David Miller - University of Chicago Medical Center
Bill Fera - University of Pittsburgh Medical Center
Chris Stevens - CTO of Orion Health
It is challenging to integrate within a Hospital system let alone across a wider exchange.
UPMC: Looking at Personal Health Records as the de Facto exchange mechanism. ie. Using the Patient as the connector. Partnering with Google because needed an un-tethered PHR.
Orion Health looking at Integration and provide a HIE solution. State of Maine launched in June 2009. Lahey Clinic local HIE - reach out to referring physicians.
The challenge for HIEs is to engage with Legacy EMRs.
Privacy is an issue everywhere. Get consumers involved. Figuring out business rules is very complex.
What is Interoperability?
Interoperability is a means to an end. CCR is a potential vehicle for inter-operability.
Orion has found that only a small amount of information is needed to create value. Everything is not necessarily the right answer.
I think this means that we need to look at incremental evolution of records. We don't need to define everything before we get started.
Need an anchor organization to do some heavy lifting.
Documentation, Visits and Labs are the key pieces of data to start with.
There is value in EMR + Claims + Patient data. But need to know source so reviewer can evaluate value of content.
Standards need to move from point to point interface to transaction orientation.
Also need to keep it simple. eg. Do we need al the complexities of SOAP for transactions.
An Anchor institution only makes sense if the Anchor has EMR data to share. No data - no value.