Currentcare set to begin data-sharing with pilot

The years-long effort to build a health-information exchange for Rhode Island is entering a critical new phase, with data-sharing set to begin in a Woonsocket pilot and, on a more limited basis, all across the state.
Sharing patient information is a key part of what the federal government considers “meaningful use” of electronic medical records, crucial to preventing errors, avoiding duplicate tests and imaging, and coordinating care across settings.
The Rhode Island Quality Institute, a collaboration of hospitals, doctors, insurers, consumers, government, business and academia, has been working toward that goal since 2002. Five years ago, it got $5 million from the federal Agency for Healthcare Research and Quality (AHRQ) – one of six nationwide – to build a data exchange as a demonstration project.
The system was named “currentcare,” and in late 2008, after choosing a small set of providers to share data in the pilot phase, the institute began recruiting patients willing to allow their information to be made available to doctors, hospitals, etc.
Now, with more than 37,000 people enrolled and more joining every day, currentcare is almost ready to go live, said Quality Institute President and CEO Laura Adams. A last round of security audits and user acceptance tests are being done, she said, and then it will launch.
Only a limited amount of data will be available – test results from Lifespan, East Side Clinical Laboratory and R.I. Department of Health labs, plus medication histories provided by SureScripts, the nationwide pharmacy data and e-prescribing network.
But that in itself, Adams said, will be valuable for doctors, who’ll be able to look up X-rays, blood tests and a complete list of all the drugs a patient is taking, for example. Eventually, the goal is to share a wide range of information, including patients’ charts and hospital records. Yet as the institute has looked at the logistics of pulling data from dozens of different EMR systems, a new challenge has arisen that led to the second upcoming pilot.
Connecting all the EMRs directly to currentcare, Adams said, turns out to be too difficult, so instead, the institute now plans to funnel the data through so-called EHX hubs, or health-information aggregators, each geared to users of a specific software.
All the doctors with eClinicalWorks, for example, would use one hub, while everyone on Amazing Charts would use another, and those on EpiChart, yet another. Those hubs, in turn, would feed currentcare, allowing the disparate systems to share data.
To test that model, the institute last fall launched the Limited EHR Aggregation project (LEAP), working with a specialty medical group, Thundermist Health Center, and Landmark Medical Center. The specialists and Thundermist, both of whom use eClinicalWorks, will upload their data through the hub, and Landmark doctors will be able to pull it up online.
The benefits are expected to be immediate, Adams said: For example, when a woman is in labor, doctors will be able to know her allergies and any other medical issues, and get the information in real time, rather than wait for it to be faxed over.
“The ability for them – with patients’ consent – to be at Landmark, call up the EHX hub, look into that record at Thundermist and see the latest data, we’re quite excited about this,” she said. Already, Thundermist has begun uploading data to test the system, she said, and by mid-February, the project should be live. “We’re learning a lot through this project,” she said. There have been challenges, for example, getting the right software versions to work with the hub, she said, and installing updates can be difficult for doctors, too. That’s why LEAP has a narrow scope, she added: “None of these software products that exchange data are really mature. …We wanted to understand the benefits and the limitations in order for us to understand how we want to select future aggregators.”
The newness of the technology – and the strict privacy laws involved – definitely has slowed the project’s progress, Adams said. But there is another serious challenge: Despite generous support from Blue Cross & Blue Shield of Rhode Island, UnitedHealthcare of New England, CVS Caremark Corp. and others (Tufts Health Plan just donated $50,000), the institute still doesn’t have large and steady enough funding to move faster, Adams said.
Aiming to speed things up, the institute is preparing to apply for new federal grants. But it is also seeking state support, through a new 0.13 percent tax on health insurance claims – or $1.30 on a $1,000 claim – that it wants the General Assembly to approve this year.
Because the tax would apply to all private insurance claims, Adams said, even for self-insured companies, it wouldn’t disproportionately affect small businesses, as premium taxes do. And the burden would be spread so thin, she added, that it would only cost an estimated $9.94 per person per year, all while producing $8 million annually for currentcare. •