California is large enough to be called a ‘nation-state’ with 35 million citizens, it is larger than many sovereign states in the world. The diversity of it’s demographic is challenging not only for health systems and providers, and with social engineers as well.
The development of health information exchanges in California is a microcosm for what must take place nationally in regard to health reform and ObamaCare.
Early study and planning for HIX began in 2004 with a major impetus by the newly formed Office of the National Coordinator for Health Information Technology (ONCHIT). Rather than forming one monolithic organization a model for regional information exchanges evolved over time.
Simultaneous interoperability standards were developed to ensure a common system of harmony between disparate EMR system, laboratory systems, pharmacy systems and more.
Federal incentives in the form of the HITECH Act has fueled significant growth in HIT since 2009.
The most recent meeting of the CAeHQ nicely summarizes the progress of health information exchanges, and it’s relationship to the national plan. It is anticipated that as the system matures individual HIOs may vanish to be replaced by the national HIE.
The development of each individual health information exchange has been sporadic and dependent upon local interests and the development of sustainable business models. Other items include trust agreements among the users of the exchanges.
Whilst some HIXs are working well, each one delivers different data fields and the comprehensiveness of it’s data. Some are simple messaging functionality, some allow transmission of continuity of care records, while others are more complete.
As yet there is little if any transparency from an electronic medical record. Rather than true integration of the data into a trusted partner’s EMR a separate portal must be engaged to retrieve patient data.
The ONCHIT Direct program remains a national infrastructure, while each region has it’s own network. There is no uniformity of size. The current size appears to be guided by the hospital systems and the individual state. Few cross state jurisdictions except for a few.
The CAeHQC recent stakeholder meeting took place on July 18,2013 via a webinar.
The slide deck of the meeting (24 slides) is linked here. (may take a moment to load)
ref: CAeHC Webinar July 18,2013 Recorded TBA available at www.ehealth.ca.gov