Customer Spotlight: Health Information Exchange of Montana (HIEM) Participants Reap Long List of Benefits, including Improved Outcomes and Cost Reduction, From Single-Source Solution

The Health Information Exchange of Montana (HIEM)  consists of rural hospitals and medical centers – all MEDITECH hospitals -- in western Montana engaged in a community-wide data exchange program. Specifically, the HIEM  consolidates patient data from existing clinical information systems in medical facilities throughout a 13,200 square-mile area in the northwest region of Montana and includes health care providers of St. John’s Lutheran Hospital, Northwest Community Health Center, Northern Rockies Medical Center, Glacier Community Health Center, Northwest Healthcare (including Kalispell Regional Medical Center), and North Valley Hospital.

THE CHALLENGE

For years, HIEM participants had grappled with disparate health care information systems on various platforms and in different locations.

“These health care providers needed to improve quality, reduce duplication of effort, and facilitate communication across treatment settings,” explains Kip Smith, executive director of the HIEM. “They also needed to break down silos of information so that they could deliver a comprehensive unified medical record that could be seen by all health care organizations within the community.”

The challenge was daunting but critical. The HIEM serves rural areas where the barriers to care are greater than in more populated areas of the country and where rural populations face higher rates of automobile accidents and risk of death by gunshot, poverty, significant alcohol abuse, and higher levels of cerebrovascular disease, hypertension, and suicide.

THE SOLUTION

The HIEM began a long journey of governance structure development, policy and procedure implementation, and technology deployment aimed at sharing health care information to improve care coordination and quality. First, they began building a fiber-optic infrastructure throughout the region to support the exchange of health care data across the geographically dispersed health care system. Next, they contracted with a new technology vendor for a secure, aggregated health care data repository to integrate vital clinical information from their disparate systems into a unified patient health care record. And finally, they expanded the solution’s base aggregation platform with clinical communication, disease management, clinical workflow, and forms and notes capabilities to improve the efficiency, effectiveness, and quality of care delivered.

“The first pilot of the program at Northwest, the largest participant, took seven months to complete,” Smith says. “It cost the HIEM between $300,000 and $350,000.”

The HIEM’s vendor solution developed a phased implementation approach that first integrated existing health care technology into vaulted data with patient matching capabilities, allowing the segregation of source data by participant while also enabling a unified health care record to be generated for a patient at any of the facilities. Once the aggregation phase was complete, strategic additions of workflow enhancements and disease management functionality were rolled out to fill gaps in data, enhance clinical communication, and remind and alert the clinical team to abnormalities, preventive treatment, and contraindications associated with patients in view.

BENEFITS

As the project expanded to the additional critical access hospitals and rural healthcare clinics, the benefits of the initial pilot exponentially increased.  Smith explains that the list of benefits from this project have been long and impressive.

“Every  member across this geographically dispersed health care team now has simultaneous access to the information they need to assess, plan, and treat patients,” he states, “The solution has reduced duplicate diagnostic testing and provides diagnostic results, disease dashboards, flow sheets, alerts, reminders, and clinical history driving quality outcomes.”

He adds that the solution offers patient matching with a single-view of a patient’s continuum of care showing 99.6 percent accuracy. The HIEM participants have seen cost reduction due to improved service leverage and the elimination of manual patient data transmissions.   The geographic area associated with the HIEM boasts an EMR adoption rate of more than 65%, well above the average within the rest of the United States.  Being able to share the information available within these systems increases the value and return on investment at each physician’s office.

As John Maher, CEO of Glacier Community Health Center, says, “This system is great! One of my staff reported this morning that they were able to pull down reports from a surgical referral prior to the follow-up visit with our clinic without having to wait for the hospital to send them. The infrastructure exercised today will allow all HIEM participants to support additional functionality and tools to benefit health care providers and patients in the years to come with a platform that provides for the addition of capabilities such as secure messaging, ambulatory order entry, disease dashboard, and patient portal/PHR integration capabilities.”

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To learn more about the HIEM, contact: Kip Smith, Executive Director of the Health Information Exchange of Montana at (406) 751-6687; kipsmith@krmc.org.