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How did the initiative to create HealthShare Exchange get started?

In summer 2011, representatives from AmeriHealth Mercy, Delaware Valley Healthcare Council of HAP (DVHC), The Health Care Improvement Foundation, and Independence Blue Cross (IBC) formed the Southeastern PA Health Information Organization (SEPA HIO) Steering Committee and began meeting to discuss the early stage formation of an HIE serving the five-county region of Southeastern Pennsylvania. Their work led to the creation of HealthShare Exchange

How were the first two use cases selected?

The Steering Committee determined that a regional HIE would have the greatest positive impact on health outcomes by focusing on clinical use cases related to improvement in care transitions. A multi-stakeholder Quality Committee composed of clinical leaders from health systems, health plans, and large physician group practices and other regional stakeholders selected hospital discharge and medication history/clinical activity summary as the most promising clinical use cases to start with. The value of the use cases was analyzed as part of the multi-stakeholder process to develop a business plan for creation of a regional HIO and HIE.

What is the hospital discharge use case?

The purpose of the hospital discharge use case is to create, via the HealthShare Exchange HIE, a standardized process for communicating timely discharge information from hospitals to primary care providers and care coordinators in order to: 

  • improve the transition of care;
  • improve the quality of follow-up care;
  • avoid re-hospitalization.
What is the medication history/clinical activity summary use case?

With this use case health care providers can request, via portals or other methods, medication histories from patients’ insurers during office visits, emergency room visits, or in-patient admissions. The medication data will be drawn from health plans’ pharmacy benefits management systems and offer real-time or close-to-real-time lists of dispensed medications including name (brand, generic) strength, supply, and date dispensed. The clinical summary data will include data on visits and admissions, including dates, visit types (office/clinical, ER, inpatient), and providers.

How was HealthShare Exchange’s business plan developed?

Through a Request for Proposal process, The North Highland Company, a respected national management consulting firm, was engaged to facilitate a multi-stakeholder process in the development of a business plan regarding the formation and implementation of a regional HIO and HIE for Southeastern Pennsylvania. 

Three working committees - Governance and Financial Sustainability, Technology, and Quality -were established to assist with the plan’s development. A wide range of health care stakeholders, including the City of Philadelphia, health plans, safety net providers such as federally qualified health care centers, and physician groups and organizations were involved. DVHC staff participated on each of the committees, as did chief executive officers, chief information officers, and quality leaders from 12 hospitals and health systems.

Was the Commonwealth involved? Does HealthShare Exchange align with the Pennsylvania eHealth Partnership Authority’s efforts to support HIE deployment across the state?

HealthShare Exchange stakeholders, its member hospitals, and representatives from the insurer community have been active participants in the original Pennsylvania eHealth Collaborative, now authorized as the Pennsylvania eHealth Partnership Authority, the multi-stakeholder committee structure and planning process put in place by the Commonwealth’s Healthcare Information Technology Coordinator to support the deployment of HIE in Pennsylvania. 

Through this involvement, HealthShare Exchange stakeholders:

  • Provided input and feedback with the aim of ensuring that the state’s HIE strategies recognize the needs and concerns of Southeastern Pennsylvania;
  • Developed an understanding of the state’s HIE-related goals and technology approaches, to ensure that HealthShare Exchange efforts would align with the state framework.

HealthShare Exchange stakeholders continue to participate in all four of the eHealth Collaborative’s “tiger” teams — Technical; Financial; Policy and Operations; and HIE Certification — to define the HIE capabilities and services needed at the state level, as part of the Community Shared Services layer.

HealthShare Exchange plans to utilize the CSS layer and functions that support inter-HIE and national exchange over time as it evolves from DIRECT to robust query exchange. The Commonwealth of Pennsylvania, as part of its CSS services, continues to explore if it will become an “Opt-in” or “Opt-out” state. This “Opt-in / Opt-out” functionality is a privacy mechanism whereby patients can consent to include their patient medical information in a health information exchange; it is generally managed at the state level. HealthShare Exchange will be prepared to support either option.

In alignment with state efforts to incentivize the use of federal Nationwide Health Information Network (NwHIN) DIRECT specifications for the secure transfer of electronic patient information, HealthShare Exchange’s technology approach is based on the use of the DIRECT federal specifications to stand up the regional HIE, with a planned migration to a more robust query model of health information exchange.