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Competition and lost revenue are keeping communities from participating in health information exchange, panelists told attendees at the Regional Healthcare Stimulus Exchange Conference.

Group Health Cooperative, Integrated Healthcare Association (IHA) and NAMMCAL have implemented electronic health records and developed community connect strategies, but are meeting resistance.

Group Health Cooperative, a Washington State patient-owned cooperative comprising 900 physicians, payers, labs and pharmacies, implemented Epic's EHR in 2003. One hundred percent of its physician order entries are computerized, said Ernie Hood, vice president and CIO. Its patient-centered medical home, EHR and patient portal are all connected.

North American Medical Management California (NAMMCAL) develops and manages provider networks comprising independent solo practitioners in three southern California counties. Its 1,600 physicians don't have the financial resources or human capital to invest in healthcare IT, so NAMMCAL subsidizes the rollout of EHRs. Approximately 20 percent of the physicians are live on EHRs, said Leigh Hutchins, president and COO.

NAMMCAL is on a dual path of implementing an EHR and HIE, but it has bumped up against the different motivations of and strategies for governance and funding from stakeholders, she said. Providers are trying to figure out whether to become an HIE or be a participant.

Integrated Healthcare Association, a statewide, multi-stakeholder nonprofit promoting quality improvement, accountability and affordability, implemented its pay-for-performance program in 2003 and has documented quality improvement. It incorporates 10 clinical IT measures, including patient registries for population management and point of care technology.

Tom Williams, executive director of IHA, pointed out that "a lot of collaboration and some kind of organizing force" is needed to move the community to participate in HIE s. "I hope state-designated entities (SDEs) can get people to the table," he said. "It's more important than actual incentives."

Source: Healthcare Stimulus Exchange

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