Hospitals have traditionally struggled with the process of getting their internal HL7 clinical data out to their immediate referring community of physicians in an electronic manner. A Provider Health Information Network™ is a secure, privacy-aware health information network that is sponsored by a large provider (typically a hospital). The information is presented either in the form of a web-based user interface, or by using bi-directional data integration/interfacing technologies - depending on the capabilities at the provider’s end. The HealthUnity ProHIN solution lets provider hospitals connect to external credentialed providers incrementally over time, with the ultimate goal of connecting the entire community of referring physicians.

A Provider Health Information Network (also referred to as a Physician Connectivity network) provides the ability for an Integrated Delivery Network (IDN) or a Hospital to connect to its referral base of physicians over a secure network and electronically exchange clinical information. The need for such a network has been realized for many years now and there are various national, state-wide and regional efforts underway. It will help for us to summarize the problems addressed by ProHINs:

Strongly integrating with the referral base

• IDNs and Hospitals are keen to provide a software platform on which to build a community. This will help further cement further the relationship they have with credentialed physicians who are in the community. Building this goodwill will ensure continued patronage by credentialed physicians to use the IDN/Hospital’s facilities.
• This has to be done in a manner in which existing anti-kickback and Stark Laws are addressed.

Inefficiencies leading to higher costs in today’s model

• Today, collaboration of clinical data happens via snail mail, fax and other manual means. These operations take up valuable time, are inherently labor intensive, are issue prone and are also not necessarily secure and address HIPAA privacy concerns
• One option is to build a web portal solution. However, multiple portals (where available) enable the viewing of information, but do not provide a method to import and incorporate it into local systems.
• EMR systems by themselves do not solve all of the communication and collaboration problems that physicians are facing. They still have to build multiple point-to-point interfaces to external systems.
• Proliferation of point-to-point interfaces increases costs involved in integrating systems in an exponential manner. These point-to-point interfaces are also very difficult to manage and support, a crucial reason why they have not gained much traction in the industry.
• Physician practices face a high barrier to adopt electronic medical record systems because such systems do not integrate with other systems other than thru expensive point-to-point interfaces.
• Non availability of prior treatment information increases possibility of repeated tests and procedures. Many insurance carriers reject claims arising from such repeated tests. With pay for performance already taking shape, those organizations that address these issues proactively will be far more ready to face the newly emerging scenario.

Quality of Care Issues

• Patient clinical information is typically locked away in multiple silos. Critical information available in one location may never be available to another provider. Moreover, patients may not know enough to be able to convey this information intelligently themselves.
• There is typically a longer turn around time for fulfilling requests for historical lab / radiology results as well as hospital discharge information when using non-electronic means. A report, critical for a patient’s treatment, could take days to reach the physician that requested it.
• Non-integration of clinical information such as medications from other providers lead to reduced chances of detecting drug to drug as well as drug-allergy interactions. This may lead to the wrong treatment being administered and aggravate the patient’s condition.

Patient Experience

• Patient quality of care suffers as a result of a slow interchange of information. Electronic information exchanges can be used to streamline operations, leading to better patient care and an inevitable improvement in patient loyalty. When non-electronic methods are used, patients may be required to provide the same, time-consuming information at multiple entities within the same region or, in many cases, within the same facility.

The HealthUnity™ solution provides at its core a set of software and services that enable secure connectivity between participating providers. The network is built on industry leading standards that enable multiple parties to collaborate without having to build non-standard interfaces. It is also built with stringent privacy policies in place, enabling tight control over both publishing and receiving of information by the parties involved.

The HealthUnity™ network is comprised of an ever-increasing set of services which progressively raises the bar of connected collaboration to a new level. The HealthUnity™ solution addresses and resolves the problem areas discussed above.

For practices that use an Electronic Medical Record (EMR) system, for maintaining clinical information, HealthUnity provides the required set of adapters allowing bidirectional transfer of clinical information to other trusted providers. For physicians and practices that do not use electronic records, HealthUnity enables connectivity to the regional network through a fully-featured client application that provides a pathway to adopting more sophisticated electronic systems in the future.

The HealthUnity™ network enables clinical information providers such as labs and radiology centers to automate the delivery of results to the requesting physicians. ProHIN provides physicians with the ability to quickly incorporate the results into their respective backend systems. This alleviates the need to build point-to-point, custom integration technologies with each system.

Our approach is radical yet simple. The HealthUnity solution begins with planning the network. We offer a pre-packaged plan that can be customized in a short period of time – this includes a complete legal framework for data sharing. Once this plan is done and signed off by the ProHIN initiating organization, it takes us under a day to configure our product to provide the network services needed to operate a ProHIN. Each member entity that joins the network can do so with a standardized implementation plan resulting in predictable results at a predictable cost. The workflows across the ProHIN are all standardized and readily available. Examples of such workflows include: demographics exchange; secure messaging; ED data – medications history, problems list, allergies and immunizations, electronic referrals, results delivery (lab, radiology), inpatient progress notes, discharge summaries, etc.

Hospitals

• Reduce costs and increase speed by disseminating information, such as discharge summaries, electronically to other providers who care for common patients
• Increase stature and connectivity with a referral base of Physicians, while still complying with applicable anti-kickback and Stark laws
• Increase utilization of technology by “pushing” machine readable information to a community of physicians rather than them having to come and log in to the hospital’s web portal
• Improve the quality of care of patients by contributing portion of data to the longitudinal clinical record of the patient
• Provide a better work experience to staff physicians by extending access to hospital-generated information to their own practices. Also, access to their clinic’s data is available while they are performing their rounds at the hospital
• Improve patient experience and turn around times by leveraging relevant information retrieved from the network. Patients will find their treatment experience more enjoyable, resulting in greater patient loyalty.
• Reduce your total cost of ownership by building a point-to–multi-point solution rather than a “one-off” point-to-point integration solution
• For a low up-front investment you will be able to try a regional network approach to data sharing. From an early base, the network can be expanded as desired.

Physician Practices

• Improve efficiency and save costs by adopting electronic collaboration methods for performing referrals, consults, etc.
• Receive lab / radiology results, hospital discharge summaries and other clinical documents soon after they are generated, avoiding lengthy delays and labor-intensive work
• Improve quality of care by leveraging instantly available clinical history from the network
• Incorporate electronic data into patient records without complex manual processes
• Begin to see the true value that previous investment in EMRs and PMS can bring by securely connecting to the HealthUnity network and accessing key data sources

Emergency Departments

• Improve quality of care by leveraging critical patient clinical information such as medication histories, problem lists and allergy information from the entire network
• Reduce treatment delays and costly paper chasing by accessing clinical as well as lab/radiology test results from the network. Also avoiding duplication of tests will mean higher reimbursements and fewer collection issues
• Efficiently and electronically distribute ED notes to those providers who provide follow on care after the ED episode is completed

Labs and Radiology Centers (owned and/or run by the IDN or Hospital)

• Increase efficiency and reduce costs by electronically distributing result information to ordering physicians
• Improve customer experience by ensuring result information is made available to ordering physicians as soon as it is generated
• Reduce the probability of double specimen draws or repeat patient inconveniencing (e.g. pre-exam dietary restrictions, administration of barium, etc.) by electronically fulfilling requests for past study findings
• Reduce the risk of insurance claim rejection due to repeated tests

Patients

• Streamlined experience at practices both at check-in, referral, treatment, follow on care, etc.
• Physicians gain access to key clinical documents without patients having to carry those documents around and exposing those key clinical documents to theft and misplacement.
• Patients will benefit by improving quality of care improvements