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June 03, 2010

Health Information Exchanges Show Value


It's no secret that electronic information exchange among doctors, hospitals, insurance companies, government payers and patients has been increasing dramatically. In fact there are now more than 190 Health Information Exchanges nationwide; no state is without one. And as predicted, these exchanges are leading to both lower costs and greater efficiency. For example, a 2009 survey by eHealth Initiative showed a nearly 40 percent increase in one year in the number of exchanges that were far enough into implementation of 'operational initiatives' to demonstrate increases in efficiency and to show a positive impact on ROI. 

The idea for a HIE in Tennessee began in 2004, back when the state was ranked the third unhealthiest in the nation by United Health Foundation. Leaders from the state government and Tennessee's largest insurance companies both were hopeful that ubiquitous access to patient records might be a key factor in improving the health of citizens. The solution, they decided, was a central point where health information for all patients could be shared and accessed. Out of those discussions came Shared Health.

Jana Skewes has been the CEO of Shared Health since its founding more than five years ago. Skewes began her career at Rush-Presbyterian-St. Luke's Medical Center in Chicago and worked her way up the administration ranks. She worked for Metropolitan Life Insurance Company in corporate health strategies for two years before moving to Rochester, New York and taking a job with Excellus, the area's Blue Cross Blue Shield organization. Her experience in both the hospital and the insurance side of the business gave Skewes a unique perspective but it was something that happened in her personal life that gave her the passion and energy that has made Shared Health successful. 

Jana Skewes, CEO of Shared HealthYears ago, when her oldest child was just over one year old, Skewes (pictured left) was diagnosed with Stage 2 lymphoma. Numerous medical visits required her to repeatedly recite what the previous doctor had said, because there was no way to share test results or consult notes. By keeping her own detailed notes, she became the source everyone relied on for her health records. However, she was struck by how broken the system was. When she was later asked by the CEO of Tennessee Blue Cross to help develop a system to integrate and share medical records among stakeholders, Skewes, now recovered and energized to make changes, were eager to sign on.

Shared Health is one of the health information exchanges furthest along in eHealth's definition of operational development. Members in the Shared Health exchange have seen a 15 percent improvement in cost efficiency, 12 percent fewer avoidable emergency department visits, and an average savings of $8 per prescription.

The Shared Health System is designed to take on the most frustrating challenges for doctors, clinics and hospitals, such as incomplete patient records, redundant paper work, constant interruptions, and the inefficient retrieval of records. The Clinical Exchange Platform, the heart of the Shared Health System, is customizable, allowing health care providers and payers to access the information in a way that does not change their existing workflow. The platform includes clinical tools designed to work easily with existing systems, as well as new tools such as ePrescribing and medication reconciliation, clinical decision support, messaging among health care team members, and child wellness support. 

In the last five years, Shared Health has grown beyond the state borders and now is one of the largest Health Information Exchanges in the country, with more than 3 million participants. There are now 5,460 registered clinician users on the exchange, accessing over 385,000 patient records and last year more than 350,000 prescriptions were sent via ePrescribe, Shared Health's electronic prescription system.

While Shared Health is taking their simple assertion that 'better information leads to better patient care' across the country, their roots are still in Tennessee. Every state is grappling with the challenge of patient lifestyle choices and compliance, and Tennessee is no exception. It's interesting to note, however, that Tennessee has moved six places up the unhealthy state scale in the last five years. While they have a long way to go, it's a good start.

Robin Wright is a consultant with more than 20 years of experience in the IT and telecom industries. To read more of her articles, please visit please visit her columnist page.

Edited by Michael Dinan
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