Health information service provider Hx Technologies has been awarded a grant for $1.7 million by the National Cancer Institute (NCI), a part of the National Institute of Health (NIH). The grant will be used to expand and enhance Hx Technologies' flagship Philadelphia Health Information Exchange, the Philadelphia, Pa.-based company said.
The Philadelphia Health Information Exchange was launched two years ago to allow the region's hospitals and clinics to privately and securely exchange digital medical records for shared patients across enterprise borders, according to Hx Technologies.
The impetus for such a large-scale project came in part from the President Bush's initiative announced last year to create an interoperable electronic medical record for every American by 2014 which was a major focal point for Bush's 2004 State of the Union Address.
The major goal of the Philadelphia Health Information Exchange is to eliminate common gaps in physician knowledge of patient medical history, said Hx Technologies.
According to Elliot Menschik, MD, PhD, CEO, the company has faced multiple hurdles in developing the exchange, the first of which was crossing institution and health system boundaries, especially in the cases of institutional competition or other factors that make cooperation less than ideal.
"Our approach has been to develop what we call a Cross Enterprise Master Patient Index, which is a very flexible form of MPI that doesn't necessarily require central administration. It leverages whatever demographic data is available for specific patients to on-the-fly determine if it should be paired together with data from another site and placed under the same patient record. So, it's much more adaptable to RHIOs [regional health information systems] in general," said Menschik.
Another obstacle has been the variety of legacy information systems in the field. Small differences in terminology at different institutions can be a big problem.
"It's something that we've tackled by developing a network appliance which drops into each site, Menschik said. "The middleware that runs on this appliance is able to talk to each of the systems, normalize the differences between them, and communicate in a standard way with other appliances and users on the network."
Preserving the integrity and independence of the different sites in terms of enforcing existing privacy and security regulations, currently being applied to paper and film records, was another key issue, said Menschik. The solution? Create "digital locks" on data that allows each institution to define their own privacy and security policy and procedure as they move toward this digital exchange world.
The iHistory product is Hx Technologies' commercially available end-to-end solution which can assist institutions as they confront these obstacles, he said.
Of the many benefits of the exchange, the biggest is the ease with which radiologists will be able to obtain prior images for patients and have side-by-side comparisons with recent images, said Menschik. Also, because the network allows filmless data sharing with outsiders, cost savings are another significant factor.
Currently the exchange supports the Hospitals of the University of Pennsylvania, Children's Hospital of Philadelphia, Presbyterian Medical Center and Pennsylvania Hospital.
The new grant will fund the expansion of the network to additional hospitals and other regional health systems, help to evaluate its effectiveness in cancer diagnosis and management, and provide additional features that will improve the interoperability standards that ensure the network's compatibility with other that emerge around the country, said Hx Technologies.
The Philadelphia network is among only a handful of other similar projects across the U.S., and is unique because of its focus on diagnostic imaging and because it is situated in one of the nation's largest healthcare markets. The network could eventually be a model for other regions and cities that seek to implement similar projects, Hx Technologies said.