Cool Technology of the Week

This week, the Massachusetts Health Information Exchange, MA-SHARE, went live with secure sharing of clinical summary records from provider to provider at Beth Israel Deaconess Medical Center, Lahey Clinic, Northeast Health Systems and Boston Children's using the recently recognized national standards harmonized by HITSP.

Here's how it works.

When a patient registers for care, their primary care giver is captured by the registration clerk. We store the National Provider Indentifier of the clinician.

When a patient is discharged from the hospital or the emergency department, a comprehensive clinical summary is automatically prepared in Continuity of Care Document format including medications, diagnoses, procedures, and all followup issues.

This electronic document is sent via SOAP/HTTPS to a hospital-hosted gateway. That gateway uses the National Provider Identifier to look up the primary care giver's institutional affiliation in our statewide provider index. The summary is then routed to the gateway of the receiving institution via the internet via SOAP/HTTPS. Once it arrives, it is routed to the clinician's Electronic Health Record, Fax machine, or secure Email box.

The end result is that we are ensuring appropriate followup, medication reconciliation, and communication among physicians using a standards-based electronic document and the internet. Further details are available in this overview.

In Masssachusetts, we exchange 100 million HIPAA transactions per year via our New England Health EDI Network (NEHEN) gateway. Massachusetts was recently recognized as the #1 e-Prescriber in the country and part of our accelerated adoption has been our use of an e-Prescribing Gateway. Now the secure summary exchange gateway is live. All three of these gateways are built on the same application platform, which is running at hospital systems and payers throughout the state. There are no transaction fees, and no charges to the patient. The software is developed and maintained via contributions from provider and payer organizations which derive value from its use. In the case of secure document exchange, we can eliminate mailing discharge summaries and ED notes, saving hospitals like BIDMC $100,000 per year.

National standards, the internet, and a business model for health information exchange in production. That's cool!