Project Details -
Completed
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Contract Number290-04-0006
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Funding Mechanism(s)
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AHRQ Funded Amount$5,189,496
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Principal Investigator(s)
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Organization
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LocationNashvilleTennessee
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Project Dates09/01/2004 - 09/30/2010
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Technology
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Type of Care
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Health Care Theme
In this project, the MidSouth eHealth Alliance (MSeHA) implemented and evaluated a regional data-sharing and interoperability service for health care entities in the Greater Memphis area. The MSeHA is a nonprofit organization that works in conjunction with the Vanderbilt University Regional Informatics Team. The Alliance enables providers to review medical information from several organizations quickly while restricting access to a patient’s medical information to current and direct care providers. This project is one of six AHRQ-sponsored State and Regional Demonstration projects begun in late 2004 and early 2005 to create a State or regional health information exchange (HIE). The main objectives of the project were to:
- Facilitate the exchange of clinical data elements among providers in a three-county region with a population of about 1 million.
- Leverage the Vanderbilt technical architecture to initiate the exchange and eventual transition to an independent platform.
- Expand the number of participating organizations to remaining safety net providers and primary care ambulatory providers.
- Develop a business model for sustainability.
Since 2005, the nonprofit MSeHA has governed and managed HIE services among 14 major health care provider organizations in the Memphis, Tennessee metropolitan area. Information available from participating organizations varies slightly among organizations. All major hospitals provide hospital discharge summary notes, laboratory data, pathology reports, radiographic reports, select transcribed notes, and a range of other clinical and administrative documents. Other participating organizations provide demographic information, registration information, and a limited number of clinical data types. Clinicians began accessing HIE data in emergency departments in May 2006 and later obtained access on hospital wards and in ambulatory clinics. As of October 2010, clinicians had access to over 7.5 million encounter records on 1.7 million patients, 4.9 million chief complaints, 45 million laboratory tests, 5 million radiology reports, and 2.1 million other reports and documents. Patients are offered the chance to “opt out” from HIE participation at the time of each encounter at participating hospitals and clinics.
The overarching findings from the current study suggest that both the process and technical models can make substantial contributions to a National HIE. The Vanderbilt-based architecture was shown to be a robust, scalable, and very inexpensive model for HIE. As a wider array of ambulatory-based electronic health records, laboratory devices, and other technologies are integrated there will be a convergence of issues regarding data centralization, privacy considerations, and data sharing provisions. Therefore, future HIE efforts will realize even greater cost benefits. This broader integration will foster more effective care coordination and allow for demonstration of care impact across entire populations and not just those who seek hospital or emergency department care.