“The benefits we experience are knowledge of what tests have already been done for patients so that we don’t repeat them, knowing what medications they are taking, and knowing where the patient has been previously.”


that practices using HIEs experience, in- cluding improved access to test results and fewer hassles associated with look- ing for information. As part of a strategy to develop the HIE infrastructure in the state, HHSC established a local grant program with THSA.


North Texas Accountable Healthcare


Partnership formed in 2009 as a coali- tion of major physicians, employers, in- surers, and hospitals in the Dallas-Fort Worth area. Joe Lastinger, its chief ex- ecutive officer, says the HIE’s mission is to promote and reward coordinated care at the local level. “Our board recognized that sharing in- formation via an open HIE was a critical first step in achieving our mission,” he said.


The HIE’s service area includes 13 counties in North Texas with participants from 137 hospitals, as well as roughly 11,000 physicians and records for nearly 7 million patients. Mr. Lastinger adds that the partner-


tee on Health Information Technology, says it’s important that physicians get involved in their local HIEs.


“Physicians should be investigating how to connect and use the information that is available,” Dr. Schneider said.


Joseph Schneider, MD


HIE benefits Dr. Schneider is chief medical informa- tion officer for the Baylor Health Care System, which has an internal HIE that recently connected with another HIE. “The benefits we experience are knowledge of what tests have already been done for pa- tients so that we don’t repeat them, knowing what medications they are taking, and knowing where the patient has been previously,” Dr. Schneider said. For Dr. Deas, Sandlot not only al-


44 TEXAS MEDICINE October 2012


lows him to coordinate care among other physicians, but also helps prevent errors that could jeopardize patient safety. “I’ve had patients give me incomplete medication lists,” he said. The HIE gives Dr. Deas quick access


to prescription records to accurately rec- oncile medications, thus lowering the risk of prescribing a medication that could cause an adverse reaction. Another advantage of participating in


an HIE, Dr. Deas says, is reduced cost. A 2009 survey by eHealth Initiative polled 40 operational HIEs that reported cost savings in:


• Reduced staff time handling lab and radiology results,


• Reduced staff time for clerical admin- istration and filing,


• Less money spent on redundant tests, • Decreased cost of care for chronically ill patients, and


• Reduced medication errors. The survey also highlights efficiencies


ship spends a lot of time working with physicians in the community to address interface, workflow, and privacy and consent policies. (See “10 Questions to Ask HIEs,” opposite page.) “While we don’t have to spend a lot of time persuading physicians of HIE value, we do have to demonstrate to them that we’re going about it in the right way,” Mr. Lastinger said.


HIE sustainability


TMA policy is that “any costs of support- ing systems providing health informa- tion technology incentives to physicians should be borne by all stakeholders, clearly defined, fair, simple to under- stand, accountable, and should support the financial viability of the considered practice.” THSA and HIEs funded through the local grant program have to develop plans to stay in business in the long term next year, according to Mr. Gilman, and many of those plans highlight fees for HIE services to ensure economic viability. “In their business and operational plans, four of the 12 HIEs indicated they intend to charge either a fixed or a tiered fee to physicians, while seven of the 12


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