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Internist William Reiter, MD, has merged medicine and commerce throughout his career, founding and eventually selling an immunology center in Florida in the 1990s, and then working as chief medical officer at a community hospital in Anaconda, Montana, near the continental divide.
Now the chief medical information officer at HealthShare Montana, the state-designated health information exchange and a central repository, he has some pretty heady ideas for data analysis and HIE, like combining claims and clinical data with HIPAA-compliant Census demographics or environmental quality data. Reiter wants to use these data sets to probe illness causes and treatment effectiveness to try to answer questions many doctors may wonder.
Of course, there’s limitations to Reiters’ ideas, like HIPAA, technology and data access. But Reiter and others working with HealthShare Montana think that approaching HIE simply as exchange misses a huge opportunity for analysis, given all the data that is or could be available—claims data especially, Reiter said. Fourteen states have claims repositories, and Reiter hopes Montana becomes the 15th.
“This is taking us into a whole new realm of capability to be able to do complex analytics,” Reiter said.
In Montana, as elsewhere, a small percentage of people with multiple chronic conditions receive a majority of healthcare system’s resources. Mapping claims data with clinical data could show the most effective treatment methods for those illnesses, Reiter said. And with more and more patients taking multiple medications, there’s a gap in knowledge about drug dosage and interactions that Reiter thinks could be filled.
[See also: Public health and HIEs: IIS integration.]
Right now, though, they’re starting small, taking the “theory to design,” Reiter said, while focusing on managing the HIE. Expected to be financially sustainable sooner rather than later, HealthShare Montana’s business model is pretty diversified, earning revenue through a combination of membership fees and software sales and helping providers achieve Meaningful Use. Brad Putnam, the interim administrator of HealthShare Montana, also wants to offer analytical services to hospitals and networks, insurers or even other HIEs and RHIOs. One client, Blue Cross Blue Shield of Montana, is using HealthShare Montana’s metrics services for its patient-centered medical home model.
That revenue, if it all works, can then help pay for research that doesn’t have an immediate commercial utility. Reiter and others affiliated with HealthShare Montana apparently have found a way to harness HIPAA de-indentified Census data, using i2b2 software, and they will have an abstract of the research displayed at the American Health Information Management Association conference in October.
“The Census data sets are our grail if one can do them in an appropriate way,” said Nick Anderson, who co-leads the biomedical informatics division at the University of Washington’s Institute of Translational Sciences, a research partner of HealthShare Montana.