Maryland health groups offer visions for statewide HIE
By Heather Hayes
Tuesday, March 03, 2009
Two Maryland health care coalitions have submitted plans for building a new statewide health information exchange.
Each proposal—developed using a $250,000 state grant – were sent last week to the Maryland Health Care Commission and Maryland Health Services Cost Review Commission. Each contains recommendations for technical architecture, governance, privacy and security and financial sustainability that will be used to develop a request for proposal for a statewide HIE.
The proposal from Chesapeake Regional Information System for Our Patients (CRISP), a coalition that includes Johns Hopkins Medical Institutions, MedStar Health, the University of Maryland Medical System and Erickson Retirement Communities, recommends an incremental growth strategy.
The initial services provided, said Scott Afzal, lead project manager for the CRISP Planning Project and director of health information systems for Audacious Inquiry, would have clear and quick value to clinicians, such as patient medication histories, lab results and discharge summaries.
CRISP’s sustainability model is based on collecting a nominal subscription from hospitals and physicians, as well as transaction fees. “We do make the assumption that that with the current push for health IT in the federal space, there is going to be an increase in the adoption of electronic health records (EHRs) by physician practices that will be supportive of our model,” Afzal stated.
The proposal from the Montgomery County Health Information Exchange Collaborative, made up of the Primary Care Coalition of Montgomery County, Montgomery General Hospital, Holy Cross Hospital, Shady Grove Adventist Hospital, Washington Adventist Hospital and the Prince George’s County Health Department, acknowledged the still-maturing health IT industry and the complexity of the Maryland health care system.
MCHIEC suggested that the state permit (but not require) the creation of several regional health information organizations (RHIOs) and explore whether a single statewide HIE or local HIEs linked by common standards would be the most cost-effective, risk-mitigating and rapidly deployable model.
The group advised that developing an effective governance structure should be the state’s first priority. “The governance organization must be trusted, representative, transparent and able to balance the multiple conflicting issues that will inevitably arise in such a venture,” MCHIEC officials wrote in their proposal. “Health information exchanges in other states have failed or struggled because of lack of attention to this critical success factor.”
An RFP for a Maryland-wide HIE is expected to be released this spring and an award made as early as this summer. Initial estimates for the system put the cost at $10 million. Funding is being provided through a small increase in the state’s hospital rate-setting mechanism.
