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November 26, 2019

Statewide health exchange must have critical mass, financial stability, report finds

Photo | Contributed Middlesex Health's flagship facility, Middlesex Hospital in Middletown.

As Connecticut prepares to launch a statewide health information exchange, its success will hinge on organizers’ ability to achieve a critical mass of participants and develop plans for long-term financial sustainability, a report by the Connecticut Health Foundation has concluded.

The state is making a fourth attempt to implement an exchange that allows doctors, nurses, pharmacists and other health providers to access and share patients’ vital medical information electronically – a system meant to improve the speed, quality and cost of care.

Officials are expected to begin testing data transfers in the coming weeks. The system could launch as soon as March.

While Connecticut’s hospitals and some state agencies already run computerized health exchanges, there is no statewide network where all providers can access records. Many non-medical providers, including those in behavioral health and long-term care, are unable to share patient data electronically.

The effectiveness of the state’s new system will depend on its ability to attract participants and raise money for continued operation, the health foundation noted. The exchange was set up with federal and state funds, and officials have secured $17.2 million to help health organizations connect to the network. But the federal money is only available through 2021. Operators of the exchange may look to impose user fees in future years to keep the system running, the report says.

The aim of the exchange is to reduce costs and improve care by eliminating duplicative tests, enhancing coordination and identifying health trends and outcomes, including inequities. A wide range of participants is necessary to create a robust system, the report says.

The health foundation and the State Health Access Data Assistance Center at the University of Minnesota, which jointly completed the study, interviewed stakeholders across Connecticut and examined practices in other states.

“The ability to securely and easily share patient health information is a critical step toward improving the quality of care for both individual patients and the health care system overall,” said Patricia Baker, president and CEO of the health foundation. “We are hopeful this report will offer lessons-learned from other states and identify key issues to watch for all of us who are eager for Connecticut to have the capabilities a statewide health information exchange brings.”

Connecticut has tried for more than a decade to launch a statewide health information exchange. Earlier attempts – costing millions of dollars and years of work – were unsuccessful. Two of those efforts were led by the Department of Social Services and a third was overseen by the Department of Public Health and a now-defunct quasi-public group, the Health Information Technology Exchange CT.

The latest initiative is being led by Allan Hackney, the state’s health information technology officer, with guidance from the Health IT Advisory Council. Hackney could not be reached for comment Monday.

Officials have expressed frustration at the pace of the project.

“The state has been taking many years and spending lots of taxpayer money and has nothing to show for it,” Dr. Jeffery Gordon, a past president of the Connecticut State Medical Society, told The CT Mirror last year. “People in Connecticut are getting frustrated. It is completely ridiculous.”

The stakes for making the system work are high. A statewide exchange would not only offer better care for patients – it also could provide financial benefits.

Federal incentives – such as those given by the Centers for Medicaid and Medicare Services – are now based on health-outcome data. Practitioners and hospitals can only receive payment if they can demonstrate that they are reducing hospital readmissions and improving the quality of care.

A health information exchange allows for better care in the moment and promotes the collection of data to show what the care achieved, organizers have said.

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