medical Society of Delaware, University of Delaware, Delaware Blue Cross Blue Shield and the Delaware Division of Professional Regulation.

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Spine surgeon brings personalized care to patients: Electronic health records key to future health savings

(Dec 13, 2012) Lewes, DE – A spine specialist has joined Cape Orthopaedics in Lewes, where he says he plans to help patients take the initiative to achieve good health.

Dr. Ronald Wisneski joined the practice in October after relocating here from Ohio.

Wisneski said the practice operates under the P-4 principles – personalized care, predictive treatments, participatory service and preventative action.

By personalizing the care to each patient, Wisneski said doctors can provide an individualized approach. Predictive treatments can look at genetics and predict the likelihood of diseases, while participatory service allows doctors to serve as healthcare educator, advisors and facilitators.

Preventative action can mean a patient changes habits or actions before a major problem or injury occurs.

“We want to take the initiative to improve our patient’s health,” Wisneski said. “I want my patients doing age-specific exercises, improving body mechanics and posture and taking action to prevent ongoing impairment.”

Photo by: Rachel Swick Mavity

Future of healthcare

Wisneski said he is impressed with healthcare in Delaware because it is the first state to have an electronic database for healthcare records.

“The Delaware Health Information Network is a centralized database of all patients that have received care at Delaware facilities,” Wisneski said. “It is the first of its kind and we now have more than 95 percent of all doctors participating.”

Wisneski said the system reduces costs both for patients and for doctors because it makes healthcare records portable. By having electronic records in a database, doctors do not need to run the same tests for a patient who has moved or is being treated by a different physician.

“It cuts down on duplicate treatments and tests,” Wisneski said. “The system puts Delaware 10 to 20 years ahead of other states.”

Wisneski said he was impressed by Cape Orthopaedics because of its many goals for the future, including working with the Affordable Care Act to bundle payments for patients.

“We want to drive value for our patients,” Wisneski said. “We look at all ways to minimize costs while delivering quality care.”

While some voice concerns that the electronic age has put doctors behind computers instead of directly interacting with patients, Wisneski said he believes electronic healthcare systems will actually allow doctors to interact more.

Before the electronic system, each nurse or doctor had to enter information during each visit. With the system, Wisneski said doctors should already have most of the information, which gives then more time to talk to and touch the patient.

Education is key

Originally from Shamokin, Pa., Wisneski, 61, said he wanted to move to the Cape Region because of the opportunity to work with Beebe Medical Center and because it is close to family living in Delaware, Maryland and Pennsylvania.

He and his wife are looking to buy a home in the Lewes area. This summer, the couple renewed their vows standing in the water at Cape Henlopen State Park. The couple has four grown daughters.

A graduate of the Temple University School of Medicine, Wisneski has specialized in spine disorders, including disc disease, stenosis, pinched nerves and spinal cord syndromes.

Enticed to visit the region by one of his former students, Dr. Mark Boytim, who works at Cape Orthopaedics, Wisneski said the opportunity came at the right time.

In the past, Wisneski was drawn to teaching hospitals like The Ohio State University Medical Center and The University of Arizona where he was a professor and chief of spinal surgery. But, Wisneski said he felt his philosophy of quality, individualized care would fit right in with healthcare providers at Beebe Medical Center.

“Beebe is a well-run regional hospital with wonderful personnel and resources,” he said.

Wisneski has also worked for the Charity Spine Surgery Mission in Ismailia, Egypt, and as associate spine surgeon at both Geisinger Medical Center in Danville, Pa. and The Hospital for Special Surgery in New York City.

Cape Orthopaedics serves residents from adolescence through their golden years. For more information, call 302-645-2805.

Lending a hand in Africa

Dr. Ronald Wisneski knows that helping patients locally is just as important as helping those who are less fortunate.

As one of the three members on the Spine Africa Project board of directors, Wisneski makes yearly trips to the Democratic Republic of the Congo to help doctors and patients there. He has worked closely with medical leaders at the world-renowned Panzi Hospital to improve education, training and knowledge of spine injuries.

According to the Spine Africa website, physical injuries, specifically spine-related injuries have begun to proliferate at a staggering rate, and have been afflicting men, women and children.

“The goal of the project is to bring care to people who have nothing compared to what’s available in the United States,” Wisneski said. “In February I will be going back to Africa to help set up a tele-medicine clinic.”

The new clinic will allow medical professionals in Africa to connect with surgeons in the U.S. via the internet.

“This will allow doctors to talk and get advice on problem cases,” he said. “The best thing we can do for Africans is to provide education.”

The project is setting up a medical school in partnership with Panzi Hospital to educate new doctors.

Working closely with both the hospitals and medical education facilities, Wisneski plans to implement a spine-based education program that will allow the local medical personnel to both properly triage and treat those afflicted with a broad spectrum of orthopaedic and spinal disorders.

“I’ve always had an interest in the philanthropic side of medicine,” Wisneski said.

For more information on Spine Africa, go to www.spineafricaproject.org.

Source: Cape Gazette.com; Author: Rachel Swick Mavity; https://capegazette.villagesoup.com/p/spine-surgeon-brings-personalized-care-to-patients/930111

Delaware Breaks Ground, Transmitting Patient Records Electronically

November 8, 2012 – DOVER, DE – In what’s being billed as a first for the state of Delaware, immunization records from a physician’s office have been electronically transmitted successfully to the Division of Public Health through the Delaware Health Information Network (DHIN).

DHIN officials announced the feat Thursday.

“We are very pleased that, for the first time, electronic immunization records were automatically uploaded to the Division of Public Health (DPH) through the Delaware Health Information Network,” said Jan Lee, MD, executive director of DHIN. “This is an important step in eliminating manual reporting and demonstrates that the systems can securely and efficiently share data. We congratulate the P&A Center and the Physician’s Computer Company (PCC) for working with us in completing this important next step.”

The Milton, Del.-based Pediatric and Adolescent Center was the first to successfully upload its immunization reports to DPH, using an automated process within its electronic health record (EHR) software. Other practices are poised to follow suit in the following weeks.

“State law requires that immunizations be reported to the Division of Public Health by every healthcare provider,” said Karyl Rattay, MD, DPH Director. “Until now, that information was prepared and sent manually; often a time-consuming task. With the electronic transfer of these records from the provider, through DHIN to the Immunization Information System, manual entry is eliminated,” she added. “This is an important step in reducing costs, increasing efficiency, and meeting federal data requirements.”

Launched in 2007, DHIN was one of the first health information exchanges in the nation to go live. More than 9 million clinical results and reports are posted on DHIN each year, and officials say patient records in the system now exceed 1.4 million, including patients from all 50 states.

PCC, which provides the EHR software used by the Pediatric and Adolescent Center, developed the computer interface. New programs were written using the HL7 messaging format, which is the new standard for submitting electronic medical data to public health agencies.

According to Lee, DHIN has come a long way in the five years it has been operational.

“Hospitals, medical practices and labs throughout Delaware have come to depend on DHIN’s centralized repository of medical information,” she said. “With the automatic transmission of immunization records to the Division of Public Health, medical practices can save time, and the records will be more accurate than using a tedious, manual system. That means greater efficiency for everyone involved. Now that one practice has a working system, we expect other practices to quickly follow and begin sending their immunization records automatically as well.”

(Source: Healthcare IT News, Erin McCann, Associate Editor. https://www.healthcareitnews.com/news/delaware-breaks-ground-transmits-immunization-records-electronically)

Delaware Open MRI Now Posting Imaging Results to the Delaware Health Information Network

DOVER, DE – September 28, 2012 – The Delaware Health Information Network (DHIN) today announced that Delaware Open MRI has begun posting outpatient medical imaging results to the DHIN system.

“We are very excited to have Delaware Open MRI reporting its results on our network,” said Dr. Jan Lee, executive director of DHIN. “Delaware Open MRI operates facilities throughout Delaware and serves thousands of patients each year. Now those test results will be available to the 96% of Delaware medical providers who are participating in DHIN.  Including these results on DHIN is a great benefit to Delaware providers and the patients they serve,” she said.

Delaware Open MRI, founded by a group of local radiologists in 1997, is one of the leading independent providers of outpatient diagnostic radiology services in the State of Delaware, with offices from Wilmington to Seaford. 

“We have been looking forward to participating in DHIN, said Jason Dobbs, IT Administrator, Tristate Imaging Consultants, LLC. “Reports from our Delaware facilities are being sent to the DHIN database and are now available to not only the referring physician, but to all approved hospitals and practices. Having those results on DHIN should both increase the quality and speed of patient care.  DHIN provides both ease of use and cost effectiveness while meeting government requirements for the security of patient information,” he said. “Regulations require that, within a few years, patient information must be put into a common digital format which can be securely shared for cost reduction and meaningful use. Delaware is leading the way with its health information system and we are very happy to be a part of it,” said Dobbs.

“In the five years DHIN has been operational, hospitals, medical practices and labs throughout Delaware have come to depend on DHIN’s centralized repository of medical information,” said Dr. Lee. “Delaware Open MRI is our first outpatient medical imaging partner and we are very happy that the company’s six locations in Delaware are now using DHIN to efficiently communicate test results to doctors and their practices.  Delaware Open MRI is the latest in a long list of Delaware medical facilities reporting results on the DHIN system including all Delaware acute care hospitals, Lab Corp, Quest, and Doctors Pathology as DHIN data senders,” she said.

About Delaware Open MRI

Delaware Open MRI is part of TriState Imaging Group, which owns and operates 29 freestanding outpatient diagnostic radiology centers in Pennsylvania, Delaware, and New Jersey, providing High-Field MRI, Open MRI, MR Arthrography, Computed Tomography, CT Angiography, CT Colonography, Dental Scans, Coronary Artery Calcium Scoring, Ultrasound, Digital Mammography, Breast Biopsies, Bone Densitometry, Digital X-Ray, Fluoroscopy, and Nuclear Medicine. Delaware Open MRI operates offices in Dover, Middletown, Milford, Newark, Seaford and Wilmington. For more information about Delaware Open MRI visit www.tristateimaging.com.

About the Delaware Health Information Network (DHIN)

The Delaware Health Information Network is the first live, statewide health information network in the nation.  Launched in 2007, today it serves all of Delaware’s acute care hospitals and 96% of the State’s medical providers. More than 9,000,000 clinical results and reports are posted on DHIN each year. Total patient records in the system now exceed 1.4 million including patients from all 50 states. For more information about DHIN visit www.DHIN.org or call 302-678-0220.  Please also visit us on Facebook, LinkedIn and Twitter (@DHIN_hie).

Now is the Time for Meaningful Use!

(September 12, 2012, 5:15 pm) – Recognizing the need to strike a balance between the urgency of modernizing our health care system and the pace of change that can be absorbed by providers and health IT vendors, CMS and ONC have implemented the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs in three stages, with each stage adding increased functionality and advanced concepts designed to improve patient care, enhance care coordination, and increase patient and family engagement. Released in July 2010, the final rules for Stage 1 focus on functionalities that support the electronic capture of data and allow patients to receive electronic copies of their own health record.

It’s important that providers take the steps now to register for the EHR Incentive Program on the CMS website. October 3, 2012, is the last day for eligible professionals who want to collect the maximum Medicare EHR incentive payment to begin their 90-day reporting period in 2012. Eligible professionals who wait until next year can still participate but will receive reduced incentives.

How Meaningful Use Can Improve Outcomes and Efficiencies

Many providers are already seeing how meaningful use of health IT like EHRs can help to improve outcomes and result in efficiencies, such as those who are working with the regional extension center (REC) established by the North Carolina Area Health Education Center Program (NC AHEC). Through the use of EHRs and features like clinical decision support and point of care reminders, the positive impact on quality of care has been significant.

NC AHEC

The NC AHEC has incorporated quality improvement and medical home services into the culture of practice systems which has provided additional benefits that translate into even larger improvements in preventive and chronic care while substantially lowering costs. As an example, the Roanoke Chowan Community Health Center was able to decrease the number of patients with a Hemoglobin A1c measurement greater than nine from 40% to less than 10% in their diabetic population. As measurement and templates in their system became consistent and point of care reminders were implemented A1cs less than seven  have increased to 60% of the diabetic practice.

Meaningful Use Stage 2

The Stage 2 Meaningful Use final rules we recently issued were intentionally designed to help providers implement health IT that will allow them to improve care and transform delivery. The Stage 2 rules focus on increasing standards-based health information exchange between providers and with patients. We expect that future stages of meaningful use will continue to advance health IT capabilities by focusing on advanced clinical decision support and patient engagement tools. The staged implementation of the meaningful use criteria is being leveraged to harmonize quality measures across federal agencies—all with the goal of improving care for patients and resulting in better health more generally and to simplify the process for providers so that they can focus on the needs of their patients.

New Orleans AIDS Task Force

The New Orleans AIDS Task Force (NATF) is just one example of an organization that has been working to develop innovative approaches to meet those goals, and the effects of Hurricane Katrina helped NATF rapidly implement a meaningful EHR system. NATF has implemented a multifactor disease-specific risk stratification based on a patient’s lab and vital sign values. Risk scores, are then determined for these values based on evidence-based clinical guidelines. Each disease has its own registry that displays a list of patients and their risk score, the clinical staff reviews the registry and proactively identifies patients who may need to meet with a nurse care manager who can make appropriate referrals, establish goals pertaining to care, and educate patients. This process has helped improve clinical outcomes which are monitored quarterly. For example,  the agency has documented an increase in HbA1C test administration for diabetic patients from 88.5% during the first quarter to 98.5% during the most recent quarter.

Meaningful Use Is Ambitious

Implementing an EHR system so that it can optimally support providers isn’t easy. EHR implementation requires practices to transform many of their existing systems, which can be costly and time consuming. Because most providers are focused on providing high-quality care to their patients, they may have limited knowledge/expertise about how to make the changes necessary to easily meet all of the meaningful use criteria. Despite these challenges, however, providers such as those working with the Virginia Health Quality Center (VHQC) understand the potential for technology to improve health care delivery and they are ready to take on the challenge.

VHQC

VHQC is the Virginia REC and Quality Improvement Organization that has been helping providers implement activities related to meeting the Stage 1 Meaningful Use and Physician Quality Reporting System (PQRS) clinical quality measures  for smoking cessation intervention—a goal of the HHS Million Hearts program. In Virginia, VHQC and the program providers are working to increase rates of screening and intervention across the commonwealth. VHQC estimates that achieving this goal will impact 237,000 patients. Assuming a national 19.3%  rate of smoking-related illness and an average annual cost of $2.08 Billion in Virginia, this can potentially save as much as $440 million. Achieving the Million Hearts benchmark, which includes reaching  every Virginian who sees a primary care physician, would exponentially increase the impact.

Meaningful Use Is Happening Across the U.S. in Every Practice Setting

There is strong support for the EHR Incentive Programs across the country.  More than 350,000 providers have either registered to participate in the program or agreed to work with an REC to achieve meaningful use in the next two years. The EHR Incentive Programs has already paid more than 120,000 providers and tens of thousands of other providers are preparing to get paid this year. Even providers in areas with historically low EHR adoption rates are aggressively working toward achieving meaningful use. For instance, more than 70% of primary care providers in rural areas and those working with federally qualified health centers (FQHC) are committed to achieving meaningful use in the next two years.

Lone Star Circle of Care

One provider who has seen meaningful results is the Austin, Texas-based Lone Star Circle of Care (LSCC).  LSCC is an FQHC in central Texas with a Level 3 Patient Centered Medical Home Recognition. LSCC utilized meaningful use of its EHR as an accelerant for change by establishing previously non-existent electronic communication between patients’ primary care providers and case managers at the health district. They also used analytics from clinical quality measures to drive automated calling queues for clinical specialists, shifting the focus away from encounter-based alerts and toward population-based outreach. This process identified and then rectified missed care opportunities. LSCC also created real-time web reports that showed each provider’s performance scores on threshold objectives to further improve performance.

Now Is the Time to Act

If you haven’t already begun the process of working toward achieving meaningful use, you should start now.

  • The first step is to register for the EHR Incentive Programs. You can learn more about how to do this on the CMS website.
  • If you’ve registered for the Medicaid EHR Incentive Program, you should try to apply for your Adopt, Implement and Upgrade funds this year so you can get the resources you need to achieve meaningful use. If you’re registered for the Medicare EHR Incentive Program, you should remember to begin your 90 day reporting period no later than October 3 of this year, if you want to get your maximum EHR incentive payments.
  • Finally, if you are having trouble understanding the meaningful use criteria or don’t know where to start, you should reach out to your local health IT REC. They can provide you with a variety of services/information that can help you transform your practice to achieve meaningful use.  A list of RECs can be found on the ONC web page.

Many providers have already attested to Stage 1 meaningful use and are meaningfully using their EHRs to improve patient care. By sharing these stories, providers can learn from those who have already attested and obtain a better understanding of how they too can make Meaningful Use meaningful.

ONC conducted a challenge to obtain these stories and received 21 submissions—two submissions were chosen as winners and two were chosen as runners up. Highlights of these submissions can be found on ONC’s website.

For More Information

Farzad Mostashari, National Coordinator for Health IT; Rob Tagalicod, Director, Office of E-Health Standards and Services, CMS; and Mat Kendall, Director, Office of Provider Adoption Support, ONC

HealthITBuzz; https://www.healthit.gov/buzz-blog/meaningful-use/meaningful-use-ehr-incentive-programs/

Testimonials

“DHIN helps me learn about new patients. I can review previous radiology, lab, and pathology reports and consults. It helps me manage the patient in practice and discuss their conditions.”

– Dr. Dyanne Westerberg, AccentCare

Delaware Health Information Network - Empowering Data-Driven Decisions

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