Yehyun Kim :: ctmirror.org
After 14 years of false starts and scrapped plans, officials said Monday they have launched Connecticut’s statewide health information exchange, a single repository of medical data that can be accessed by any provider tied to a patient’s care.
Forty-four providers have already signed on to the system, known as “Connie,” including Hartford HealthCare, Yale New Haven Health and the Pro Health Physicians network.
Health care practitioners are required to participate in the HIE. By law, hospitals and laboratories have one year to sign up once the exchange is deemed operational. Other providers have two years. The state has set up a secure email system so medical personnel who don’t have access to the proper technology can communicate with the HIE until the infrastructure is in place. Funding is available for providers who need help connecting to the exchange.
Officials have said it could take two to three years to get everyone fully on board.
“We are now officially on the path that many other states have traveled to improve health care by sharing data so that it’s available when and where it’s needed,” said Vicki Veltri, head of the Connecticut’s Office of Heatlh Strategy. “Information that’s accessible in real time is critical for good health care.”
The launch of the exchange comes after more than a decade of failed attempts and shifting plans.
The first bid started in 2007 with a plan to build a network for Medicaid patients. But most physicians had not yet switched to electronic health records, and the state’s medical professionals weren’t ready for it.
A second attempt in 2011 – through the Department of Public Health and a quasi-public group called the Health Information Technology Exchange CT (HITE-CT) – got off to a stronger start but was mired in a legal battle and later folded. The third venture was overseen by the Department of Social Services and lasted 10 months, beginning in 2016. That effort also centered on Medicaid-based initiatives, while larger plans for a statewide HIE were left for those who spearheaded the fourth – and most recent – attempt in 2017.
At least $18 million was spent on the first three projects. About $48 million was set aside for the latest effort, with 10% of that covered by the state and federal funds making up the rest. By last fall, more than $20 million of the $48 million had been spent. Officials did not have an updated figure on Monday. HIE organizers are required to use the remainder of the federal money by September 2021.
After COVID-19 spread through Connecticut, health officials here – including the exchange’s former director, Allan Hackney – lamented the system’s late arrival. The need for up-to-the-minute, robust patient information has become more pressing during the pandemic, and the lack of a broad health information exchange put the state at a disadvantage, they said.
Other states have used their systems to trace outbreaks in nursing homes, to identify COVID-19 hotspots in communities, to analyze data on race and ethnicity and to help agencies, like public health departments and regional health districts, access more extensive patient information in the midst of an emergency.
“I just wonder how many people could have been saved had we had this up and running,” Hackney, the state’s former Chief Information Technology Officer, told The CT Mirror in October. “How many health care workers could have avoided burnout if we had this data? I get very frustrated.”
Yehyun Kim :: ctmirror.org
The exchange will allow health practitioners to get fuller patient medical histories. If a person receives a coronavirus test at a physician’s office in New Haven and walks into an emergency room in Putnam a week later, the hospital doctors could view the person’s results, along with any underlying conditions he or she may have.
The network gathers data from physician practices, laboratories, hospitals, radiology offices and community organizations, giving providers a comprehensive look at a patient’s background.
“Wherever and whenever you need to get health care in our state, your provider will be able to access needed health information so they can provide the best treatment, better care coordination, and not duplicate tests in the process,” Veltri said. “If you typically get care in the northeast corner, but find yourself in need of emergency treatment at the shoreline, you won’t have to worry about treating physicians not having real time lists of your medication or health conditions.”
Connecticut will use an “opt-out” system, meaning patient data will be shared across the network unless a patient opts out. Only a handful of HIEs nationwide still have an “opt-in” system, in which data can’t be shared unless a patient consents.
Those who wish to opt out can do so by filling out a form available at ConnieCT.org.
Ellen Andrews, executive director of the nonprofit CT Health Policy Project, a research and educational organization, said leaders at the exchange should do more to let the public know what is happening with their medical data and make clear that they have the choice to opt out.
“I’m concerned that there’s no public education campaign,” she said. “The best opt-out process, if nobody knows about it, it’s just a tree that falls in the forest.”
Officials at the exchange have said that while providers and insurers will have access to the HIE in the short term, others, such as researchers, may be considered for access in the future. Patients will eventually be able to log in and view their own data as well.
Jenn Searls, executive director of Connie, said leaders at the exchange are working with the Office of Health Strategy to come up with a long-term funding strategy that likely will include some federal money and a subscription model for participating organizations.
Connecticut is one of the last states in the nation to launch a broad health information exchange.
Some states have a single network that serves all residents. Others, like Texas and California, have several regional HIEs that cover different pockets of the state. And a handful have started the networks but run into problems, forcing them to dissolve the systems and start over.