In This Section
Participants in the Wisconsin Health Information Exchange are already reaping the benefits of shared health information. Further, communities, including payers, employers, public health and patients are positively impacted by operation of WHIE. Timely and cross organizational data supports more informed decision making , improves treatment and lowers costs for everyone. But we have just gotten started. We see a future where health information technology will spark innovations in health care delivery. Learn why.
The potential value of sharing electronic health record information is well-known, yet providers remain hesitant to make significant investments in health information technology. In 2009, it was estimated that only 12 percent of hospitals had instituted electronic physician’s notes, while 75% reported adoption of electronic lab and radiologic reporting. Small physician practices have been especially wary of investing in IT systems, fearing both the costs and workflow changes that could affect their practices.
Here in Wisconsin over 60% of physician practices are now using an electronic medical record. Beginning in 2011, “meaningful use” requirements of electronic medical record systems requires participation in an exchange to share the data, extending the value of information in any one system. WHIE is the technical manager for these statewide efforts with the Wisconsin Statewide Health Information Network.
Good information is at the heart of good health care. This includes complete information about the patient, as well as reliable information about the best treatment options. This information should be available quickly and accurately, when and where it is needed. A patient’s health information should follow the patient. Unlike other business sectors, America’s health care system has been slow to adopt information technology. We still rely primarily on paper-based models that impede effective information exchange. And because most Americans receive care from multiple health care providers, it is even more important to ensure efficient, coordinated, and secure exchange of information in all sectors of the health care system.
Health information exchanges, like WHIE’s regional network, can improve health care quality substantially by providing timely access to health care information so that authorized providers can make more informed health care decisions. Health information shared through exchanges improves the quality of care by avoiding duplication of diagnostic testing and medical errors, and has been shown to reduce costs. Patients can be much more directly involved in maintaining their health and participating in decisions about their own care. Health care providers can collaborate more effectively in treating their patients.
There are many more possible ways to reuse the data that is collected though the exchange to benefit health care delivery. For example, data can be used to support “pay-for-performance” programs that reward providers for high-quality care. Information about the quality of care delivered by different providers could provide consumers more opportunity to make informed decisions about their health care, and further motivating providers to focus on quality.
Finally, health information exchange networks have important public health implications: New technology can help to quickly identify disease outbreaks and provide data to support improvements in health care.
Sadly, tens of thousands of Americans die in hospitals each year as a result of medical errors. In fact, medical errors are the eighth leading cause of death in this country. Health information technology holds the potential to reduce medical errors dramatically by maintaining and sharing accurate patient health records, as well as providing clinicians with current information and reminders about medications, prevention, and follow-up care. A large number of research projects in the US Department of Health & Human Services, Agency for Healthcare Research and Quality’s patient safety portfolio focus on information technology as a way to improve patient safety.
Many Americans are injured or die each year as a result of medication errors. Estimates vary widely, but more importantly these are the types of errors that can be prevented entirely with timely reporting and sharing of prescription data. The elderly are particularly at risk. According to a study published by the Society of Internal Medicine a few years ago, 41% percent of seniors reported taking five or more prescription medications, and more than half had 2 or more prescribing physicians.
Adverse drug events and thousands of hospitalizations per year could be prevented through e-prescribing, the ordering of prescriptions via computer. These systems can help physicians match the most effective therapy with the immediate needs of a specific patient, and do so at the best price for the patient. For example, when a physician enters a prescription for a patient, a computer program can double-check the medication, the dosage, and dangers from possible interactions with other drugs that the patient is taking, as well as possible allergic reactions. This drug information can then be shared with the patient’s entire health care provider team.
When we reach the point that each consumer’s health information is truly portable, following the patient, the true promise of health information exchanges will be achieved. Overall, adults in the U.S. receive only about 55 percent of recommended care for a variety of common conditions. Clinical decision support systems can help ensure that physicians and others have the most current information about the condition they are treating and are not overlooking important treatment options. These systems can provide treatment reminders at the point of care that apply to the specific patient being treated. In this way, evidence-based findings about best practices can be put into effect quickly. With health information technology widely in place, researchers could also learn much more quickly about the effectiveness of new therapies, adding rapidly to the body of evidence-based medical knowledge.
Health information technology is crucial for improving the quality, safety, and effectiveness of health care. When health information data are brought together in interconnected systems, clinicians will have access to information that is more timely and comprehensive than the current paper-based model can provide. The information will be specific to the patient being treated, and available at the point of care. This will result in better treatment decisions and fewer medical errors. Health information technology will provide a new information foundation for health care that will be complete and up-to-date, resulting in more patient-specific and patient-centered care.
Imagine if every person in America had their personal health record – with their medical histories and customized health education and guidance – available to their provider electronically. No matter where an individual needs to access the health care system, this patient information would follow them. Such a breakthrough would dramatically increase consumers’ participation in their own health maintenance and care – and possibly improve their satisfaction and even their outcomes. Access to critical patient information, including allergies and medications helps care providers ensure the safest and highest quality of care for patients at each appointment or encounter with a care provider.
Initial funding was from a Medicaid Transformation Grant from the US Centers for Medicare and Medicaid through WI Department of Health Services (DHS) as well as participating health systems. Ongoing funding is from participating health systems through the Milwaukee Health Care Partnership, DHS, Humana, the Business Health Care Group, Independent Care (iCare) and grants from the Center for Disease Control, through DHS Division of Public Health.
Additionally, individuals and organizations may become members and contribute to WHIE, a nonprofit organization. Learn more about becoming a member.
Only care providers that have a care relationship with a patient, established by registration for an appointment or admission to an emergency department at a hospital have access to patient information. These care providers are already authorized under state law to receive medical information from other providers on patients they are caring for. The health information exchange simply replaces slow and cumbersome paper record systems with electronic systems. In non-emergency settings, access to patient history through WHIE also requires patient consent. All access requires a unique user account be established, with each user being assigned a designated role, restricting their access to only those functions appropriate to their role in patient care.
Because of the sensitive nature of health information, advanced measures are used to prevent unauthorized access. For information that is reported for public health purposes, data is stripped of patient-specific identifiers.
Wisconsin Statewide Health Information Network (WISHIN) is the state designated entity charged with overseeing implementation of a secure statewide health information network and information-sharing services. For this initiative, the Wisconsin Health Information Exchange serves as the technical manager. Wisconsin Health Information Technology Extension Center (WHITEC) has been the federally designated organization to provide education and technical assistance to small and independent primary care practices to help them implement electronic health records and achieve “meaningful use” of the data. Learn more.