Thursday, January 25, 2007

Report from the IERHIO Annual Summit Meeting

Inland Empire Regional Health Information Organization held it’s annual summit meeting this week in Riverside California under the auspices of the RCMA and SBCMS. A live meeting web conference had presenters from Canada, Pennsylvania and Northern California. The group was quite eclectic with different approaches to the challenge of health information data input, storage and exchange. The Department of Public Health of Riverside County was also represented by Janis Neuman M.D. and and Geoffrey Leung M.D They discussed their ongoing projects and needs. Dr Leung recently returned from Taiwan and stated that he wished the U.S. was on a par with Taiwan in regard to health IT. Laura Landry represented the Long Beach Initiative. Their non profit has been funded and they have selected a vendor. They have excellent support from grants as a result of the expertise of P.H.F.E.
The attendance and support of area and regional hospitals was non-existent, although we have heard each hospital and IPA are investigation EMR solutions. Also present were Dr. Ron Bangasser from Beaver Medical Clinic and Dr. Edward Hess, formerly from Kaiser Permanente. Commentary was heard regarding the Kaiser experiences and their usage of “Epic”.
A presentation was made by Sabatini Montatesti, who is the CEO of ES Enterprises Inc. ES Enterprises is building out a non profit health data exchange for northeast Pennsylvania including Geisinger Medical Center and surrounding hospitals, clinics and physicians. This rural area has unique challenges in that there are a great number of uninsured patients. Funding for the non profit was through charitable donations and hospital contributions. The depth of his knowledge and architecture for the health data exchanges is impressive.
We also heard from other vendor solutions. Clinical Integration was represented by Mark Crespin, Steve Leider and Paul Bessingminder who presented from Vancouver, B.C.
Practice Fusion presented their proposed solution as well. The vendors had an opportunity to answer some challenging questions from our steering and advisory committee.
Ellen Badley represented the California Department of Health representing Cindy Ehnes. She spoke briefly about the Governor’s proposal for health IT and his “Universal Health Care for California” The “takeaway message” for her was the importance of reducing the chasm between state health care and private health care, and that health IT for each is not mutually exclusive.
Our group is obviously biased toward developing some form of integrated health information system.
There was much philosophical and hypothetical discussion about several models both financially and technically.
There was a great concern that our dysfunctional health care system would consider starting another venture in IT regardless of our motives. The group also discussed the inadvisability of a political state ment of universal health care without a major overhaul of the IT infrastructure to support increased numbers of insured in the system. We certainly cannot provide more care for less money and not without a revolution in our health data system.
While some believe a non-profit organization offers some advantages it is the opinion of this writer that is a more expensive and time consuming entity to form and attract users.
My belief is that a sound private entrepreneurial model with a private placement and subscription service would offer greater efficiency and less cost to develop. Because of the intense capital investment to plan, build and maintain an enterprise level solution and/or small practice solutions initial start up cost is critical.
Mission critical items include time to implement, reliability, vendor experience and availability. Jeff Rose of Health Alliant discussed time to implement and train a system in Riverside County at one week per installation which added up to 900 weeks for the provider and hospital base in our region. (which is over ten years)
As a result of two years of independent study, meetings, and information gathering I have developed some opinion on what our region can accomplish in a cost effective and expedient manner.
A proposal will be forthcoming in the next several weeks.
Thank you to all who have attended these meetings, donating valuable time, effort and much expertise for the benefit our our health care system and our patients.

Gary Levin M.D.
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