As a result of the federal Health Information Technology for Economic and Clinical Health (HITECH) Act and other regional healthcare drivers, local planning for HSX began in earnest in the summer of 2011. The Health Care Improvement Foundation (HCIF), a regional quality improvement non-profit organization, joined with hospitals, health plans, physicians, government representatives, and safety-net providers to explore how a formalized HIO could enable better care for patients in the region.
Rather than starting from a technology foundation, the HealthShare Exchange vision and business plan is patient-focused and responsive to the unique quality needs of the regional market. Some of the compelling market drivers include:
The standards of the region’s 9-1-1 system require that emergencies are brought to the nearest emergency room, not the patient’s preferred hospital.
Within the largest IDN’s (independent delivery networks), sample data demonstrates that for a high proportion of patients, primary care physicians (PCPs) routinely refer patients for admission to hospitals outside of their IDN relationship. Conversely, patients discharged from the hospital often return back to a PCP office that is unaffiliated.
Findings of PAVE Collaborative Project
The Health Care Improvement Foundation (HCIF) initiated the PAVE Collaborative Project in the spring of 2010. In this initiative, more than 45 organizations, including hospitals, home care providers, payers, and community agencies joined to improve care transitions and reduce hospital readmissions. The project has promoted the spread of innovative tools, training, and resources for healthcare professionals, patients, and family caregivers. However, project outcomes revealed that crucial gaps remain in coordinating care following hospital discharge, and during other transitions between care settings. Motivated by the PAVE Project findings, HCIF and the Delaware Valley Healthcare Council (DVHC) took a leadership role in the Southeastern Pennsylvania initiative for forming a health information organization.
Uncoordinated Information Exchange
At time of discharge from an inpatient stay or ER visit, the hand-off to the next provider is not well-coordinated. Whether part of an IDN or not, in many cases, the discharging facility does not know the name of the patient’s primary care physician or how to contact this provider. Even if information is transmitted, it is usually incomplete and sent by handwritten hard copy or fax instead of electronically.