CM Information Specialists & Secure4Sending

Coffey Break – Depth Charge

2011-12-06T10:11:00.000-08:00

Hello Everyone,

The subject I’ve chosen for this edition of Coffey Break – Depth Charge is about the history of sending information electronically. Whose idea was that to create PDF’s, encrypt the information so it could be sent to others? I can take credit for what was done here at CMIS and the first version of CopyMed Secure. I can assure you, at the same time I was asking a programmer to create this method of sending records, there was someone, somewhere else in the world with the same idea. His name may have been Steve Jobs or Bill Gates. Well maybe not these two visionaries who had a much larger view of the world of computers and functions.

I acted on my ideas with help from lots of people. We are still making changes to our program, now called Secure4Sending. The premise is the same –to get confidential information to others by encrypting the information and sending it as a PDF – Portable Document Format, and decreasing the wait time for the documents. We had too many instances where we mailed or faxed records and then were told “I don’t have the medical records you mailed/faxed”. There had to be a solution to this ongoing problem. The wait times for medical information have been reduced from months to days and now to SECONDS. Our barometers for measuring our tolerance for waiting has changed vastly to the point that waiting for an update on an APP on my iPhone is like waiting for an eternity! In SECONDS after a request is finished, someone can have those records.

Now that we have this ability to send information electronically, we can help you with meeting MEANINGFUL USE provisions. We must be able to respond to patient requests within three days (Core Objective 12) and provide what is electronic, in an electronic format to the patient. Many of you are exploring using CD’s and flash drives in providing information to patients. Secure4Sending allows you to send what is electronic in a PDF – something patients will understand. Also, in order to respond to requests within three business days, as your ROI provider we can offer the ability to work remotely within your EHR. As requests come in, they are processed at our remote location each day, not just once or twice a week, on the days we visit your offices.

Some things are real and changing: The US Post Office is closing offices. Mail delivery will be changing perhaps becoming more expressive, and longer wait times to receive mailed letters. People are choosing to get rid of land lines. Faxing is just another way of gambling about the delivery of information – will it get there or not? Secure4Sending makes all kinds of sense and Remote ROI using Secure4Sending is just another step of using technology to enhance patient care and outcomes because health information is shared with the provider by the patient or at the point of care with documents sent via Secure4Sending.

Thanks for reading this version of Coffey Break – Depth Charge. I hope all of you enjoy the holidays and contact me anytime with your questions about how we can help you navigate Meaningful Use objectives.

Bonnie Coffey

President/CEO

CM Information Specialists

6875 Highway 65 NE

Fridley, MN 55432

763 572 0802

Obama Administration takes new steps to encourage doctors and hospitals to use health information technology

2011-12-02T14:07:00.000-08:00

Obama Administration takes new steps to encourage doctors and hospitals to use health information technology to lower costs, improve quality, create jobs

FOR IMMEDIATE RELEASENovember 30, 2011

Contact: HHS Press Office (202) 690-6343

Cleveland, OH -Today, U.S. Department of Health and Human Services (HHS) Secretary Kathleen Sebelius released a report showing that doctors' adoption of health information technology (IT) doubled in two years. HHS also announced new actions to speed the use of health IT in doctors' offices and hospitals nationwide, which will improve health care and create jobs nationwide.

While protecting confidential personal information, health IT can improve access to care, help coordinate treatments, measure outcomes and reduce costs. The new administrative actions announced today, which were made possible by the HITECH Act, will make it easier for doctors and other health care professionals to receive incentive payments for adopting and meaningfully using health IT.

"When doctors and hospitals use health IT, patients get better care and we save money," said Secretary Sebelius. "We're making great progress, but we can't wait to do more. Too many doctors and hospitals are still using the same record-keeping technology as Hippocrates. Today, we are making it easier for health care providers to use new technology to improve the health care system for all of us and create more jobs."

In addition to improving the health care system, data indicate that the national transition to health IT is creating jobs. Over 50,000 health IT-related jobs have been created since the enactment of the HITECH Ac. According to the Bureau of Labor Statistics, the number of health IT jobs across the country is expected to increase by 20 percent from 2008 to 2018, much faster than the average for all occupations through 2018.

HHS also announced its intent to make it easier to adopt health IT. Under the current requirements, eligible doctors and hospitals that begin participating in the Medicare EHR (electronic health record) Incentive Programs this year would have to meet new standards for the program in 2013. If they did not participate in the program until 2012, they could wait to meet these new standards until 2014 and still be eligible for the same incentive payment. To encourage faster adoption, the Secretary announced that HHS intends to allow doctors and hospitals to adopt health IT this year, without meeting the new standards until 2014. Doctors who act quickly can also qualify for incentive payments in 2011 as well as 2012.

These policy changes are accompanied by greater outreach efforts that will provide more information to doctors and hospitals about best practices and to vendors whose products allow health care providers to meaningfully use EHRs. For example, in communities across the country HHS will target outreach, education and training to Medicare eligible professionals that have registered in the EHR incentive program but have not yet met the requirements for meaningful use. Meaningful use is the necessary foundation for all impending payment changes involving patient-centered medical homes, accountable care organizations, bundled payments, and value-based purchasing.

These efforts will complement existing outreach efforts to doctors and hospitals including the Obama Administration's work to create a nationwide network of 62 Regional Extension Centers. The extension centers are comprised of local nonprofits that provide guidance and resources to help eligible health care providers participate in the Medicare and Medicaid EHR Incentive Programs and meaningfully use health IT.

Also released today, a new Centers for Disease Control and Prevention (CDC) survey found 52 percent of office-based physicians in the U.S. now intend to take advantage of the incentive payments available for doctors and hospitals through the Medicare and Medicaid EHR Incentive Programs. EHR incentive payments for eligible health care professionals can total as much as $44,000 under the Medicare EHR Incentive Program and $63,750 under the Medicaid EHR Incentive Program. The CDC data also show the percentage of physicians who have adopted basic electronic health records in their practice has doubled from 17 to 34 percent between 2008 and 2011 (with the percent of primary care doctors using this technology nearly doubling from 20 to 39 percent).

To meet the demand for workers with health IT experience and training, the Obama Administration has launched four workforce development programs that help train the new health IT workforce. The training is provided through 82 community colleges and nine universities nationwide. As of October 2011, community colleges have had 5,717 professionals successfully complete their training in health information technology. Currently there are 10,065 students enrolled in the training programs across the nation. As of November 2011, universities have graduated over 500 post-graduate and masters-level health IT professionals, with over 1700 expected to graduate by July 2013.

While improving the health care system, health IT can help keep information private and secure. Federal laws require key persons and organizations that handle health information to have policies and security safeguards in place to protect health information-whether it is stored on paper or electronically.

For more information on how health IT can lead to safer, better, and more efficient care, and for a fact sheet about today's announcement, visit http://www.healthit.gov/

For more information about the Medicare and Medicaid EHR Incentive Programs, see http://www.cms.gov/EHRIncentivePrograms

For more information on the 2011 CDC survey data referenced above, seehttp://www.cdc.gov/nchs/surveys.htm

For more information about the HHS Recovery Act health IT programs, see http://www.hhs.gov/recovery/announcements/by_topic.html#hit

Secure4Sending's new website!

2011-09-12T08:03:00.000-07:00

We are happy to announce that Secure4Sending has a new website. Please take some time to visit the new site and give us any feedback.

www.secure4sending.com

Fact of the Week:

2011-07-20T09:51:00.000-07:00

Secure4Sending can securely transfer anyone's personal or private information to anther person. Secure4Sending documents are delivered 100% of the time.

Job Opening: Release of Information Specialist

2011-07-06T13:19:00.000-07:00

CM Information Specialists currently has a part time opening in the Twin Cities.

Duties include but are not limited to verifying information, copying/scanning records, computer entry and phones.

Applicants must be detail oriented, motivated and energetic with a positive attitude and an excellent work ethic.

Medical records experience a plus but not required. High School diploma or GED required.

Email resumes to Brianna@cminfospec.com

Thank you 2011 Minnesota Rural Health Conference Attendees

2011-07-01T07:40:00.000-07:00

Thank you to all that visited our booth at the Minnesota Rural Health Conference in Duluth.

CM Information Specialists is now offering
on-site or remote release of information services. Remote release can free up valuable space at your site and increase your reimbursement rate. We are experts in ROI and have flexible staffing options to meet your sites needs.

Secure4Sending can help your site meet meaningful use requirements by sending your paper or electronic charts electronically to patients or requesters securely. Secure4Sending also has a tracking and reporting function.

Secure4Sending is free to use at your site for current CMIS clients, our staff is already trained on using the software, or it is available for private use for 29.95/month/user.

For more information on CM Information Specialists and Secure4Sending please visit
www.cminfospec.com or www.secure4sending.com

Fact of the week

2011-06-13T09:34:00.000-07:00

Fact of the week: Secure4Sending does not email medical records. Secure4Sending sends an email letting the patient or requestor know their medical records are available to be accessed. To access the medical records the patient or requestor has to use a unique ID and password.

The Price of Privacy - by Secure4Sending

2011-06-02T09:00:00.000-07:00

What is the price for privacy?

The proposed changes to HIPAA announced on May 31, 2011

by Health and Human Services, whereby a hospital or physician

must provide an accounting of disclosures to the patient can be a

burden to many smaller providers. What does this mean? How do
they keep track of each time a patient's medical record is accessed?
Secure4Sending has an accounting of disclosures - easy to use.
Secure4Sending will not only track disclosures but also allow you to
send medical information via the internet, securely! It's like faxing,
only better because each transmission gets there!

No more faxing records! Use Secure4Sending and send records electronically.

2011-05-20T06:47:00.000-07:00

Ok Twins Fans! It can’t get any worse than this, right? One loss and then another, and another! Where is Joe Mauer? Word on the street – he was at the Mayo Clinic for another opinion and examination for the leg weakness he has had since his bout with the flu this spring. I wonder how those doctors are sharing Joe’s medical records? Is he pulling copies of his visit with Dr. Cohen out of his back pocket when he gets to the Mayo Clinic? Maybe the records are shared by FAXING the records! Oh! How tempting is it, to peek at those copies coming off the fax machine and to be the first to know what’s ailing Joe! FAXING is so old school, not secure because others can see what is coming off the fax machine. Why didn’t they think of sending Joe’s records from one doctor to another over a secure email like Secure4Sending? That way the doctors are the only ones who see Joe’s medical information as they exchange their professional examination results with one another. I don’t want to know what’s wrong with Joe unless he wants to tell his fans. Otherwise his medical information is private just like mine!

Thank you MHIMA visitors!

2011-05-16T06:36:00.000-07:00

Thank you to all that visited our booth at the MHIMA 2011 Annual Meeting! We had a wonderful time meeting new people and chatting with old friends.

On the left we have a picture of our CEO, Bonnie Coffey with the winner of our prize basket Maureen McGovern!

Here is our booth! Thanks again to all that came by!

Sending Records With Secure4Sending

2011-05-13T10:31:00.000-07:00

The airwaves were full of talk about Joe Mauer, the Minnesota Twins most popular player not playing this current season. Joe’s medical problems are persistent with knee arthroscopy in December 2010 and his current bilateral leg weakness. He lost 15pounds and looks ‘thin’ after a bout with flu like symptoms.

You know Joe is no ordinary Joe. He visits Dr. Steven Cohen in Baltimore, MD. He sees physicians in the Twin Cities. How do they share Joe’s medical information? My guess is they fax information to one another, still using paper and technology created in the 1980’s. Secure4Sending is the answer to the doctors sharing Joe’s medical information. If Dr. Cohen was a subscriber, he could just move his electronic medical information about Joe to the Secure4Sending portal, and select which of Joe’s physicians would receive his most recent assessment of Joe’s condition. Once Joe’s doctor receives the report from Dr Cohen, then the therapy and rehabilitation plans can be prescribed so that this Twins all star can get back to hitting the ball and get the Twins on track for another spectacular winning season.

Meeting meaningful use requirements with Secure4Sending

2011-05-12T08:31:00.000-07:00

Are you meeting meaningful use?

This week a client called in and got me thinking. Are you meeting meaningful use?

Did you know that our technology by CMIS, Secure4Sending, also known as Secure2 can help your facility meet meaningful use requirements?

Secure4Sending can send your facilities medical records electronically to your patients. It’s now more important than ever to meet these meaningful use requirements and we want everyone to know CMIS is prepared to help.

Secure4Sending simply takes your paper or electronic medical records and the authorization and uploads them into S4S. Next it creates a cover letter and combines all the separate documents into one file. Once the file is ready S4S will send an email to your patient letting them know their medical records are ready for retrieval. The patient will login to the S4S secure site and enter a code and password that was provided for them. The patient has 24 hours after they login to save or print their records, if not, the records are deleted and they will need to get a new code and password to view their records. Your facility will have the ability to track and report on the records as well.

If you are already a CMIS client then Secure4Sending is free to use! Our staff is already trained on how to use the software and can easily add it to their daily routine. If you are not a CMIS client but would still like to use S4S we have a low monthly fee to use the software.

We are dedicated to providing you with the latest technology. We want our clients to be prepared for the future and be able to provide the best service possible.

For a demo of Secure4Sending please contact Justine at Justine@cminfospec.com if you are a CMIS client. If you are not a client of CMIS and would like a demo of Secure4Sending and pricing options please contact Courtney at Courtney@secure4sending.com

MMGMA

2011-03-30T08:26:00.000-07:00

Thank you to all that visited our booth at the 2011 MMGMA Winter Conference! We would like to congratulate the winner of the Secure4Sending and CM Information Specialists iPad giveway, Todd Johnson! He is pictured on the left of the screen with our VP, Ron Raymond (right). Bonnie Coffey, our CEO, is pictured above standing at our booth. For more information on Secure4Sending and CM Information Speciailists please visit our websites at www.secure4sending.com and www.cminfospec.com or contact Courtney Rooney at Courtney@secure4sending.com.

Secure4Sending

2011-03-09T10:02:00.000-08:00

Secure4Sending is an elegant, interoperable, proprietary, web-based secure document exchange protocol. No special systems are required and the software works with all electronic medical records. All you need is a document, a computer, and internet access. It is the safest, most efficient and cost-effective way to send protected health information and other confidential documents.

S4S is secure and uses 128 bit encryption, advanced firewall protocols and PCI compliant (the same designs used by Fortune 500 financial institutions) to provide the best document security possible. Scheduled and random system audits are done and published for your site’s use. All system maintenance is done by our staff to keep your time focused on patient care, not software. S4S adds the benefit of ARRA and HiTech compliance for your site – once deployed you site will meet these new requirements with no cash investment.

Your paper records are never removed from your site. Our process streamlines the capture, storage and release process by preparing the release from digital records not your original files. The release files are deleted from the S4S system but can remain archived in your image portal for future reference. Once the release is completed, tracking reports are available on-line, day and night.
Secure4Sending helps you collect the highest return on billable requests in today’s market. It also helps to eliminates paper, printing and postage costs.

For more information on Secure4Sending please visit our website at
www.secure4sending.com

2010-12-03T10:14:00.000-08:00

Why We're Good

•We Know Release of Information

Release of Information:
Release of Information (ROI) has changed tremendously since CMIS was founded in 1986 ROI today requires highly skilled personnel who understand the legal, technical, and procedural issues governing the handling of confidential health documents. CMIS’s comprehensive, on-the-job health document specialist training program distinguishes us from our competitors. This commitment to our personnel has built CMIS’s successful reputation for ROI services in the upper Midwest.

•We Protect your Records

Confidentiality:
With CMIS, protected health information and the equipment that supports our work always stays onsite.
CMIS health document specialists process requests by mail, fax, or electronically in the quickest possible timeframe at your location. There is no central server causing backlogs. Quick turnaround and onsite equipment minimizes the chance of protected health information ending up where it does not belong or being seen by unauthorized persons. This CMIS policy limits liability exposure and improves efficiency. And with CopyMed Secure, the requestor has nearly instant access resulting in faster turnaround time and faster payments on claims.

•We have Experience

Experience:
Release of Information (ROI) is the basis upon which CMIS’s reputation has been built. Since our founding in 1986, ROI has evolved well beyond the simple photo copying of a medical record. Today’s process involves validating authorizations, pulling only the portion of the chart required (designated record set), interpreting a facility’s policy, deciding on a method of delivery and so much more.

•We are Flexible

Flexibility:
CMIS’s flexibility can adapt to any client size. Whether you require one person, once a week for one-half hour, or you require multiple shifts to fit your needs, CMIS can help. We provide trained personnel to meet your ROI requirements and provide HIPAA complaint services from traditional paper copying to cutting-edge, encrypted electronic data transfer.

•We Provide Excellent Customer Service

Customer Service:
Tremendous customer service is our strength. We customize the level of services based on the facility’s need. CMIS can answer phones, assist patients in person, help train your staff in basic ROI principles, address space concerns and scan patient charts to disc.
We are experts in our industry. Not only do we take pride in satisfying our clients, but CMIS management is always available when you need them. You receive timely, polite responses and you will routinely see CMIS management on-site.

•We Hold our Employees Accountable

Quality Checks:
CMIS health document specialists quality check their own work for accuracy, quality and adherence to facility policy based on stringent training. In addition, every health document specialist is subject to an unannounced quarterly quality review to guarantee quality compliance. This process promotes high quality workmanship, professional standards, and customer satisfaction.

•We Provide Continual Training

Job training & follow up:
CMIS’s on-the-job training involves a committed manager who stays with health document specialists for an average of four weeks. Additionally, annual classes for all health document specialists address policy and legislative updates. Yearly testing evaluates health document specialist understanding of statutes and procedural issues.

Training:
CMIS’s health document representatives receive extensive on-the-job training and regular follow-up training. They also receive continued education through seminars and other course work. CMIS values the dedication and contributions of our health document specialists and appreciate the difference they make. CMIS health document specialists receive annual training, and after three successful years, are certified by the Association of Health Information Outsourcing Services (AHIOS).

HIPAA:
CMIS health document specialists receive regular HIPAA training. CMIS’s management team is responsible for disseminating HIPAA related amendments through regular communications. This team interaction keeps CMIS health document specialists abreast of changing legislation and industry trends. CMIS employs HIPAA consultants to perform gap analysis to ensure policies, designated record sets and other related issues are in compliance.

AHIOS ANNOUNCES MEMBER PRESENTATION AT THE

2010-09-16T08:37:00.000-07:00

BOSTON, Mass., September 16, 2010 — The Association of Health Information Outsourcing Services (AHIOS) announced today that Bonnie Coffey, former AHIOS president and charter member, will be presenting an education track at the 2010 American Health Information Management Association (AHIMA) Convention and Exhibit in Orlando, FL.

Coffey’s presentation, titled “Overcoming EMR Roadblocks in the ROI Process” will focus on the differences between a clinical electronic health record (EHR) and a legal health record (LHR), and will discuss how technology can have a significant impact on the release-of-information (ROI) process. Additionally, Coffey’s presentation will outline the five critical roadblocks in the complex ROI process that must be overcome by the health information management (HIM) department before a record can be released, and will explain why human intervention is imperative in the HIM environment.

“I am honored to be speaking at this year’s AHIMA Convention and to be included in such a distinguished group of HIM professionals,” said Bonnie Coffey. “Now more than ever, with changing regulations under ARRA and the HITECH Act, it is imperative that HIM professionals understand the impact of recent legislation on our industry, and I am pleased to contribute to the industry by providing education and resources to healthcare professionals across the country.”

For more than a decade, AHIOS has worked to sustain its mission by increasing awareness of the value, importance and complexity of the outsourcing industry and establish standards of excellence in the ROI process. One of the most critical components of the organization’s mission is to pursue fair and equitable treatment of the outsourcing industry through legislative, regulatory and legal processes.
Coffey will be giving this presentation on behalf of AHIOS on September 29, 2010 at 11:35 a.m. at the Gaylord Palms Hotel and Convention Center, in Orlando, FL. The 2010 AHIMA Convention and Exhibit, which is dedicated to health information management, runs from September 25th through the 30th.

About the Association of Health Information Outsourcing Services
Established in 1996, AHIOS promotes, strengthens and enhances the health information management outsourcing industry while ensuring excellence in the handling and dissemination of confidential patient-identifiable information. Its goals are to increase awareness of the value, importance and complexity of the industry’s services; establish standards of excellence for the industry of health information management outsourcing; pursue fair and equitable treatment of the industry through legislative, regulatory and legal processes; and create educational and networking opportunities for members.

About AHIMA
The American Health Information Management Association (AHIMA) is the premier association of health information management (HIM) professionals. AHIMA's more than 53,000 members are dedicated to the effective management of personal health information required to deliver quality healthcare to the public. Founded in 1928 to improve the quality of medical records, AHIMA is committed to advancing the HIM profession in an increasingly electronic and global environment through leadership in advocacy, education, certification, and lifelong learning.

Secure4Sending

2010-07-28T10:45:00.000-07:00

Secure4Sending (S4S), is our safe and secure way to send and receive medical records. The software has many advantages:

Security: By using S4S you get to process records correctly and send them securely. Our system was designed by CM Information Specialists, Inc.; a national leader in the release of information field.

Revenue: By using S4S we will invoice requesters for all records that can be charged for and at the correct rates – and collect on these invoices for you. Not only does this reduce your work but also raises the amount of money you collect - a win-win scenario!

Cost: By using S4S you will reduce their paper, printing and postage costs, savings that will add to your bottom line.

Safety: By using S4S you will reduce the risk of a breach and can report on and track disclosures; all in a secure, web-enabled environment.

Simplicity: By using S4S you have a HIPAA compliant, easy-to-understand system that is intuitive and simple to use.

You don’t need to have electronic medical records currently to take advantage of secure4sending. Our system will accept scanned images and by working with our systems we can use release of information proceeds to convert your paper to digital, freeing up valuable space.

What makes Secure4Sending different is that we allow you to release the medical records yourself. You control the process and records. We take care of the software, the security and all back office support. We also pay you a significant part of the collected revenue.

Secure4Sending can help you become more efficient, reduce cost and collect on more invoices. For more information or for a free demo please email Justine@cminfospec.com

2010-07-28T07:11:00.000-07:00

Health information exchange
The ABC’s (and more)
By Bonnie Coffey

The introduction of the electronic medical record (EMR) has created an evolving infrastructure to secure, share, duplicate, and transmit protected health information electronically. The Health Information Technology Economic Clinical Health (HITECH) Act, passed in 2009 as part of The American Recovery and Reinvestment Act (ARRA, or stimulus bill), is intended to accelerate this electronic evolution. HITECH makes federal funds available to hospitals and provider offices to adopt EMRs to improve patient care and the delivery of health care through improved systems for sharing personal health information.

One of the planned outcomes of having an electronic medical record is the ability to share information among health care entities. The EMR is actually a subset of the electronic health record (EHR), which comprises the shared information from all shared EMRs (see sidebar). Thus, according to Dave Garets and Mike Davis in a HIMSS (Healthcare Information and Management Systems Society) Analytics white paper from January 2006, “EMRs will never reach their full potential without interoperable EHRs in place.”

In Minnesota, legislation passed in 2007 created the Minnesota E3 Initiative (under Minnesota Statute §62J.536), which aims to make submitting medical claims more efficient. The electronic exchange of eligibility claims and payments began in January 2009. Further, the state’s e-Prescribing Mandate requires that “effective January 1, 2011, all providers, group purchasers, prescribers, and dispensers must establish and maintain an electronic prescription drug program that complies with the applicable standards … for transmitting, directly or through an intermediary, prescriptions and prescription-related information using electronic media.” (Minnesota Statute §62J.497) According to the Minnesota Department of Health Web site (www.health.state.mn.us), “Minnesota is the first state to require that all providers and health care purchasers exchange transactions electronically, using a single standard data content and format.”

The focus now in Minnesota and elsewhere is getting electronic medical record systems to talk to other electronic record systems in different health care organizations. A number of options for exchanging data and information are discussed below.

Interoperability: sharing information
Interoperability refers to the capability of disparate systems to share information. Ways to share information range from sharing the raw data from one system to another (as in electronic data interchange or EDI) to the universally accepted Portable Document File, or PDF. EDI is the direct exchange of data from one computer to another computer in a standard format. (Think electronic banking or electronic funds transfer.) It is the data format used by the vast majority of electronic commerce transactions in the world, using strictly formatted message standards to send data from one computer to another. PDFs are images of the original data; they are easily transported from one computer to another because there is no need for the systems to talk to one another, but only to accept the formatted images using the easily downloadable Adobe Acrobat application.

HIEs and RHIOs
Regional Health Information Organizations (RHIOs) are state or local entities, created under as part of the U.S. National Health Information Network. RHIOs oversee and support health information exchange on a regional basis in a manner that is consistent with how care is delivered in the particular market. Health Information Exchanges (HIEs), which also move health care information electronically across organizations and disparate information systems, are created by entities such as state health departments, large hospital organizations, and insurance companies that share health information within a network of business partners.

HIEs and RHIOs are gaining a larger presence, in part because the HITECH Act designates funds to create an interoperable framework for data exchange among health care entities in a region. In the September/October 2009 issue of CMIO magazine, health care journalist Neil Versel wrote that “health information exchanges are thriving, with 57 now established across the U.S. (40 of which have achieved tangible cost savings), and meeting their mission to unite, overcome competitive pressures and issues, and share pertinent patient data at the point of care to improve the lives of people.” (“Health Information Exchange: Patient Data on the Move”)

Entities belonging to HIEs and RHIOs exchange a limited data set called a Continuity of Care Record (CCR), which includes information on recent medications and treatments. The CCR can also include patient demographics, insurance information, diagnoses, allergies, and care plan. Because the CCR is created in the standard data interchange language XML, the CCR can potentially be created, read, and interpreted by any EMR software.

Axoloti Corporation provides health information exchange software to RHIOs. The Social Security Administration, through its Disability Determination Services, is working with HIE providers such as MedNetWorld. What was once a paper-intensive process of requesting medical documentation for disability benefits under SSI will become a paperless exchange of information through the National Health Information Exchange (NHIN), resulting in quicker claims processing.

Minnesota’s HIE (MN HIE) was established in 2008 with funding from Blue Cross and Blue Shield of Minnesota, Fairview Health Services, HealthPartners, Medica, the Minnesota Department of Human Services, and UCare. The MN HIE is mapping its progress in connectivity on its Web site, www.mnhie.org.

Epic Systems, a dominant supplier of EMR software in the Midwest, offers another system of interconnectedness for Epic users. In an emergency and with patient consent, physicians can access the patient’s Epic medical records from another Epic user with Epic’s Care Everywhere software. For example, a physician treating a patient at North Memorial Hospital may access the patient’s medical information from an Allina Clinic through Epic. The system has made seamless the exchange of this type of information, traditionally requested by phone and sent by fax.

Personal health records
Whether on the larger HIE horizon or on a local level, as with Epic, exchanging information is key to the functionality of an electronic health record. Patients increasingly are seeing the need to organize their own health records, and a number of software applications allow them to do so.

Google Health and Microsoft Vault are examples of commercial applications patients can purchase that allow them to share their personal health record (PHR) with a provider, no matter where the patient resides. CDs and flash drives allow patients to share medical information without the annual recurring costs of maintaining a PHR with a commercial vendor such as Microsoft or Google.

The upside to any of these commercial products is that engaged patients can take control of their health and share information they have collected with their provider. The downside is that patients may be inconsistent at collecting and organizing the information or may leave critical information out of the personal health record because they don’t agree with, don’t like, or don’t fully understand a particular diagnosis.

Other ways of sharing health information
All of the above ways of sharing health information, through PHRs, HIEs and RHIOs, are informal in that the agreement to share information comes from the patient at the time of treatment. For formal requests to release medical information, involving a signed authorization by the patient, dozens of software applications and services are available to hospitals and medical providers. Some of these applications have been developed by release of information (ROI) service companies working with hospital and clinic HIM (health information management) departments. The ROI service companies have developed ways of exchanging information with the requesters of medical information to realize economies of scale and to achieve quick delivery of needed information for claims, litigation, and continuity of care for patients.

With many of these systems, information transmitted electronically to a requester can be saved as a PDF, then easily stored or printed by the requester. This process reduces the wait time for information, as well as time formerly spent scanning and indexing information transmitted by fax or mail. The three “P’s”—paper, postage, and printing—are eliminated because records can be transmitted as a PDF instead of printing and mailing/faxing the information. ROI companies investing in this technology include Healthport, MRO, Discovery Support Services, Universata, and CM Information Specialists.

What will be the new norm?
Health information may be more protected than financial information. If banking can develop a way of sending information from one bank to another through electronic funds transfer, and the application has become a universal norm for banking, can the same be done for health information? Some say medical information is too difficult to share because of regulations, such as the need to track each disclosure of protected health information under HIPAA. But if more patients use the Microsoft and Google PHR applications, they could encourage the exchange of medical information using technology rather than handling paper records. Technology can provide new ways for patients and providers to share medical records.

Arnold Rosoff, a Wharton professor of legal studies and business ethics, takes a futuristic view of sharing information, suggesting that biosensors could be used in transmitting data into medical records. Such possibilities can’t be dismissed. The challenge will be to find a way to share information via easily used technology that assures the security and accountability necessary for the compliance-heavy world of health information management. An example: In January, Epic Systems’ iPhone EHR application, called Haiku, became available on Apple’s AppStore. The Haiku app works on both the iPhone and iPod touch, allowing authorized clinical users of Epic’s EHR access to clinic schedules, hospital patient lists, health summaries, test results, and notes.

As new technology is created and developed, sharing of health information across different platforms will become a reality, not just a dream. With the push from the federal government to provide incentives to digitize medical information, sharing this information is well on its way to becoming the new norm.

Bonnie Coffey is president and CEO of CM Information Specialists Inc. and Attain Document Services, Fridley.

Sidebar
EMR/EHR: What’s the difference?

The National Alliance for Health Information Technology has established the following definitions for EMR and EHR:

EMR: The electronic record of health-related information on an individual that is created, gathered, managed, and consulted by licensed clinicians and staff from a single organization who are involved in the individual’s health and care.

EHR: The aggregate electronic record of health-related information on an individual that is created and gathered cumulatively across more than one health care organization and is managed and consulted by licensed clinicians and staff involved in the individual’s health and care.