On HIEs and Interoperability: Q&A With Sutter Health CMIO Dr. Christopher Jaeger

In late June, Sacramento, Calif.-based Sutter Health announced plans to launch a fully integrated inter-network health information exchange this summer.

Here, Christopher Jaeger, MD, CMIO of Sutter Health, discusses Sutter Health's journey to deploying an HIE, the benefits of data sharing across networks and his thoughts on the future of health IT.

Question: When did Sutter Health start thinking about implementing an HIE?

chris jaegerDr. Christopher Jaeger: For several years now, Sutter Health has exchanged health information with other organizations that use the Epic electronic health record platform. For years, we've also used various means to electronically deliver diagnostic test results to providers. In 2012, we began exploring the potential use of an enterprise HIE solution to broaden our health information exchange efforts.

Q: What are the benefits you hope to achieve through the HIE?

CJ: Published studies prove a seamless, coordinated approach to care prevents unnecessary admissions and duplicative testing and results in more efficient care. An HIE across the continuum of care will help our network enhance quality and reduce the cost of care for our patients. Moreover, through access to more robust health information regarding the patients for whom we care, we will be able to more effectively leverage population health tools and techniques to improve the overall well being of the communities we serve.

Q: How can an HIE improve care coordination and clinical quality?

CJ: Sutter Health is an open integrated delivery network — many of our patients receive care within Sutter and at other non-affiliated organizations. The Sutter HIE will allow us to create a 360-degree view of a patient's health information and allow all members of the patient's care team to see that information and securely communicate with everyone involved in the patient's care. Through markedly improved health information access and easy, secure communication, we'll greatly improve care coordination — especially across transitions of care. This in turn will help patients and their care teams better manage chronic conditions, identify potential problems earlier and reduce unnecessary duplicate testing, just to name a few of the many benefits.

Q: What might hospitals be wary of or be cautious of when developing/implementing HIEs?

CJ: Security is most certainly the greatest concern for organizations that may be interested in implementing or participating in an HIE. While the potential benefits of interoperability and health information exchange for individual patients and our healthcare system as a whole are tremendous, we also have the responsibility to take every possible step to safeguard our patients' health information. Therefore, organizations implementing an HIE must invest adequately in their privacy and data security functions and partner with their technology vendors to ensure robust safeguards are in place and remain up-to-date.

Q: Do you have any advice for other health systems looking to begin information exchanges?

CJ: Beyond their potential concerns related to privacy and security, healthcare leaders may have reservations about sharing patient information with competitors for fear of loss of some competitive advantage. However, to provide patients with the right care at the right time and in the right place, organizations must share patient information. Every health organization already does this today via arguably antiquated means such as fax and 'snail mail.' These methods are slow and don't always get the right information to clinicians when, where and how it's needed, and faxing in particular is relatively insecure.

Organizations should view an HIE as a faster and more secure replacement for the old methods used to deliver health information to other providers. The HIE also has the added benefits of inbound data exchange, a more complete view of their patients' health information through aggregation of data from multiple sources and secure messaging among all members of patients' care teams — regardless of organizational affiliation. Not only will their patients benefit in terms of improved care and outcomes, their providers will be more empowered to do what they're trained to do — deliver high-quality care for patients.

Q: What are your thoughts on the ONC's interoperability timeline proposal?

CJ: The ONC's interoperability timeline proposal is aggressive, but, as a result, it's a strong catalyst for the evolution and adoption of standards, policy and technology to help us reach our collective interoperability goals. While larger, more integrated organizations — like Sutter Health — might be capable of implementing the requisite operational and technical requirements, it's important to note that small practices, community clinics and numerous other types of provider organizations may not be, especially given the large amount of change and demands they're already facing (e.g., ICD-10, payment reform, etc.). Just as we aim to assist such organizations under the umbrella of the Sutter HIE, we hope other large organizations will do the same.

Q: What is your ideal vision of the health IT landscape for the future?

CJ: True interoperability with the patient at the center of the model—a secure 360-degree community record for each patient that they, their families and their care teams may access with secure messaging, care coordination task assignment and monitoring and seamless clinical decision support that crosses individual EHR implementation silos.

More Articles on HIEs:

NextGen, Mirth Launch Interoperability Platform
12 Recently Announced HIEs
The ONC's Five Steps to Interoperability by 2024

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