CEO SUMMARY: Regional health information exchanges (HIEs) are becoming more common. In Southern Indiana, the HealthLINC HIE is boosting the value that the community hospital laboratory provides to physicians. At the top of the list is expedited turnaround of laboratory test results, often within just two to three hours. Another major goal is for the HIE to support integration of patient care. HealthLINC, in Bloomington, Indiana, is also connected to HIEs in Indianapolis and Cincinnati.
DIFFERENT FORMS of health information exchanges (HIEs) are becoming operational across the United States. Local clinical laboratories and pathology groups are learning how to support the needs of these HIEs to accept and distribute laboratory test data.
One thriving example is HealthLINC. This non-profit heath information exchange operates in southern Indiana. HealthLINC demonstrates how electronic information sharing can contribute to improved patient care. At the same time, an HIE like HealthLINC can be used by community hospital laboratories within the network to deliver real time laboratory test data from inpatient, outpatient, and outreach testing to all physicians participating in the HIE.
Established in 2007, HealthLINC is based in Bloomington. It integrates communication among providers while speeding delivery of laboratory, radiology, physician notes, and many other allied health test results via an electronic clinical messaging system.
HealthLINC’s network currently connects two hospitals, one lab and 254 physicians in a seven-county region. Included is bustling Monroe County, which is home to Indiana University, and the city of Bloomington.
“Doctors can schedule patients sooner for follow-up, because they get lab test results so much faster—often within two to three hours,” stated Todd Rowland, M.D., the Network Director at HealthLINC and President of E-Health Consulting, Inc. “Before HealthLINC became operational, it was common for physicians to schedule patient follow-up visits in two to three weeks to ensure laboratory and other test results would be back.
Faster Access To Lab Results
“Our HIE accelerates information sharing and allows physicians to be more responsive to patient needs,” emphasized Rowland. “This is particularly true when a patient is anxious about the results of a diagnostic test.”
“There’s no installation or special equipment needed,” observed Rowland. “For a physician to access data in a patient’s EMR, all that is required is for the physician to log in. Our application provides security in complete compliance with Health Insurance Portability and Accountability Act (HIPAA) rules.”
“Clinical messaging changed the way we do business here in our laboratory,” said Kelli Wesley, MT, Client Services Manager at the laboratory of 297-bed Bloomington Hospital. “There’s much more collaboration across the clinical services in the hospital.
Positive Changes In The Lab
“For example, the HealthLINC system makes it possible for the laboratory, the imaging department, and allied health areas to access information on a patient from all the providers—not just the lab,” noted Wesley. “It’s easy to use and saves time and paper.
“This is quite a change,” she continued. Before HealthLINC, our laboratory regularly hand-delivered or faxed lab test results to physician practices. Now our laboratory electronically posts lab test results directly to the patient record. Among other benefits, it means that staff at the referring physicians’ offices no longer must match up paper lab test reports with the right patient’s health folder.”
Wesley noted that the HIE has generated savings for her hospital from two sources. “Internally, use of HealthLINC has increased collaboration among the departments in the hospital, including the laboratory,” she stated. “Externally, our hospital lab can use the real-time electronic connectivity of the HIE to better serve outreach physicians who are also in the network.
“The feedback we get at our lab is that the quality of care is better,” noted Wesley. “Doctors need to know a patient’s history—no matter where that patient receives care.
“HealthLINC also hooks our hospital and our laboratory into the electronic health network used in Indianapolis,” she explained. “This is another benefit in patient care, because Bloomington-area patients are routinely referred to specialists in Indianapolis. With the HIE, all the laboratory test data on these patients is immediately available to those specialists.
“Our healthcare community here in Southern Indiana is more wired than most of the country,” continued Wesley. “Based on our experience with an HIE here, I believe that, as healthcare providers across the country are electronically linked, it will save unnecessary procedures and people will get better care.”
Wesley pointed out that HealthLINC has been good for business at her labora- tory and suggested that a regional HIE can help hospital laboratories and small independent laboratories better compete against the national lab companies. “Large commercial labs have provided on-line lab test results for some time,” said Wesley. “HealthLINC now gives us the same capability. Plus, physicians like the fact that our hospital laboratory LIS has inpatient lab test results, which they can view in the patient’s electronic medical record.”
Another example of how a community HIE integrates all classes of providers is HealthLINC’s partnership and integration with HealthBridge. Healthbridge is one of the nation’s earliest, largest, and most successful EMR networks.
Partnering With HealthBridge
Launched in 1997, HealthBridge connects 28 hospitals, 5,500 physicians and 17 health departments in the tri-state region and the greater Cincinnati area. It is a member of the National Health Information Network (NHIN).
HealthBridge provides technology and data management services to HealthLINC. “The HealthBridge data center hosts HealthLINC on its servers and deploys technology via ‘cloud’ computing with EMR Lite, an off-the-shelf, Web-based software application from Axolotl Corporation,” explained Rowland.
“Leveraging Healthbridge technology was very cost-effective and saved time,” he said, “This enabled us to rapidly deploy the HIE here in our community.
“As a trend, the use of health information exchanges is still in its earliest stages,” noted Rowland. “Currently, only some 80-plus EMR networks operate nationally. However, that is expected to change rapidly because of federal incentives to encourage physicians to adopt electronic medical record (EMR) systems and federal grants in support of HIE development and expansion.”
A federal stimulus grant is helping Rowland grow HealthLINC, which he plans to expand to 10 counties. Another goal is for the network to be financially sustainable by the end of next year. Rowland noted that HealthLINC offers several functional modules, including Clinical Messaging and ePrescribing.
“Currently, hospital data centers subsidize the cost of connecting physician practices to the diagnostic results management sources,” noted Rowland, “That’s because doctors are unlikely to pay for a test reporting service that simply replaces the ‘free’ fax service.
“Hospitals have been willing to subsidize this service because it provides incredible efficiencies for their data centers, and makes it likely the physicians will send them their lab work,” he added. “Federal incentives for physicians to adopt and use electronic medical records (EMRs) will be a positive factor in helping further improve the integration of health data and healthcare services.”
Good For Hospital Labs
In communities where a health information exchange like HealthLINC has become operational, community hospital laboratories have benefited from the capabilities and features enabled by the HIE. It is an early example of how and why adoption and use of HIEs in similar communities may be favorable to hospital laboratories in the longer term.
Physicians’ Offices Like Benefits from HealthLINC
USE OF HEALTHLINC IS PRODUCING worthwhile benefits, both in improving patient care and in reducing the cost of care. Physicians and staff members are enthusiastic about the introduction of the health information exchange (HIE).
“I’m able to call my patients from home once I get information from the hospital, which is great,” said Lisa Jerrells, M.D., a Bloomington family practitioner. “If I’m concerned about a patient, I can send them home, confident that—later in the evening, I will have immediate access to patient data and can call my patient at any time.”
Quick turnaround of diagnostic reports can affect both physician and patient satisfaction. “The benefits of clinical messaging are numerous, but number one is accessibility to patient labs,” said Beth Hash, Office Manager at Ageis Women’s Health Care in Bloomington, one of the first practices to participate with HealthLINC. “Back before we had clinical messaging, we had to call medical records at the hospital to obtain them, then wait for them to be faxed.
“Now we can just go in [to the patient’s electronic record] and view all the relevant clinical information,” explained Hash. “Also, when our doctors are at the hospital, they can access patient records kept in our office and enter clinical updates to those records.”
Staff in physician offices quickly learned to use HealthLINC’s capabilities to streamline routine operations, “Clinical messaging is vital to our practice, and we use it daily,” said Charlene Hardesty, Practice staff and Coordinator at Clarion CV Surgeons. “It allows me to customize reports. I can sort out what information I need. In turn, that saves both paper and time that was formerly spent tracking down paper patient files.”