NYU Langone Health Information Exchange

National health policy has focused major attention on the widespread adoption of electronic medical records and the interoperability of health information as key components of health reform. Federal investment of nearly $50B in HIT related programs, including incentivizes for physician EHR adoption, is driven by the Office of the National Coordinator (ONC) within the Department of Health and Human Services (HHS).  ONC is spending $2 billion on developing the nation’s underlying healthcare information infrastructure; both at the national and state levels.  As a result, health information networks, also known as Health Information Exchanges (HIE), are being implemented across the nation.  Read More

Health Information Exchange (HIE) technology has been used across the country as part of our nations interoperability initiatives over the past five years.  The technology itself has matured substantially, however, it’s use across the country has been predominately driven by national and state grants leaving the business sustainability at the regional, state, and national levels unclear.   What is clear is that health reform and meaningful use will drive healthcare providers, across the continuum of care, to connect and create communities.  Several key drivers motivate the national investment in health IT:  improving health care quality and outcomes, reducing costs, and advancing opportunities for research.  Numerous features of electronic health records can improve quality and outcomes, including reducing medication errors and alerting prescribers to potential drug interactions, creating care pathways that embody evidence-based treatment guidelines, and ensuring transmission of accurate information at the point of transitions in care such as from inpatient to outpatient care or across hospital systems. 

HIEs, for example, support improved health outcomes by allowing patients’ clinical data to be shared between providers and other stakeholders in a connected coordinated care team.  EHR implementation can assist in controlling costs by eliminating duplicative testing, offering as default options the less expensive of two treatments of equal efficacy, and promoting self-care and care management for chronic conditions.  New York State is diligently attempting to position itself as a winner.  Since 2007, New York State has invested approximately $260 million in HIT and HIE and plans on spending another $170 million over the next three years.  The current HEAL grants have funded over a dozen HIE’s across NY State, all of which are in production exchanging patient data in a number of different models.  True to it’s New York theme,  “if you can do it here, you can do it anywhere”,  the state is beginning to recognize the value of this health information infrastructure for research use.  A new emerging initiative, sponsored by HANYS, called PACeR (Partnership to Advance Clinical electronic Research)  is beginning to gain momentum.  The diversity of the New York population combined with a rich healthcare infrastructure supported by world-class academic medical centers, research institutes, and pharmaceutical companies can make New York the world’s capital of clinical research and personalized medicine. NYU Langone Medical Center (NYULMC) is also positioning to be a winner in national health reform by it’s active leadership in regional, state, and national HIE initiatives as well as the new PACeR pilot.   In order to best position NYULMC to leverage these external national HIE initiatives we are proposing that we establish our own NYULMC private HIE.  NYULMC has selected the industry leading advanced HIE platform, from Axolotl, to create an NYULMC Connected Community with new innovated capabilities that will include an integrated operational service center for ensuring our members world-class services to achieve meaningful use objectives, best practice workflow measured by clinical quality and performance based analytics, as well as core support services to insure a technically robust and secure environment thereby protecting physician and patient privacy and confidentiality.  

We believe that a focused effort around an NYULMC HIE initiative will take integration of health information across a connected delivery systems to the next level thereby dramatically improving individual health outcomes (e.g., by maximizing data transfer during care transitions between systems), system efficiency (e.g., by reducing redundant or duplicative care and associated medical errors and over-utilization costs), and population health metrics (e.g., by ensuring optimal alignment of care with DOHMH priorities such as smoking cessation).   By optimizing access to clinical trials across this connected community could position NYULMC as a leader in facilitating patient, and physician, access to cutting-edge medical research.