Strategic and operational plans for health information exchanges have been rolling in to the Office of the National Coordinator for Health Information Technology as states begin implementing their HIEs through HITECH Act grants.
Organizations designated to lead HIE development under the stimulus law are required to submit detailed plans that explain how they will govern, design and launch the exchanges in their state. The plans must be approved by the ONC before states can move forward or receive HITECH Act funding.
Among the 15 plans submitted, the ONC has given three states — Maryland, New Mexico and Utah — a green light to proceed with their HIEs. While the lengthy plans discuss ways to meet federal requirements, from engaging stakeholders to following national data and technical standards and complying with privacy and security regulations, each one mentions the development of a master patient index (MPI).
A patient index identifies all patients in a health care setting, and providers use unique numbers to organize and extract information from patient records within the MPI. It is a core element of the infrastructure of HIEs, according to the organizations that have approved HIE plans.
“An accurate master patient (person) index, in electronic format, may be considered the most important resource in [an HIE] because it is the link for positively tracking patient, person or member activity within an organization, or across organizations and across patient care settings,” the state of New Mexico stated in its strategic and operational plan.
In its plan, the Utah HIE said it will create a statewide MPI with the help of Intermountain Healthcare. That Salt Lake City-based health system received a grant from the National Library of Medicine and National Institutes of Health to start working on the index, which the exchange expects will support clinical information exchange.
The state of Maryland has estimated its MPI will cost $350,000 in the first year of implementation, and $140,000 annually for the next three years. That cost is one component of the core hardware and software services that make up the infrastructure of the HIE, the state said in its written plan.
“For an HIE to function, providers need a reliable way of matching their patients with available records in the network. This is no trivial task, and even within a single enterprise, matching a person with his or her past records is not always easy,” Maryland wrote in its plan.