Delaware Health Information Network

DE Health Information Network Approves MedicsDocAssistant(TM) EHR

(July 23, 2012) DOVER, DE and PARAMUS, NJ — The Delaware Health Information Network (DHIN) has named Advanced Data Systems (ADS) and the MedicsDocAssistant EHR as DHIN-certified. Certification verifies that MedicsDocAssistant has been tested and approved for interoperability and interconnectivity with DHIN’s various Data Senders, and that ADS programmers have successfully demonstrated interconnectivity capability with them.

DHIN’s Data Senders are among the most recognizable healthcare companies in the state of Delaware. They include BayHealth Medical Center, Beebe Medical Center, Christiana Health Systems, Doctors Pathology, LabCorp, Nanticoke Health Systems, Nemours, Papastavros’ Associates, Quest Diagnostics, Saint Francis Hospital, and Tristate Imaging Group.

Dr. Jan Lee, Executive Director of DHIN said, “We are pleased to announce this very noteworthy accomplishment on the part of ADS and DHIN. We look forward to having thehealthcare providers utilizing the MedicsDocAssistant EHR in Delaware take full advantage of this new integration.”

David Barzillai, President of ADS said, “Becoming DHIN certified is something about which we are extremely proud. Our current and future Delaware clients are now assured of the ability to interface and interconnect their MedicsDocAssistant EHRs with DHIN’s Data Senders. It was a pleasure working with the DHIN staff in helping to perfect this capability.”

More information on ADS and DHIN can be seen by visiting their websites. Their media representatives can also be contacted as noted.

About the Delaware Health Information Network: The Delaware Health Information Network (DHIN) is the first, and most mature, live statewide health information network in the nation. Launched in 2007, today it serves all of Delaware’s acute care hospitals and 93% of the State’s medical providers. More than 9 million clinical results and reports are posted on DHIN each year. Total patient records on the system now exceed 1.3 million and include records for 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).

About Advanced Data Systems: Since 1977, ADS has been a leading provider of automation solutions to medical practices of every size and specialty, to imaging centers, and to revenue cycle management companies. The Company’s Medics solutions include the MedicsDocAssistant EHR, MedicsPremier and MedicsElite for comprehensive PM, and MedicsRIS for radiology. ADS provides quick Implementation, comprehensive Training and excellent ongoing Support with Updates. Over 30,000 providers rely on solutions from ADS.

About MedicsDocAssistant EHR’s certification: MedicsDocAssistant Version 6.0 has been tested and certified under the Drummond Group’s Electronic Health Records Office of the National Coordinator Authorized Testing and Certification Body (ONC-ATCB) program. This Complete EHR is 2011 / 2012 compliant in accordance with the applicable certification criteria adopted by the Secretary of Health and Human Services. It does not represent an endorsement by the U.S. Department of Health and Human Services or guarantee the receipt of incentive payments. The system must be utilized by the eligible professional (EP) in accordance with current Meaningful Use (MU) requirements. Once MU requirements have been met, the EP can attest in order to obtain his or her EHR Stimulus Act incentives.

Media Contacts:

Marc E. Klar
Vice President, Marketing
Advanced Data Systems
800-899-4237, Ext. 2061
marc.klar@adsc.com

Randall J. Farmer, M.S., M.eD.
Director, Provider Relations and Business Development
Delaware Health Information Network
302-678-0220
randy.farmer@dhin.org

Healthcare IT Connect: Forecast-High of HIE Insights

(June 21, 2012) HERNDON, Va.–As temperatures rose across the nation, so did opinions on health information exchanges (HIEs) in two panel discussions June 21 at the Healthcare IT Connect Summit. During the panels, the overriding consensus among participants is the need to build a use case for HIEs.

Are HIEs positioned to add value and provide timely support to patient-centered medical homes (PCMHs) and accountable care organizations (ACOs)? asked Lynn Dierker, senior program director, National Academy for State Health Policy (NASHP).

John Kansky, vice president of product management at the Indiana Health Information Exchange, noted that patients attributed to ACOs will receive 30-45 percent of their care outside of the ACO system. That raises the question of how to entice health plans, providers and payors to foot the bill to share clinical data–data generally hoarded for leveraging purposes.

According to Dave Goetz, vice president, state government solutions, Optum, health plans have been reluctant to support HIE because:

  • Savings are based on assumed reductions in future spending;
  • Saving must be real, near-term and accrue to the plan;
  • HIE has no focused clear use cases on where the risks and returns are;
  • Company structure can inhibit ability to realize value and provide support;
  • Low adoption lessens impact and perceived value; and
  • Health plans are often explicitly excluded from governance and data-sharing.

“[HIE] must have a business case,” said Goetz. If an HIE must present a business case, how can an organization build value among its targeted community?

One piece of advice Jeffrey Milller, CEO, North Carolina Health Information Exchange, mentioned was to start with basic functions before trying to advance services. “You don’t want to swim with sharks if you can’t [swim] freestyle,” Miller commented. Jan Lee, executive director, Delaware Health Information Network (DHIN), echoed this sentiment by stating a key principle to drive adoption and utilization at DHIN was doing core services “very well” before expanding service lines.

For DHIN, that service was an electronic clinical results delivery service for lab, pathology and radiology results. She said she can present data to potential HIE participants where, within the provider community of Delaware, from the time discovery tools were made available, there was a 30-33 percent reduction in the rate of high costs, labs and radiology studies in two years. “At Medicare reimbursement rates, that equates to $6.5 million in the state of Delaware over a two-year period of time,” she said.

Assessing sustainability, Kanksy doesn’t know how an HIE that isn’t well established can help an ACO. Because accountable care models and HIEs rely on the reality that clinical data needs to be present within the system, how can HIEs make a business case to show that they a) have enough clinical data and b) that data can show value to other organizations?

Another piece of advice Miller gave was that a “death knell” for HIEs is to fixate on the initiative plan. For example, one of the main services North Carolina HIE provides is a hosted EMR; a service not mentioned in the first draft of their model. When asked by an audience member if he felt he had wasted time on his original plan, Miller responded that if you don’t have a plan, you’ll never know where you’re going. “If you have a plan, you can see if you’re not on that plan and react to it,” he said, noting organizations can adjust plans to change focus or adjust operations to get back on track.

While he admitted he spent money upfront on governance and policy issues he would’ve not had or baked into a residual budgetary timeline based on what he knows about current HIE adoption in his state, Miller concluded plans are important to have to drive toward goals.

Source: Jeff Byers, CMIO: https://www.cmio.net/index.php?option=com_articles&view=article&id=34417:healthcare-it-connect-forecast-high-of-hie-insights

658 Providers in Delaware Receive $21,128,340 under EHR Incentive Programs

(June 20, 2012) More than 100,000 health care providers have been paid under the Medicare and Medicaid Electronic Health Record (EHR) Incentive Programs, the Centers for Medicare & Medicaid Services (CMS) and the Office of the National Coordinator for Health Information Technology (ONC) announced today. Of those, 658 eligible providers in Delaware have received $21,128,340 in payments.

CMS Acting Administrator Marilyn Tavenner and National Coordinator for Health Information Technology Farzad Mostashari, M.D., Sc.M., first proposed the 100,000 goal in March in a blog that declared 2012 the “Year of Meaningful Use”.

“Meeting this goal so early in the year is a testament to the commitment of everyone who has worked hard to meet the challenges of integrating EHRs and health information technology into clinical practice,” said Acting Administrator Tavenner. “Not only have state Medicaid programs, public health departments, and many other stakeholders given their support to the Medicare and Medicaid EHR Incentive Programs, but numerous eligible health professionals and hospitals have recognized the potential of EHRs to provide better patient care, reduce medical errors, cut down on paperwork, and eliminate duplicate screenings and tests.”

The EHR Incentive Programs, which began in 2011, provide incentive payments to eligible professionals, eligible hospitals, and critical access hospitals as they adopt, implement, upgrade, or meaningfully use certified EHR technology in ways that improve care. Eligible professionals include physicians, nurse practitioners, certified nurse midwives, and some physician assistants.

As of the end of May 2012:

  • Over $5.7 billion in EHR Incentive Program payments were made.
  • More than $3 billion in Medicare EHR Incentive Program payments were made between May 2011 (when the first payments were released) and the end of May 2012.
  • More than $2.6 billion in Medicaid EHR Incentive Program payments were made between January 2011 (when the first states launched their programs) and the end of May 2012.
  • More than 110,000 eligible professionals and over 2,400 eligible hospitals have been paid by the Medicare and Medicaid EHR Incentive Programs.
  • Approximately 48 percent of all eligible hospitals and critical access hospitals in the U.S. have received an incentive payment for adopting, implementing, upgrading, or meaningfully using an EHR.
  • One out of every 5 Medicare and Medicaid eligible professionals in the U.S. has received an incentive payment for adopting, implementing, upgrading, or meaningfully using an EHR.

“The EHR Incentive Programs have really helped jump-start the use of electronic health records by health care providers all across the country,” said Dr. Mostashari. “Thanks in great part to the work conducted by the ONC-sponsored Regional Extension Centers and Beacon Communities Programs, more and more providers across the country – especially those in rural communities – are now ready to use EHRs.”

ONC, which works closely with CMS on the EHR Incentive Programs, provides grants to Regional Extension Centers (RECs) to support health care providers in the adoption and Meaningful Use of EHRs. The REC for Delaware is Quality Insights of Delaware – Regional Extension Center (QIDE REC).  In this capacity, QIDE REC serves as:

  • Trusted advisors that provide unbiased support throughout the EHR process – from start to finish.
  • Experts with broad, practical Health IT knowledge.
  • Two-way pipelines connecting providers to the local and federal resources needed to understand the changing health care landscape.

Through the end of May 2012, over 133,000 primary care providers and 10,000 specialists were partnering with RECs to overcome common EHR adoption barriers. Of these providers, 70 percent of small practice providers in rural areas as well as 74 percent of critical access hospitals are working with RECs. RECs work to ensure these clinicians meet meaningful use standards and receive incentive payments through the Medicare and Medicaid EHR Incentive Programs. Over 12,000 providers working with RECS have already received incentive payments. In Delaware, QIDE REC is currently working with 1,262 providers, 300 of which have successfully attested to meaningful use within the Medicare EHR Incentive Program, qualifying them for incentive payments. 

Health information exchange (HIE) is also a critical part of the equation for the nation’s successful transition to an electronically-enabled health care system.  QIDE REC works collaboratively with the Delaware Health Information Network (DHIN), the state’s health information exchange (HIE), in a focused effort to get provider’s systems to “talk to each other”.  As of May 31, 2012, there were 579 Delaware organizations enrolled in the DHIN and 376 have reported using an EHR.  Of these 376 organizations, 173 practices, or 46%, have an EHR that features a certified interface with DHIN.

Since its launch in September 2010, the Community College Consortia Program has rapidly trained more than 13,000 professionals nationwide. The majority of students are mid-career health care or IT professionals with prior experience in fields outside health IT. Student demographics included significant minority and rural representation. By leveraging distance learning platforms, the program has trained students in all 50 States, the District of Columbia, and Puerto Rico.

The Medicare and Medicaid EHR Incentive Programs provide incentive payments for using EHR technology in ‘meaningful’ ways that lead to higher quality care, improved patient safety, and shared decision making by patients and physicians. Under the Medicare EHR incentive program, eligible professionals can receive as much as $44,000 over a consecutive five-year period. Under the Medicaid incentive program, eligible professionals can receive as much as $63,750 over six years. Under both the Medicare and Medicaid EHR Incentive Programs, eligible hospitals and critical access hospitals can receive millions of dollars for implementing and meaningfully using certified EHR technology.

Under the Medicaid EHR Incentive Program, eligible providers can receive incentive payments in their first year of participation by successfully registering through CMS’ web-based registration system and then demonstrating to their state that they are eligible and have adopted, implemented, or upgraded certified EHR technology. Medicaid EPs and eligible hospitals do not need to attest to meeting meaningful use criteria in the first year. However, they will have to demonstrate meaningful use in subsequent years.

Forty-four states are participating in the Medicaid EHR Incentive Program as of May 2012. For more information on which states are participating, please visit the EHR Incentive Programs Web site. CMS expects the remaining states to launch their Medicaid EHR Incentive Programs by the end of 2012.

For more information on the Medicare and Medicaid EHR Incentive Programs, visit: https://www.cms.gov/ehrincentiveprograms/.

Information on ONC’s broad range of activities may be viewed at https://healthit.hhs.gov/portal/server.pt/community/healthit_hhs_gov__home/1204.

Christiana Care Health System Wins Prestigious Center for Medicare and Medicaid Innovation Grant

WILMINGTON, Del., June 19, 2012 /PRNewswire-USNewswire/ — Christiana Care Health System has been awarded a $10 million grant from the Center for Medicare and Medicaid Innovation to design a new care model that will harness pioneer information technology to transcend the gaps that currently exist within health care to provide more coordinated care and greater value for patients.

Announced today by CMMI under the agency’s highly-competitive “Health Care Innovation Awards,” Christiana Care’s proposal is tailored to use existing hospital and office information systems to trigger alerts specifically for patients who need extra care both during hospitalization and upon discharge to their homes. The alerts will help a team of nurses and other health care professionals respond quickly and effectively to the patients, enabling them to recuperate in their homes and safeguarding them from symptoms that can result in a costly readmission.

Christiana Care’s proposal – known as the “Bridging the Divides” model – was one of only 107 projects picked for the Innovation Grants from more than 3,000 applicants nationwide.

“This breakthrough opportunity will truly transform care to significantly improve the value of the care we deliver and most importantly improve the quality of life for the patients we are privileged to care for,” said Robert J. Laskowski, M.D., president and CEO of Christiana Care. “Our Bridging the Divides model enables us to tailor the delivery of health care to the unique needs of our patients, allowing them to remain in the comfort of their homes. CMMI’s decision to recognize our proposal also gives health care systems across the nation the opportunity to learn from this new model of care.”

The proposal will aim at improving care in numerous ways, including:

  • Using predictive analytics to identify which patients are more likely to experience readmissions, develop complications and need a higher level of care
  • Creating an electronic patient portal and personal health record to enable patients to communicate with the care management team
  • Comparing patient-specific outcomes with evidence-based recommendations in cardiology
  • Using a software-driven care management program designed to improve patient outcomes

Christiana Care’s proposal is focused on treating Delawareans who suffer from ischemic heart disease, which occurs when the arteries that supply blood to the heart muscle become hardened and narrowed. This buildup results in a lack of oxygen or blood flowing to the heart and can lead to chest pain and heart attacks. Over time, ischemic heart disease can weaken the heart muscle and can contribute to heart failure and arrhythmias.

“The work under this grant can serve as a model for the nation as we work together to deliver high quality affordable health care to Delawareans,” Gov. Jack Markell said. “Christiana Care is building on the considerable investment we have made in Delaware’s healthcare information infrastructure.  Technology, information, and innovation are critical to reducing health care costs and improving quality of care. Christiana Care will help us move from a sick care system to a health care system.”

While the care management of heart and vascular disease patients by and large has been delivered in the same way to every patient in order to achieve optimal results, Christiana Care’s model is aimed at identifying whether resources can be applied to small segments of the population who need them the most in order to use the resources most prudently and effectively.

“The Affordable Care Act allows us to increase access to affordable, quality care by finding innovative ways to get better health outcomes for less money,” U.S. Sen. Tom Carper said. “This federal funding, made possible by the Affordable Care Act, will help Delaware’s doctors and nurses to use new technologies and electronic health records to better coordinate care for Delawareans, especially those with heart disease. This project helps to improve patients’ health and reduces unnecessary visits to emergency rooms and hospitals, increasing the quality and efficiency of health care services in Delaware while also lowering costs. I applaud the Administration’s efforts to support this initiative and congratulate Christiana Care on receiving this much-deserved grant.”

“When it comes to stopping heart disease, prevention is the best and most cost-efficient option we have,” U.S. Sen. Chris Coons said. “With this federal grant, Christiana Care will help keep Delawareans healthier and lower healthcare costs by facilitating stronger communication between our state’s care providers. It’s important that the government and medical community continue to work together to stem the tide of this rapidly growing disease that is currently the number one cause of death in Delaware. I congratulate everyone at Christiana Care on winning this grant, and look forward to seeing its positive impact on our communities.” 

“Making better use of data is key to improving the quality of care that patients receive, as well as reducing healthcare costs,” Congressman John Carney said.  “Investing in this data hub will ensure that doctors and nurses have the information they need to help a patient manage heart disease and access important resources for effective care, while avoiding unnecessary and expensive visits to the hospital.  I applaud Christiana Care for taking the initiative to develop this system, and I look forward to the positive impact it will have for Delawarepatients.”

Christiana Care’s proposal is uniquely suited to carry out in the First State because of the Delaware Health Information Network. Because this network functions as a data collector for all Delaware hospitals and collects more than 92 percent of lab results statewide, health care professionals already are capable of accessing the most current, critical information on patients.

“Through this model, we will be wrapping the patients’ information around them to close the divides that hinder the delivery of effective, high quality, longitudinal patient care,” said Randall Gaboriault, the chief information officer for Christiana Care and the chair of the Delaware Health Information Network. “We are using information and technology to change the way care is delivered in a way that is meaningful, evidence based and outcome driven.”

“Both Christiana Care and DHIN are innovators and leaders in health care and this award is another validation of our success in working together,” added Bettina Riveros, Secretary of DHIN and chair of the Delaware Health Care Commission. “We may have won the CMMI grant, but the Delawareans that our dedicated health care professionals treat each day are the true beneficiaries of this award, as it will lead to better care and better outcomes.”

Christiana Care’s partners in the project include the American College of Cardiology, the Society of Thoracic Surgeons, the Delaware Health Information Network and the University of Delaware. The partners also include several doctors in the community.

The federal Centers for Medicare and Medicaid Services created the CMMI to improve the health of Medicaid, Medicare and CHIP patients – and by extension all Americans – while combating escalating costs. The $1 Billion Health Care Innovation Challenge – funded through the passage of the Patient Protection and Affordable Care Act in 2010 – carries a triple aim: better health, better health care and reduced costs.  The Innovation Challenge provides 3-year grants of $1 million to $30 million to health care providers, payers, local government entities, and public-private partnerships, including collaborative efforts among multiple payers.

For more information about Christiana Care, visit www.christianacare.org/whoweare.

SOURCE Christiana Care Health System

It’s full steam ahead for medical data highway

(June 3, 2012) – Health care is and will be changing in Delaware regardless of what the U.S. Supreme Court decides on the Affordable Care Act later this month.

Delaware physicians started changing paper-based patient records to electronic ones back in 2006 as part of a Centers for Medicare and Medicaid Services technology initative. Since then, Quality Insights of Delaware, as part of the American Recovery and Reinvestment Act, is assisting even more physicians to not just buy an electronic records system they can just plug in, but to use electronic records to improve patient care and achieve “meaningful use,” a set of quality measures each practice has to attain. To date more, than 1,400 Delaware physicians have sought that assistance. But why is all this necessary?

When I first went into practice as a family physician, I would care for my patients in the office, admit them to the hospital when necessary and then follow them through the hospital stay, to an extended care facility if that was required, and then back to their home with even a home visit now and then. Over the years, with increasing pressures and demands on my professional time, I, like many other primary care physicians, became essentially office-based, transferring patient care to collaborating colleagues. However, with the increasing complexity of medical care, it has become increasingly difficult to maintain the necessary detailed follow up which today’s sophisticated medicine requires. In medical parlance, we are moving patients from silo to silo, often without the critical information their health care professionals need to optimize their care.

To counteract this downward spiral, across the country, new systems of caring are starting up. Within primary care practices the Patient Centered Medical Home (PCMH) is the most basic. Under it a practice changes its internal workflow so that instead of just the physician, a care team is created which takes responsibility for the patient’s health care, monitoring each of the patients to make sure preventive care is done, that patients make their specialty consultation, that patients return to their PCP for follow up of important health issues. Here in Delaware, there are several PCMH initiatives under way, with the Medical Society of Delaware’s Patient First being the largest effort to date.

Accountable Care Organizations will be the next step in Delaware, as health care groups band together to take responsibility for patients within a geographical area, usually under contract with one or more insurance plans, such as Medicare.

All of this may seem to be overwhelming complex. Obviously, it cannot function within a paper-based system. Therefore, electronic health records are a baseline necessity for any place a patient goes, so that their data, whether at the office, hospital, extended care facility, home health, or outpatient radiology and laboratory, can move with them and in anticipation of future need. But to do that, all of these silos need to be interconnected, so information can be transferred between the silos, so care can be coordinated.

In Delaware, the Delaware Health Information Network is the connection. This “health information exchange” is growing in membership and complexity. Eventually it will allow patient information to flow securely between all of the silos in real time, making patient’s information available regardless of where the patient goes within the state. In a far future development, this information will be available nationwide so that travel beyond our state borders will not limit care.

What does all this mean to the patient?

While a lot of new words and abbreviations are being tossed about that patients need to understand, we can acknowledge that the health care system is not anywhere near perfect or mature.

While we are bulldozing a lot of interconnecting paths within the medical community and some actually have asphalt, we have a long way to go before we get anywhere close to a mature and sophisticated informational medical superhighway. In the interval, which will take years to complete, as we are moving from silos of care to patient focused care, each patient needs to take responsibility for knowing about their own health status and working to make sure their basic, as well as critical health information, moves with them at all steps in the process.

Edward R. Sobel, DO, is the medical director for Quality Insights of Delaware.

(Reprinted from The News Journal, June 3, 2012, https://www.delawareonline.com/article/20120604/OPINION07/306040025/It-s-full-steam-ahead-medical-data-highway?odyssey=mod|newswell|text|Opinion|p)

Statewide medical record system touted

(May 24, 2012) – Randy Gaboriault’s mother, Kathleen “Kay”, came down with pneumonia about two months ago, went to a “stand-alone” hospital in Florida, and was prescribed an antibiotic and discharged. She followed up with a primary care doctor. Within a matter of days, she went into cardiac arrest, suffered brain damage and died. Ten days earlier, she had been on the golf course.

Gaboriault, who is chief information officer for Christiana Care Health System, believes her outcome could have been different had the hospital known about the cancerous tumor removed from her lungs years earlier. Maybe it would have kept her instead of sending her home.

But the staff didn’t have access to her medical records and couldn’t better tailor her care to her medical history. As his mother’s health was failing, Gaboriault and his family scrambled to pull all her records together. They were still receiving them four days after she died.

“It was a nightmare,” Gaboriault said.

As Gaboriault’s family learned, a lifetime of health records can become fragmented without a central place to keep them. Often, accessing these records means waiting for phone calls, faxes, records requests and the mail.

But that could change in Delaware. The state has a centralized, electronic warehouse for health information – the Delaware Health Information Network, or DHIN – and the country’s first statewide health information exchange has been going for five years. The concept was born 15 years ago, under the auspices of the Medical Society of Delaware, now-Sen. Mike Katz and then-Gov. Tom Carper, among others.

All of Delaware’s hospitals, nursing homes and federally qualified health centers are enrolled in DHIN, as well as several of Delaware’s hospices, health insurers, imaging centers, pharmacies and nearly all medical laboratories. When patients receive care at any of these places, their health information is fed into the DHIN. Physicians who are enrolled in the DHIN – currently 92 percent of Delaware’s medical providers – can then sign on and access patient health information.

“If a patient came in and said, ‘I had a blood test done by the cardiologist,’ rather than calling and asking them to fax it over, we can access it directly through DHIN very quickly – and we do that every day while in front of the patient,” said Dr. Jerome Abrams, a family practitioner at Dover Family Practice.

People don’t need to be, as Gaboriault put it, integrators of their own care because doctors can use the DHIN to access their information, even if they went to Nanticoke Hospital for a procedure and Lab Corp for tests.

Abrams was one of the beta testers for the DHIN, helping develop the tool to suit the needs of a primary care practice. Others, like the Division of Public Health, use DHIN to track disease outbreaks and to improve surveillance and monitoring. DPH Director Dr. Karyl Rattay said the DHIN could be used to maintain the cancer registry and newborn screening data.

According to Dr. Jan Lee, executive director of the DHIN, it was a place where health information, like test results, landed back in 2007 and fewer than 10 percent of health providers used it. But in 2009, when a search function was added so doctors could find health records, that number jumped to 45 percent. In 2012, that number has more than doubled again.

Dave Walczek, chief information officer at Bayhealth Medical Center and a member of the DHIN board of directors, said they also created a portal that allows DHIN information to automatically feed into physicians’ electronic health records, if they have them. Providers do not need to have electronic records to access information through the DHIN.

Electronic health records adoption is a goal of the 2009 American Reinvestment & Recovery Act, pushing for their “meaningful use” to maintain and utilize health information. Mark B. Thompson, external affairs officer for the Medical Society of Delaware, said 78 percent of society physicians – nearly 75 percent of Delaware’s doctors – have adopted some form of electronic health records. The U.S. average is only as high as 35 percent of hospitals and 46 percent of physicians.

A report this month from the Kaiser Family Foundation states that at least 20 percent of health care expenditures are due to waste, including overtreatment and failure to coordinate care. Kaiser asserts that a lack of efficient, integrated systems to electronically store and transmit health information contributes to higher costs and lower efficiency in health care.

The DHIN may prevent doctors from ordering duplicate tests or prescribing unnecessary medications, and may help them better direct their treatments. This could translate to cost savings and more efficiency, as well as better patient care. The current challenge is getting everyone on board and everyone connected across different technology platforms, though the DHIN has health IT teams on the job.

“Eventually, they say, we will be able to get reports from other physicians, but that hasn’t quite happened yet,” said Abrams.

Randy Gaboriault is also chair of the DHIN and recently experienced firsthand the effectiveness of the network he has helped create. Not long after his mother’s death, the fit man experienced chest pain, which he initially attributed to a pulled muscle, but eventually he was prompted to visit a cardiologist at Christiana Hospital. Because all of Delaware’s hospitals are part of the DHIN, the physician had access to Gaboriault’s blood work from a recent health screening.

After an EKG and a check of the stored blood work, Gaboriault had piece of mind that he had not experienced a heart attack. He also avoided unnecessary tests.

Walczek is excited to see competing health organizations in the state coming together toward DHIN’s common goals, and for the possibilities the DHIN affords Delawareans with respect to managing population health.

“It’s a conduit to bring information back and forth, to see what’s going on with patients, so care is not so fragmented. DHIN is really the glue that can bring it all together.”

(KELLY APRIL TYRRELL, The News Journal, https://www.delawareonline.com/article/20120524/NEWS/305240042/Statewide-medical-record-system-touted?odyssey=tab%7Ctopnews%7Ctext%7CHome&nclick_check=1)

Delaware Health Information Network Marks 5th Anniversary

Dover, Delaware (May 18, 2012) – Leaders from throughout Delaware gathered at Christiana Hospital today to celebrate the anniversary of another major “first” for the First State. Five years ago the Delaware Health Information Network (DHIN) went live online and became the nation’s first state-wide health information exchange.

Delaware Health Information Network Marks 5th AnniversaryIn those five years, the Network has grown rapidly and now includes all of Delaware’s acute care hospitals, all long-term nursing care facilities, all major medical imaging firms, and 92 percent of healthcare providers. More than nine million medical history results are expected to be posted to the system this year for the 1.3 million patients on record.

Appropriate medical treatment can begin more quickly

“What this means for patients in Delaware is that emergency room physicians and medical providers have instant access to patients’ test results and other medical information,” said Dr. Jan Lee, Executive Director of DHIN. “With that information readily available, appropriate treatment can begin much more quickly…and that will save lives.  In addition, with doctors able to see test information that has already been conducted on a patient, unnecessary, duplicative and expensive tests have been reduced by as much as 33% percent. Consequently healthcare costs are reduced and better care is provided more quickly,” she said.

However, DHIN was not established to only save money. “The real impact of DHIN is with patient care,” said Randy Gaboriault, DHIN Board Chair and CIO of Christiana Care. “Physicians now have at their fingertips the information they need to quickly determine a proper course of treatment.  That information was often delayed or had to be repeated before DHIN became available,” he said. 

Governor Markell Notes Delaware’s Leadership

Delaware Health Information Network Marks 5th Anniversary Governor Markell “We celebrate Delaware’s leadership in a formal exchange of health information that is helping doctors, hospitals and medical professionals deliver better care,” said Governor Jack Markell.  “When a patient transfers from the hospital to a skilled nursing facility, for instance, that facility can now query the DHIN to confirm discharge instructions.  When a patient in an emergency room references a recent CAT scan, emergency room doctors can retrieve those results from the DHIN to help them make better informed diagnosis. DHIN is the technology foundation for us to truly transition from a sick care system to a health care system.”

New Technology

Of particular interest to physicians attending the event was the demonstration of new technology that will be available on DHIN soon.  Medicity’s “I-NEXX” platform will allow physicians to access to a variety of applications that will provide specific types of product and services relevant to improving patient care.  The user experience will be similar to using a smart phone where icons of the different apps are displayed and clicked-on as needed.

Medication History Expected Online Later This Year

Dr. Lee announced that the next big addition to the DHIN system will be the availability to medical providers of patient medication history. “We have been working hard to get that information into the system and it will be available later this year,” she said. “Prescription information is often not available for doctors treating new patients. Having it online will help eliminate prescribing drugs that may have dangerous interactions with other medicine the patient is taking. It is important information for providers to have and an essential next step for our program.”

Medicity Provides Technical Infrastructure and Support

Delaware Health Information Network Marks 5th Anniversary: Governor Markell Throughout its tenure as the leading state-wide health information exchange, DHIN has contracted with Medicity (https://www.medicity.com/) as the company responsible for the technical infrastructure and overall support of the network. “DHIN is the innovator in health information exchange. We are proud to be associated with this ground-breaking organization who is realizing the benefits of combining information technology with community collaboration to improve healthcare,” said Brent Dover, President of Medicity.   “The benefits DHIN has achieved over the last five years have defined our market and are an example of what providing health information exchange should do for all communities,” Dover added.

About the Delaware Health Information Network (DHIN)

Delaware Health Information Network (DHIN) is the first and most mature, live, statewide health information network in the nation. Launched in 2007, today it serves all of Delaware’s acute care hospitals and 92% of the State’s medical providers.  In 2012, more than 9,000,000 clinical results and reports will be posted on DHIN for over 1.3 million unique patients. Total patient records in the system include records for 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).

(News.Delaware.Gov: https://news.delaware.gov/2012/05/18/healthinformationnetwork/)

Delaware, a leader in HIE and other health IT

By Mary Mosquera

While Delaware is moving slowly on health insurance exchanges and other pieces of health reform, it has demonstrated that it is an innovator, having established the first operational statewide health information exchange in the country in May 2007. Small states often can be inventive because their size allows for flexibility.

The Delaware Health Information Network (DHIN) provides secure direct delivery of lab and pathology results, radiology and transcribed reports, and demographic and billing information. It also includes clinical history, including medications, searchable by authorized DHIN users.

In February, DHIN accomplished full participation of all acute care hospitals and skilled nursing facilities in the state, along with 86 percent of Delaware providers, in the network, essentially a statewide community health record.

The statewide HIE gives Delaware the ability to improve the quality of care while managing its cost, said Delaware Gov. Jack Markell, a Democrat who took office in 2009. “This is the fundamental technological foundation we need to build a system of focused and managed health care that keeps people healthy,” he said in announcing the achievement.

Rita Landgraf, secretary of Delaware Health and Social Services, said that connecting Delaware’s nursing homes with DHIN was “a critical milestone and a key component to eliminating medication errors. By enabling access to discharge summaries and other information, we can ensure seamless transitions of care for resident in these facilities.”

DHIN has a Web-based portal for providers without an electronic health record (EHR), including auto-print for paper charting and direct interface into the EHR with patient record matching for those providers with EHRs.

Delaware’s April 24 Republican primary played out against the backdrop of healthcare innovation. Delaware has the smallest number of delegates, 17, of the four primaries taking place the same day. With former Massachusetts governor, Mitt Romney, the presumed GOP presidential candidate, the primaries have become ho-hum affairs.

Earlier this month, Romney told an audience in Wilmington, Del., that he would repeal the health reform law or issue an executive order for waivers to the 50 states. He has called for each state to create its own health reform plan.

Delaware may be most renowned as the state where in 2010 the Tea Party-backed Republican candidate Christine O’ Donnell defeated nine-term Rep. Mike Castle, a moderate, in the primary before she lost the U.S. Senate bid in the general election, in part due to some bizarre advertising that referenced witchcraft.

In 2012, Delaware is trying to come up with some real-world solutions to developing a health insurance exchange and extending coverage to its 104,000 uninsured individuals without breaking its budget.

The Delaware Health Commission is the entity within the Delaware Health and Human Services Department exploring health insurance exchanges, which are to go live in 2014 under the health reform law. Delaware has received the early $1 million exchange planning grant and $3.4 million establishment grant. The Public Consulting Group Inc., which offers research about state and local programs, provided earlier this month a feasibility analysis and recommendations for a strategy going forward on the exchange.

States that are small or have small populations are concerned about how they will handle the cost of health insurance exchanges. The consulting group estimated from studying other state exchanges that Delaware would enroll about 35,000 through the exchange in 2015.

“Delaware has also taken a lead role in communicating with CCIIO about issues facing ‘low-population’ states,” the consulting group explained in its report, referring to the Center for Consumer Information and Insurance Oversight, which oversees exchange development in the Health and Human Services Department.

Delaware is considering a federally facilitated exchange, a mixed state and federal exchange concept, which will allow the state to keep costs down yet maintain control over plan management and outreach. The federal government would help on website infrastructure, eligibility and enrollment, according to the consulting group.

In other healthcare improvements, the Medical Society of Delaware and Blue Cross Blue Shield of Delaware, the state’s largest health insurer, have partnered on a patient-centered medical home pilot, called the Patients First in the First State program. The model encourages a team approach to patient care and promotes the use of EHRs and electronic prescribing to improve patient outcomes.

The insurer has provided a grant for education and training of physicians and their staffs as they transition to the medical home model, according to Dr. Randeep Kahlon, president of the Medical Society of Delaware.

Government Health IT (https://www.govhealthit.com/news/delaware-innovates-big-small-state)

Delaware Becomes First State to Enroll All Acute Care Hospitals in State-Wide Community Health Record

Dover, Delaware (February 20, 2012) – The Delaware Health Information Network (“DHIN”) announces full participation of all acute care hospitals and skilled nursing facilities in the state, along with the vast majority of Delaware providers, in the first statewide community health record. This enhances a health care information exchange started in May 2007, when DHIN became the first operational statewide health information exchange in the country.

“With the addition of Nemours/A. I. duPont Hospital for Children in 2011 and Nanticoke Memorial Hospital in 2012, we are proud to announce that all of Delaware’s acute care hospitals, all of Delaware’s 46 skilled nursing facilities, and 86 percent of our health care providers participate on the Delaware Health Information Network,” said Jan Lee, M.D., Executive Director of the DHIN.

DHIN offers “directed” exchange of health information that enables point-to-point electronic delivery of clinical results to an ordering provider, as well as a longitudinal community health record that aggregates data across time and care settings into one comprehensive, searchable database. An emergency room has immediate access to patient health care information, saving precious minutes when care is most critical, nursing facilities can access discharge summaries, and all care providers get a full view of their patient’s health status.

“This ability to search for existing results has led to a dramatic reduction in the ordering of high cost labs and radiology studies. The addition of Nemours/A.I. duPont Hospital for Children and Nanticoke Memorial Hospital to those sending clinical data into the DHIN database means the community health record will more completely reflect all care provided in all settings,” said Dr. Lee.

“Making key clinical information available to providers that was once fractured across hospitals is no longer an obstacle for the citizens of Delaware,” announced Randy Gaboriault, Chair of the Delaware Health Information Network and CIO of Christiana Care Health System. “With all hospitals and skilled nursing facilities connecting to the nation’s first statewide health information exchange, Delaware and the Delaware Health Information Network continue to be the First State, setting the standard for information and care integration.”

“A statewide health information exchange gives Delaware the ability to improve the quality of care while managing the cost of care,” said Governor Jack Markell. “With this exchange, doctors across the state have information that enables them to make quicker and better medical judgments for people. This is the fundamental technological foundation we need to build a system of focused and managed healthcare that keeps people healthy. The use of technology in health care is vital to improved quality and reduced costs.”

“When I was Governor, the Delaware Health Information Network was just a concept. After being elected Senator, government agencies engaged with an extraordinary partnership in the health care community to make DHIN the first of its kind in the nation,” said Sen. Tom Carper (D-Del.). “Today, Delaware’s health information network achieved an important milestone with every hospital statewide ready to participate. Furthering the efforts of the DHIN will enable us to improve health care and save money all at the same time. That’s what I call a win-win for Delaware.”

“Connecting Delaware’s nursing homes with the DHIN is a critical milestone and a key component to eliminating medication errors. By enabling access to discharge summaries and other information, we can ensure seamless transitions of care for residents in these facilities,” said Rita Landgraf, Secretary of Delaware Health and Social Services. “We want to ensure the right care, at the right time, at the right place, whether for those in our skilled nursing facilities, our Medicaid recipients or others in the state’s care, and we want to provide these positive outcomes in the most cost-effective manner possible.”

“At Nanticoke, we believe that electronic medical records and health information networks are core quality initiatives and truly enhance patient quality of care and patient safety. We are extremely delighted to be a member of the Delaware Health Information Network,” said Steven A. Rose, President and Chief Executive Officer of Nanticoke Memorial Hospital.

The Nemours/Alfred I. duPont Hospital for Children, as a HIMSS (Healthcare Information and Management systems Society) Davies Award winner and Stage 7 designated hospital, has a long-standing commitment to using health technology to improve patient care and understands the effort required to successfully implement new technologies and the very real and positive impact they can have on quality and safety.

“At Nemours, we promise to do whatever it takes to help children grow up healthy and reach their full potential, and we work closely with partners around the state to achieve this promise. Our work together further strengthens Delaware’s standing as a leader in the adoption of health information technology and a model to other states regarding the value that health information exchange brings to patients and health care systems,” said Gina Altieri, Nemours Vice President for Corporate Services.

Nanticoke and Nemours/Alfred I. duPont Hospital for Children are in the process of interfacing with the DHIN. All skilled nursing facilities are enrolled in DHIN and training will be completed by the end of March.

“The Medical Society of Delaware has long supported the DHIN and recognizes the critical importance of health information exchange as a foundation to high quality and coordinated care, said Mark Meister, Executive Director of the Medical Society of Delaware. “Ensuring that Delaware physicians have the critical information they need at their fingertips and enabling them to coordinate care across providers is a critical step toward supporting positive health outcomes and healthier Delawareans – a goal we are all working toward.”

About DHIN

The Delaware Health Information Network (DHIN) was enacted by the Delaware General Assembly in 1997 as a public-private partnership for the benefit of all citizens of Delaware to advance the creation of a statewide health information network and to address Delaware’s needs for timely, reliable and relevant health care information. The Delaware Health Information Network (DHIN) is the first live, statewide health information network in the nation. Launched in 2007, DHIN serves all acute care hospitals and skilled nursing facilities, and 86 percent of the State’s medical providers. More than 7,000,000 clinical results and reports are posted on DHIN each year– and the total patient records in the system now exceed 1,000,000. DHIN has adopted regulations to govern its operations and has policies and procedures in place to support privacy and security of patient information. 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).

Contact: Michael Sims, DHIN, 302-678-0220

Delaware Health Information Network Signs First Medical Imaging Partner: Delaware Open MRI, One of the Largest Outpatient Practices in Delaware

DOVER, DE – FEBRUARY 7, 2012 – Delaware Health Information Network, the nation’s first state-wide health information exchange, today announced that Delaware Open MRI has signed on as the first outpatient medical imaging partner in the program.

“During the last five years, hospitals, medical practices and labs from across the state have come to discover how efficient DHIN is for securely moving medical information ,” said Dr. Jan Lee, executive director of DHIN. “Delaware Open MRI is our first outpatient medical imaging partner, and we are thrilled that the company’s six locations throughout the state will be using DHIN to efficiently communicate test results to doctors and their practices.”

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.  Once on-board, Delaware Open MRI will join Bayhealth, Christiana Care, Beebe Hospital, St. Francis Hospital, Lab Corp, Quest, and Doctors Pathology as DHIN data senders. 

According to Dr. Steven Edell, Administrator Director, DHIN will meet a pressing need: a reliable and secure way of providing images and reports to referring physicians.

“We are always looking for ways to improve communication with our providers,” said Edell. “One challenge is that the medical profession has so many disconnected systems for reporting and exchanging information. DHIN solves that by bringing them all together across Delaware, offering quick and efficient access to patient information and test results. It gathers all the reporting in one convenient, virtual location, which translates to better communication between professionals and better care for patients.”

Delaware Open MRI begins training on DHIN this month and anticipates going “live” with the system in May.

About TriState Imaging Group

Delaware Open MRI is part of TriState Imaging Group which owns and operates thirty-two 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 For more information about Delaware Open MRI visit www.tristateimaging.com.

About the Delaware Health Information Network (DHIN)

Delaware Health Information Network (DHIN) is the first live, statewide health information network in the nation.  Launched in 2007, today it serves more than 75% of Delaware’s acute care hospitals and 80% of the State’s medical providers.  More than 7,000,000 clinical results and reports are posted on DHIN each year– and total patient records in the system now exceed 1,000,000. 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).

Testimonials

“The information on DHIN is so helpful to our practice. We have patients come into the office that can’t remember where they had lab/radiology work done. Utilizing the DHIN system, we log onto DHIN, type in the patient’s name and we can see where the patient had reports done. It really does help us from having to call around and track down that information.”

– Debbie McGinnes, Nurse – Bijan Sorouri, MD, PA

Delaware Health Information Network - Empowering Data-Driven Decisions

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