KHI News Service

Major health information exchange initiative announced

Collaboration to include doctor and hospital groups linking with efforts underway in Wichita and KC

By Mike Shields | July 12, 2010

The Kansas Medical Society and the Kansas Hospital Association announced today that they will join to create a statewide health information exchange, early phases of which are expected to be operational in the state's two largest metropolitan areas by year's end.

The initiative, organizers said, will incorporate the work already done by two fledgling regional exchanges - one each in Wichita and Kansas City - that so far remain the most advanced efforts to date to have Kansas medical providers linked electronically so that patient information can be easily and immediately shared.

"It's still very new and a lot has to happen yet, but at least we've got a preliminary statement of collaboration," said Jerry Slaughter, executive director of the Kansas Medical Society, describing the new statewide initiative.

Slaughter said among other things the groups in the collaborative need formal endorsement from their respective director boards before the exchange is launched. Financial plans and a business model aren't fully developed, either. A non-profit corporation must also be formed.

But at a collaborators' meeting Monday at the medial society's Topeka headquarters, it was evident that the groups are already pressing forward together. Officials said they agreed to join on a statewide exchange as the result of discussions that began a few months ago.

Officials representing the regional exchanges in Kansas City and Wichita have already agreed they will sign a single vendor to provide a gamut of services to exchange participants in each city. They said they are in late-stage negotiations this week with the two finalist companies vying for the contract, which would run for five years. A contract for statewide exchange services is certain to be valued in the millions of dollars.

The finalists are Axolotl Corp. and Informatics Corporation of America, said Laura McCrary, director of the regional health care initiative for the Mid-America Regional Council in Kansas City, Mo., which is playing a key role in the Kansas City exchange effort.

The plan is that the company that is selected will serve both the regional exchanges, which together will become a springboard for a statewide exchange that initially will draw members from the medical society and the hospital association. Those two groups represent about 5,000 doctors and 125 hospitals.

Organizers of the effort said they ultimately intend to make the exchange open to pharmacists, safety net clinics, nursing homes and other providers of medical services anywhere in Kansas.

Executive order

The governor on June 30, issued an executive order creating a non-profit, public/private entity to govern Kansas health information exchange.

Members of the new collaborative said they hope to work closely with the state and other entities involved in advancing the deployment of health information technology but felt they needed to push forward on their own because of looming deadlines facing primary care providers.

"At the end of the day, somebody is going to have to actually do it," Slaughter said. "We have felt a sense of urgency."

The federal economic stimulus of 2009 included $34 billion in incentives for medical providers to maintain and use electronic health records for their patients. The first round of incentives for providers who can demonstrate they have "meaningful" digital information systems begin in 2011. Those who don't have certified systems in place by 2015 face penalties.

The American Recovery and Reinvestment Act also called for creation of state or regional health information exchanges so the records could be easily transferred from one provider or treatment location to the next. The law allows for those exchanges to be run by state governments or designated non-profit groups.

The federal goal is for every American to have a digitized health record by 2014 and an exchange system that would allow, for example, an emergency room doctor in Florida or Hawaii timely access to the medical history of a vacationing Kansan who had suffered a heart attack.

The state was awarded a $9 million federal grant in February to develop a health information exchange plan, which the e-Health Advisory Council has been working on for several months. The council members early on said they hoped to have an exchange operational by October this year, but that timetable is now unlikely. The e-HAC group, which is scheduled to meet again Tuesday, is expected to complete its final operational and strategic plans next month.

The council has been under the direction of Kansas Department of Health and Environment Secretary Roderick Bremby and some members have chafed at what they consider the panel's slow pace given the federal deadlines.

But members of the new doctor/hospital collaborative said they would likely have come together in some fashion regardless if the state had moved quicker on making a statewide exchange a reality.

Tom Bell, president of the Kansas Hospital Association, said the collaborative intended to build on the "excellent" work already done by e-HAC and KDHE.

"What we're talking about is an outgrowth of what the state has done. What we're talking about is the next step," he said. "Something we think will be very collaborative."

Like nothing ever seen

Slaughter said the medical society and hospital association have worked together on other things in the past, "but probably nothing on this scale."

"In terms of the financial impact, when fully deployed statewide it's going to be enormous," he said, "and from the sheer quantity of clinical information coursing through this network, it will be like nothing our state's ever seen."

Though most Kansas doctors use computers for the business side of their practices, a relatively small percentage across the state, especially in rural areas, have embraced health information technology for patient records or other clinical needs.

Slaughter said getting all primary care providers linked to an exchange would be "an expensive and complicated process."

But he said the state's relatively small population could make the task easier.

"I think we have a reasonably good chance of doing it since we're a small midwestern state and tend to be homogeneous," Slaughter said. "I'm not sure you could do it in a state like California where there are probably 20 different exchanges. This is not a slam dunk by any means but we're hopeful."