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Indiana Health Information Exchange Inks Deal with AT&T

The Indiana Health Information Exchange (IHIE) is touted by leaders as the largest health information exchange in the nation, but its ability to become even more prominent was hindered by technological details and infrastructure—a challenge that will now be lifted, says IHIE President and Chief Executive Officer Harold Apple, by a company most Hoosiers associate with cell phones: AT&T.

The nonprofit IHIE has forged a partnership with the company's health care business arm AT&T Healthcare Community Online (HCO). Using its cloud-based technology, HCO will increase the IHIE's capacity—linking more hospitals, doctors and patients in Indiana, and perhaps beyond, to the electronic transformation in health care.

Inside IHIE's electronic borders is what its leaders call "an ocean of information"; the repository contains four billion pieces of clinical data in electronic form for 10 million patients. On a daily basis, some three million "transactions"—electronic movement of that data—take place among the 80 facilities and 19,000 physicians connected via the exchange.

To store the burgeoning amount of information and continue its mission to "ensure health information is where it needs to be, when it needs to be there," the IHIE needed a solution to connect more hospitals, clinics and physicians to the exchange.

"[The partnership with AT&T] provides the capability for the IHIE to grow much larger than what it currently is and at a faster pace," says Apple. "This is a business that's driven by lowering costs. To lower costs, you have to have a very large scale number of patients, physicians and various stakeholders in the health care community. The whole idea is to improve our capability by partnering with a company that has national resources available." Listen

Apple says the three-year partnership is the first in the U.S. that connects a local health exchange with "a national player." Health IT leaders believe the partnership is needed now than ever before, because EMRs are driving health care reform. The federal government is pushing for EMRs for all Americans by 2014 and earmarked $2 billion in the American Recovery and Reinvestment Act of 2009 to invest in health IT infrastructure.

"The reason why this is so critical now is because hospitals and providers are being incentivized by both Medicare and Medicaid to implement EMRs; there's significant funding available or penalties for providers who do not move forward with getting in the digital world," says Andrew VanZee, health IT director at the Indiana Family and Social Services Administration. "That puts a lot of pressure on organizations—like the IHIE—who are data intermediaries to be able to meet the demand of the market. That's why collaborating with a national partner like AT&T is beneficial for the IHIE." Listen

Apple notes that each electronic transaction within the IHIE carries a cost; utilizing AT&T's HCO Clinical Message Exchange will reduce that cost and accelerate its delivery from IHIE's centralized repository in Indianapolis to the entire "community of care." Listen

"The larger the network, the less costly each transaction will be," says Apple. "If a primary care physician refers a patient to a cardiologist, he can fundamentally push a button and send his patient's entire record electronically to the referred-to doctor. Historically, that would've required someone making a photocopy of the patient's records and physically transporting it. It's much less costly to transfer that record in an electronic format."

The IHIE believes the partnership with AT&T puts the infrastructure in place to expand beyond Indiana's geographic borders to become a regional exchange.

"Indiana is seen as one of the leaders nationwide for health information exchange; the development of health IT has been occurring here over the last 10 to 15 years. Many other states today are starting from scratch," says VanZee. "We've got a significant lead on being able to deliver these products and services, and now, continuing to be at the forefront of advancements in the quality of care provided by utilizing these electronic means." Listen

While the average Hoosier may not notice the "behind the scenes" technological upgrades, health IT leaders believe patients may notice a "more connected" experience at their clinic, characterized by caregivers having access to pertinent health information at the point of care—moving IHIE one step closer to its ultimate goal of increasing the efficiency and decreasing the cost of health care in Indiana and beyond.

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