HIBC Initiatives

HIE Pilot Projects

A Health Care System Connected by Shared Information
Health Information Exchange (HIE) is a critical component of the national health care quality revolution. Nationwide, the Office of the National Coordinator for Health Information Technology (ONC) is supporting states’ efforts to rapidly build HIE capacity within and across states through the State HIE Cooperative Agreement Program.

As part of the planned statewide Hawai‘i HIE, HIBC is leading and facilitating the implementation of HIE systems in North and East Hawai‘i. The HIE systems will connect providers in those regions and enable the secure sharing of patient information.

Progress Driven by Collaboration
In North Hawai‘i the pilot HIE is a public HIE. This means that the data is from healthcare organizations that have different electronic health record (EHR) systems, and that participating HIE members are not affiliated with each other. In a public HIE, the EHR systems are not the same making the exchange of patient information more challenging than private HIE’s that send and receive data using the same EHR systems.

This HIE initiative is anchored by North Hawaii Community Hospital (NHCH) and utilizes the Alere Accountable Care Solution system. Participants in this HIE include a family practice, a specialist and a federally qualified health clinic (FQHC) in addition to three NHCH physician groups. Other critical participants in the HIE are the two laboratories that provide nearly all the external lab results and an e-prescription network that feeds filled prescription information into the HIE.

In East Hawaii, the pilot HIE is being created in partnership with the Hawaii Medical Service Association (HMSA) and Hilo Medical Center. HIBC is implementing an advanced analytical system, Microsoft/Caradigm Amalga Unified Intelligence System (UIS) software, to improve communication along the continuum of care and analyze quality of health outcomes. The East Hawaii HIE will merge clinical and claims information to provide a view of patient care over time to manage individual and population health.

Twenty-three primary and specialty care providers are connected to Alere Accountable Care Solutions. HIBC’s key accomplishments for North Hawai‘i’s pilot HIE are:

    Extended multiple data sources and functionalities to providers in addition to their current EHR’s.
    Connected with Hawai‘i HIE to transmit clinical data.
    Provided access to inpatient and ambulatory practice systems’ demographic patient data, clinical notes and transcription reports.
    Created feeds of lab results from two organizations that cover 90 percent of external lab test on the island.
    Created feeds from two EHR’s: eClinical Works and GE Centricity.
    Extended DIRECT secure message capability between providers with the first DIRECT message sent in 2012.
    Improved efficiency of physicians and support staff.

HIBC’s key accomplishments for East Hawai‘i’s pilot HIE are:

    Created a collaborative agreement to bind project stakeholders together in a governance structure.
    Identified project roadblocks and developed an action plan to achieve as much of the project scope as possible.
    Actively working toward a sustainability plan with HMSA and other project participants.
    Worked together with participant IT teams to implement connections between each organization’s systems.
    Demonstrated data connections from Hilo Medical Center and Bay Clinic to the Amalga system.
    Delivered a simple process for providers to view Hilo Medical Center, Bay Clinic, and HMSA patient information. 

Hawai‘i Island HIE

  • Waimea Medical Associates
  • Island Gastroenterology
  • Cleveland Clinic Radiologists at North Hawaii Community
  • North Hawaii Hospitalist Physicians
  • North Hawaii Medical Group

Hilo Medical Center is participating in the East Hawaii HIE and collaborating on the integration of clinical data.

Hawaii Medical Service Association is participating in the East Hawaii HIE and collaborating on the integration of claims data.

Lessons learned:

    1) Buy-in and executive committment is needed across organizations in case of turnover.
    2) External funds do not create vision nor sustainability.
    3) Concurrent technology implementations compete for small organizations’ time and resources.
    4) An HIE with a small patient population requires complete participation to ensure success.
    5) Secure an independent organization to establish governance structure and contractual agreements.
    6) Address challenges to employee access to Patient Health Information (PHI).
    7) Select experienced technical resources to ensure project success.
    8) Address project issues early on to demonstrate value and increase sustainability options.