Electronic Health Records

Adoption & Implementation News

How health information exchange helps integrate health IT

By Kyle Murphy, PhD

- Health information exchange (HIE) is primarily about access to data by providers and patients, but secondarily it has the potential to bridge information gaps in an industry experiencing increasing acquisitions and affiliations that force disparate health information systems to become integrated.

Not only does CHRISTUS Health span seven states in United States, but it also includes hospitals and facilities in Mexico and Chile. The top-ten Catholic health system in the US comprises more than 40 hospitals and facilities. The electronic exchange of health information is therefore important on multiple levels: for the benefit of local communities and the organization of the expanding health system.

As the health systems looks to standardize its operations across sites, George S. Conklin, Senior Vice President & Chief Information Officer for CHRISTUS Health, and his colleagues have looked for ways to integrate the organization’s various information systems, which vary depending on the kind of arrangement struck with physician networks and ambulatory centers. In this Q&A, Conklin explains the role HIE has played in helping CHRISTUS Health integrate its providers and data.

What approach has CHRISTUS Health to manage its health IT systems across multiple sites?

From an acute care perspective, we adopted a strategy going back to 2006 of moving toward significant standardization — our language around healthcare services, deliveries of data, data governance. We have been well into that now for seven to eight years. From a procedural and business process perspective and clinical procedure perspective, we’ve undertaken remarkable amounts of standardization. In fact, when I talk to my sister and brother CIOs in Catholic healthcare, years ago they said, “Boy, we wish we could do that,” and now they’re all being pushed into doing it and having to unwind years of very autonomous system implementations in each of their facilities. For them, it has been an expensive process.

READ MORE: From EHR Use to Information Exchange for Community Health

Given that, we have a remarkable amount of variability across the organization from a systems perspective and that’s driven in part by our clinical integration strategy and also for that matter by our asset growth strategy. As we acquire organizations, if they have perfectly good information system that can handle our processes and standards, then we will implement those in the existing system. The IP so to speak for our organization is not in the particular system for an acute care hospital, for instance, which in our case is Meditech. It’s in our processes and data standards we’ve set for the organization.

How has HIE adoption improve integration efforts?

We have a bunch of different information systems, a bunch of different technologies that we need to tie together and we decided about three years ago ourselves to implement our own HIE in order to be able to couple together all of the different information systems that are part of the integrated network. We decided to implement the Medicity HIE and have been rolling that out across the organization and making it operational in each one of our regions. It’s the vehicle into which we plug all those different components of the integrated delivery system.

How do you get providers to integrate HIE into their clinic settings and workflows?

Within our integrated delivery network, which is a contractual risk-sharing network, use of the systems and the HIE itself becomes a requirement of playing. Your system has to be able to plug into the HIE; it has to be able to play. And in order for you to be an active participant, you have to use the system. In those instances it’s easy because it becomes a stipulation of participating in these risk-sharing networks.

READ MORE: North Carolina Group Achieves EHR Integration for Referrals

From the perspective of the community-based HIEs, it is all about providing value to clinicians, making their day simpler and easier and faster. Providing services like being able to show your CCD is key, and then adding more services onto that like a patient portal and utilizing patients to help push their docs into using the systems. My adoption of any technology is going to be narrative-driven — it’s capturing a wide array of different stories. It is a workflow changer and many doctors are difficult to move on that, but you have to give them that precipitating moment when they say, “That’s right.”

How does this private HIE interact with other HIEs in Texas?

We are very involved with community-based HIEs like Greater Houston Healthcare Connect (GHH), Healthcare Access San Antonio (HASA), Health Information Network of South Texas (HINSTX) in Corpus Christi, the Louisiana HIEs, which are state-run entities there. We’re deeply involved with every one of those different projects in order to ensure that (1) we have a voice at the table and (2) you get both the best care and we have some control over what’s done to you but also the price of care.

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