“Certain HIEs are catching on and do- ing well; other HIEs are still in the de- velopment stage,” he said. He adds HIEs are an important
step in health information technology that physicians should support. “It will help our patients, and in a
value-driven heath care system, HIEs become critically important,” he said. If physicians don’t support HIEs in Texas, cost of care will continue to go up, decreasing the overall value of care physicians are able to provide, he says.
Internist Dwight Mark Toups, MD,
cares for patients at CHRISTUS Phy- sician Group, which connects to the HIE Greater Houston Healthconnect. He says he recently saw a patient for a routine appointment, and she revealed to him she had been in the hospital and received a computed tomography scan for abdominal pain, but she did not mention anything else about the hospital visit. Dr. Toups said he used the HIE
to look up the patient and found that physicians at the hospital found a mass on the patient’s kidney. When he asked the patient why she didn’t men- tion the mass, she told him, “I just as- sumed you knew that.” Dr. Toups says he eventually would
have found out about the kidney mass through the hospital discharge sum- mary, but the HIE allowed him to find out more quickly and see that his pa- tient received the appropriate care as soon as possible. “It made it more timely. It also gave
a broader safety net,” he said. “It saves you from errors of omission.” Dr. Toups says more and more phy-
sicians are prioritizing the use of HIEs, but many still worry about the privacy and security of the information. “It’s a matter of learning how to trust sys- tems,” he said. There is value in centralizing pa-
tient information, Dr. Toups says. When one institution has an isolated patient record, there’s no way to verify the accuracy of the information, he adds.
HIEs allow health care profession-
als to share every physician encounter in addition to data from pharmacies and claims data. “That puts all the info at hand to be analyzed,” he said, which in turn improves the accuracy of infor- mation because it allows physicians to validate and verify everything from al- lergies to insurance. Robin Mansur, chief marketing of-
ficer at Greater Houston HealthCon- nect, says it’s telling that Dr. Toups’
patient assumed he knew the details of her hospital visit. “We can see plan- ets on our cellphones,” she said. “Pa- tients sometimes expect that informa- tion technology in the medical com- munity is more advanced.” Ms. Mansur says many physicians
already have put so much effort into converting from paper records to elec- tronic health records (EHRs). “We ap- preciate how much they have invested and can significantly add more value to their investment,” she said. Connecting to a local HIE is the
next logical step in the process, and it’s a step that physicians will benefit from by having community-wide ac- cess to critical patient information within their EHR clinical workflow, she says. “We focus very much on value and
the kinds of information physicians and hospitals want to see,” she said. Ms. Mansur says Greater Hous-
ton HealthConnect has an agreement with three EHR vendors — Greenway, Aprima, and Athenahealth — that of- fer discounts or in some cases no fee to connect physicians with the HIE. “We’d like to see more EHRs stepping forward and making a commitment to affordable interoperability,” she said.
WHERE THE DATA WOULD TRAVEL
Under the health service enterprise gateway proposed by the Health and Human Services Commission Electronic Health Information Exchange (HIE) System Advisory Committee, physicians could report all meaningful use data to one place. The gateway would separate the data and forward it to the correct state department. Likewise, state health departments could more easily send information to physicians using the gateway.
PHYSICIANS k EHR k HIE k GATEWAY k STATE HEALTH DEPARTMENTS 52 TEXAS MEDICINE April 2015
EXPANDING THE GATEWAY Dr. Schneider says though many EHR vendors charge physicians to connect to their local HIE, they also charge to connect to each separate government agency that requires data from physi- cians fulfilling Stage 2 of the Centers for Medicare & Medicaid Services (CMS) meaningful use program. Cur- rently, physicians have to report dif- ferent data to separate state agencies, including lab results, newborn screen- ings, immunization data, and cancer cases. But the HHSC Electronic HIE Sys-
tem Advisory Committee is asking: What if physicians could report all that data to one source? The Texas Department of State
Health Services (DSHS) currently has a pilot “gateway” that helps physicians
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