January 30, 2009

Health info alliance notches milestone

Health info alliance notches milestone

In Memphis last October, the Midsouth eHealth Alliance registered its 1 millionth patient.

No one flung confetti, but the occasion did represent a growing opportunity in that city to improve health care and lessen the waste of resources.

The Alliance (www.midsoutheha.org) is a trailblazing health information exchange project supported by Memphis health care providers, the U.S. Agency for Healthcare Research and Quality, the state of Tennessee and Vanderbilt.

The participating providers include hospitals, safety net clinics and one large medical group (University of Tennessee). As they gather patients' consent to treat, providers offer patients an opportunity to opt out of regional data sharing. As these disparate providers create electronic medical records, they securely transmit a copy to a regional data bank, unless the patient has opted out. The system, now in use in safety net clinics and 14 emergency rooms in greater Memphis, retrieves records instantly and presents them to clinician-users in a consistent, useful format.

With more than 1 million patients now in the system, for each new visit it's overwhelmingly probable that some amount of clinical information about the patient is available for lookup in the clinic and ER. Records may include clinical notes, discharge information, lab results and other information.

Mark Frisse, M.D., M.B.A., professor of Biomedical Informatics, leads Vanderbilt's contribution to the Alliance. He sees portable electronic medical records as helping a fragmented U.S. health system to begin to coalesce around the needs of individual patients.

“A revolution is inevitable, the horse is out of the barn. Within a decade people all around the country will have portable electronic medical records. It's similar to the arrival of the Internet; at some point we realized that these technologies irreversibly and positively changed our lives,” Frisse said.

It's not yet known to what exact degree the Alliance is boosting safety and quality of care in Memphis, but in Frisse's view, that the venture has proven workable and useful, and appears sustainable, is itself a significant outcome.

The Memphis project was conceived and launched by Bill Stead, M.D., associate vice chancellor for Strategy and Development, and Tennessee Gov. Phil Bredesen. The state put in $7.2 million and the Agency for Healthcare Research and Quality $5.2 million. Under contract with the state, the Regional Informatics Program at the Vanderbilt Center for Better Health provides project management and evaluation, technical know-how, and planning for eventual expansion beyond emergency rooms and beyond Memphis.

Vanderbilt also donated use of the core technology for the duration of the five-year program, including a heavily modified version of StarPanel, the electronic medical record application developed at Vanderbilt. Earlier this month, technical support for the Alliance was moved to a Vanderbilt commercial offshoot, Informatics Corporation of America.

Current public funding will continue through 2011. Infrastructure costs for continuing the project come to $2.5 million per year.

Wider use of portable electronic medical records will require competing hospitals and physician groups to set aside their inherent mistrust of each other.

“Our project is working because health care executives in Memphis concluded that hording data doesn't make economic sense,” Frisse said.

“Putting patients first is always a winning strategy.”