From referrals to personal health records, health information exchange initiatives through the Direct Project were in the spotlight during a recent National eHealth Collaborative webinar.
Brian Ahier, president of Gorge Health Connect, Inc. focused on how their pilot project could facilitate health information exchange via Medicity HISP technology in three uses: the transmission of primary care physician (PCP) referrals and summary care records sent to hospitals, sending discharge information from hospitals back to the referring PCP and, lastly, the exchange of summary care records and results between PCPs and specialists. He seeks to extend use cases through scale to include syndromic surveillance, immunization data, quality reporting and patient communication.
Additionally, Ahier noted two methods of exchange: one-way directed exchange and two-way directed exchange. One-way exchange, which includes provider to provider and lab to provider “sequences,” consists of basic referrals, lab result reports, public health reports from labs and public health reports from providers.
An example of two-way exchange could be a hospital exchanging medication information with a PCP, and then the hospital exchanging a clinical summary back to the PCP. The sequence in this type of exchange could involve hospital admittance and discharge.
Summary care records made its way into Sean Nolan’s presentation as well. Nolan, chief architect of Microsoft’s Health Solutions Group, hopes to send patients home with a “body of information,” such as immunization records and patient education after they’ve been discharged. That was an appropriate segue into PHRs to incorporate HealthVault, Microsoft’s PHR model. Nolan’s point was that the Direct Project can aid in the transition of data from Google Health, which will be put to bed on Jan. 1, 2012, into HealthVault.
Nolan also pointed out that the exchange of personal health information (PHI) to PHRs — and PHI across disparate practices as a whole — must be done securely. The importance of certificate discovery, or digital membership cards, play a role in exchanging information because it’s needed on both ends. The question, Nolan said, is who do we give certificates to and who do we trust?
The final speaker, David Kibbe, M.D., senior advisor of the American Academy of Family Physicians, focused on emerging issues. Kibbe believes that more standards are needed for the growth and scale of information exchange. Additionally, ONC’s governance rule for a Nationwide Health Information Network, is projected to be strict, said Kibbe. Therefore, balancing the Direct Project’s innovation versus ONC’s exchange regulations will be something to watch.