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Ask the expert: HIE participation not that complicated at basic level

Robust EHR-to-EHR HIE participation fueled by complex data standards is a goal for hospitals. Primary care providers, however, can start with less.

Dan Paoletti, CEO of Ohio Health Information Partnership (OHIP) -- the organization leading Ohio's state health information exchange, which comprises several public and private regional HIEs -- serves health care providers on a spectrum from large hospitals to solo physician practices. Check with your state HIE to see what basic services are available and what their requirements are.

What is the minimum equipment, software and services a provider needs for health information exchange (HIE) participation?

Dan Paoletti: As long as providers have broadband access to the Internet, that's really all they need to participate in OHIP. If they have the electronic medical record (EMR), they will have the computer. We've sort of taken this bottom-up approach; worst-case scenario: If they have a broadband, a computer and ultimately a printer, they can have HIE participation. That way they'll receive continuity of care documents, lab reports, etc., from hospitals, specialists and other physicians.

The EMR can be outside the universe of ONC-certified EMRs. In Ohio, we even have hospitals with hitching posts out front of the hospital, because they're small, community-based and they have an Amish population. They are critical-access hospitals still trying to work toward EMR adoption that we're working with on the regional extension center side. They have physicians -- literally, single docs with a computer -- but they haven't adopted electronic medical records.

So how can we enable the hospital to get a record to that physician? We basically set them up with a secure inbox, and we can route that information right to the printer so we can replace the fax in a more secure way.

We've really tried to account for everybody. So it could be the Cleveland Clinic or a little mom-and-pop physician practice out in Amish country that we need to account for. We've got to manage it all -- as well as the technology we've put in place to do that.

For those who can't contribute right now [i.e., feed their patient data into the HIE], we're enabling them to receive data, and we set them up with directed exchange so they can scan something in, add in a message and send that securely. In 2013, we are rolling out the ability to grab information from a file anywhere in the doctor's system and pass it to the community health record of the patient, which would then make it viewable to other providers. As they get accustomed to that, we'll roll out some more advanced technology.

We started slow with a lot of folks, which is still going to make a great impact because that information is crucial to transition of care.

Let us know what you think about the story; email Don Fluckinger, features writer, or contact @DonFluckinger on Twitter.

This was first published in December 2012
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