December 19, 2011 | last updated June 4, 2012 11:29 am

Medical data exchange gains momentum

David Gilbertson, CEO, the Health Information Technology Exchange of Connecticut (HITE-CT)

Connecticut is inching closer to its goal of creating a statewide health information exchange, but many key policy and legal issues still need to be hashed out before patient data begins to flow among providers in the state.

In recent weeks, the quasi-public agency charged with creating the exchange has made several significant decisions including hiring a new CEO to lead the group and putting out a call for providers to join an initial roll out of the exchange.

David Gilbertson, the former chief information officer at the University of Connecticut, has been named the CEO of the Health Information Technology Exchange of Connecticut, or HITE-CT, an agency that has been working for the past few years to develop a statewide system that will allow physicians and hospitals to share patient data.

Gilbertson, who spent 26-years working on health IT in the military, said there remain many unanswered questions around privacy, financial, and functionality issues, but eventually getting an exchange up and running will transform the state's health care industry.

"Moving health information around and making sure it's in the right place at the right time is going to be vital to transforming how we do health care in this country," Gilbertson said.

On the front burner for Gilbertson is getting an early deployment of the exchange off the ground. HITE-CT is looking for hospitals and small and large group practices to join a pilot program to begin testing the exchange.

Gilbertson said the goal is to have a pilot program running by the first half of 2012. Today, limited testing is going on among some providers, but it has not involved any sharing of clinical data.

The next step is to get providers to test production connections, operational workflow, and security and privacy protections. Providers that participate in the initial roll out will also have financial incentives. Gilbertson said they have heard interest from the provider community, but hospitals and doctor practices also have a lot of questions, particularly around the long-term financing for the exchange and what value they will derive from it.

John Brady, chief financial officer and vice president of the Connecticut Hospital Association, said he expects several hospitals to participate in the pilot program, but he agrees many unanswered questions remain.

The funding issue is particularly weighing on hospitals minds. The state has received a $7 million grant from the federal government to help with its efforts but that money won't last forever and it's not clear how the exchange will operate long-term once that funding dries up.

The goal of the statewide exchange is to streamline health care communication by allowing providers access to a patient's medical records, which may be spread over multiple provider and payer networks.

That could enhance the speed of the delivery of care and reduce health care costs by cutting down on duplicative services.

According to data from the Institute of Medicine the U.S. wastes $700 billion each year on unnecessary or duplicative tests and procedures that don't improve patient health. By sharing data on previous lab test results hospitals could reduce some of that wasteful spending, advocates say.

Connecticut has been trying to develop an exchange since at least 2006, when the state Department of Public Health invested $300,000 in eHealthConnecticut.

That organization was originally appointed to start a statewide exchange, but the role has shifted hands several times since then.

HITE-CT was created in 2010 to take over the reins after the state received $7.3 million from the federal government.

The HITE-CT board of directors consists of public officials, consumer advocates and industry representatives.

Before Connecticut ever reaches its goal of creating a statewide exchange, however, many critical issues need to be hashed out, officials said.

Funding uncertainty and concerns about security and effectiveness have led to the slow growth of exchanges around the country.

Connecticut is no different.

Developing an infrastructure that is operable and protects private patient data as it's passed on from one provider to the next through an electronic portal is no easy task.

HITE-CT recently hired Phoenix-based Axway to setup the exchange's infrastructure, so the process is still ongoing.

There's also a question of patient participation and education.

Mary Griskewicz, who is the senior director of healthcare information systems at the Healthcare Information and Management Systems Society, said many states are debating whether to have an opt-in or opt-out policy. An opt-in policy would require permission from patients before their healthcare information is stored in the exchange. The opt-out policy would require patients to proactively ask that there data not be used in the exchange. The issue has created a divide between consumer advocates and industry representatives.

Connecticut has not made a decision on which strategy it will pursue, Griskewicz said. If providers are forced to gain permission from every patient to use their data, it could become too burdensome.

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