The Governor of Puerto and the local Department of Health (PRHD) will conduct a descriptive analysis of the public policies, business practices, and state laws that affect electronic health information exchange by working with RTI. With this one-year study, the PRHD will be able to identify and propose practical solutions. At the same time the PRHD will be able to preserve the privacy and security requirements of applicable federal and state laws and develop a detailed plan to implement solutions that improve the interoperability of the current Health Information Exchange effort throughout the public and private sectors.
Currently, the government of Puerto Rico has invested approximately $52 million in three projects: the Hospital Information System / Electronic Medical Record (HIS/EMR), the Smart Card, and a Data Warehouse, including all necessary infrastructure and support technology. To date, the HIS/EMR has been implemented in one hospital and about 30 Treatment and Diagnostic Centers (known in Spanish as CDTs), where approximately 75% of these CDTs have achieved 100% implementation. The rest of the CDTs are in the process of implementing auxiliary service modules (for example, Laboratory and Pharmacy modules). It is important to mention that these facilities process most of their billing transactions under HIPAA regulations and that some of their transactions are still processed with proprietary software. In addition, it must be pointed out that interoperability and integration of the PRHD HIS/EMR with other auxiliary services (for example, laboratories, pharmacies, radiology laboratories) of relevant third parties has been scarcely tested in the past.
Meanwhile, the private sector has been developing and implementing hospital information systems, which include electronic medical records' functions, as well as auxiliary service modules, such as those used in laboratories, pharmacies and radiology services. An automated clearinghouse, Inmediata, that follows the Standard Transactional Code Regulation of HIPAA, is providing services for MCS, COSVI, MMM, Cruz Azul, HUMANA, Preferred, and few other health insurance companies. MC-21 serves as the Pharmacy Benefit Manager (PBM) for the Puerto Rico Health Insurance Plan. At present, MC-21 does not exchange information with other systems. Many laboratories use SAIL, CompuSoft, and Lab Warehouse Inc. These systems are being developed locally and do not have the ability to exchange or integrate information from other clinical systems.
Puerto Rico's participation in the Privacy and Security project is part of the Governor's and the Secretary of Health's vision to promote and support the broad interoperability of health information exchange by identifying variation in policies and state laws that affect health information exchange and by proposing and implementing detailed plans that remedy gaps and extend best practices in both the public and private sectors. This is a collaborative effort to make the electronic health information exchange a forthcoming reality.
How to get involved
The Project Management Team would like to extend an invitation to interested organizations, companies, and individuals to participate in gathering data, assessing privacy and security practices and policies that affect the exchange of health information, and identifying and overcoming barriers to the interoperability of health information exchange, thus improving the cost-effectiveness and quality of the health care available to all.
If you would like to get involved, please contact us at the following e-mail address: email@example.com. We will soon be providing more details on how to get involved.
Links to relevant web pages
Links to related information sites will soon be posted.