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What is HealthShare Exchange? What is its overall vision and mission?
HealthShare Exchange is the health information organization (HIO) that will plan, develop, implement, and operate the regional health information exchange (HIE) for the five-county region of Southeastern Pennsylvania. HealthShare Exchange has been incorporated as a non-profit organization in Pennsylvania and is in the process of applying for federal 501(c)(3) non-profit status.
HealthShare Exchange’s vision was articulated in the business plan as follows: 
“We envision a collaborative and coordinated health care environment for Southeastern Pennsylvanians where:
  • Health care providers and stakeholders have access to shared community information assets to support key clinical decisions across care settings;
  • Quality outcomes, patient safety, and population health are improved;
  • Costs are contained through improved efficiency and reduction of duplicative services;
  • Patients and consumers benefit through an improved experience with the health care system, with special focus on the chronically ill and underserved communities.” 
How will HealthShare Exchange help hospitals and health systems meet stage 2 meaningful use requirements?

The final rule for stage 2 of the Medicare and Medicaid Electronic Health Record (EHR) Incentive Program’s meaningful use criteria contains provisions related to the establishment of HIEs. Specifically, the rule requires that hospitals that transition patients to other care settings or providers must transmit a significant amount of clinical data for at least 50 percent of care transitions. In addition, for at least 10 percent of care transitions, data must be sent electronically. At least one of these electronic transmissions must be successfully sent to a provider on a different EHR platform.

By providing a communication platform that would allow health care providers to send and receive clinical patient information securely, the HealthShare Exchange of Southeastern Pennsylvania HIE would assist hospitals in meeting this stage 2 requirement. 

Why is HealthShare Exchange’s potential to improve care transitions so important for Southeastern Pennsylvania’s patients, providers, and insurers?

HealthShare Exchange would be especially beneficial to Southeastern Pennsylvania because the region has many diverse, high-quality health care resources, including 12 large health care systems. This diversity leads to a common scenario where patients visit multiple providers. For example:

  • Up to 50 percent of patients who are readmitted within 30 days of discharge return to different hospitals than the ones from where they previously received treatment.  
  • “In network” discharges, those where facilities discharge to ambulatory practices within their integrated delivery systems, account for less than 30 percent of discharges.
  • The standards of the region’s 9-1-1 system require that emergencies be brought to the nearest emergency rooms, not to patients’ preferred hospitals. This requirement has the unintended consequence of disrupting the coordination of care that chronically ill patients may be receiving within integrated delivery networks.

These utilization patterns create challenges for care coordination — and opportunities for improved care transitions — through the exchange of health information via HealthShare Exchange. 

In fact, The Health Care Improvement Foundation was motivated to take a leadership role in the early stage development of HealthShare Exchange as a result of efforts to improve care transitions and reduce hospital readmissions through the Foundation’s collaborative PAVE Project. By promoting the availability and use of innovative tools, training, and resources for health care professionals, patients, and family caregivers, PAVE achieved significant reductions in readmission rates. At the same time, project outcomes revealed that crucial gaps remained in coordination of care following hospital discharge and during other transitions between care settings. The Health Care Improvement Foundation envisions HealthShare Exchange as a way to reduce these gaps and improve care coordination.