Frank Clark, CIO of the Hospital Authority and Medical Center of South Carolina who spearheaded the regional HIE Carolina eHealth Alliance, doesn’t laugh when discussing the competitive nature of data-hoarding providers. Clark spoke with Government Health IT Editor Tom Sullivan about his experience convincing participating hospitals to unshackle their data, if only for a short time.
Q: What was the hardest part about building the HIE?
A: Nailing down the data sharing agreement. Getting the lawyers to agree, and just working through all the politics, and the competitive nature of these organizations. We are finally live across three of the hospital organizations. We still don’t have Tenet and, of course, HCA works out of Nashville and Tenet’s out of Dallas so everything has to go back to the corporate mother ship. They don’t seem to have any local autonomy, which makes it even more difficult. We’re live and have been so for a while now on the first use case across 10 emergency rooms.
Q: That use case being the ED, how do providers actually share records, print-fax-scan or electronically?
A: It’s all electronic, real-time over a secure link. Records don’t get stored permanently. That was one of the issues we had to get over. Given the competitive nature of these organizations, everybody thought there was some agenda. I drove the project, and I’m not a disinterested party so they were afraid our marketing people were trying to get access to their data to steal market share. The hard part was getting over that. So we all share the data. Essentially, it’s a temporary view and the ED physicians decide how long the information will be available, depending on how long they need it. It’s 45 minutes or 60 minutes or something like that. So there’s no central repository. There’s a service located at the facility and the only data that gets stored is just enough demographics.
Q: Having only a temporary view might suffice in an ED, but not so well in, say, an oncology unit…
A: Most healthcare is delivered not in a hospital but in a physician’s office. In our case, we employ 1,200 physicians so we have all of the information that’s collected in our clinic as part of our electronic medical record. So if someone does an EMPI (Enterprise Master Patient Index) call and that person has been seen in our hospital or clinic, the doctor gets that information. That’s not true of the other facilities. But our next use case, the next largest primary care physician group in town, we are bringing them into the HIE so that when they refer a patient to one of our specialists or admit a patient into one of their hospitals, we push an E32 doc from the primary care doctor to the specialist so they will be able to see what care has been given to that particular patient. Now, we haven’t decided whether that is going to be stored permanently somewhere or not. Again, there are struggles with the lawyers.
