Government Technology - January 2009 - (Page ca5)

Louisiana Rural Health Information Exchange Physicians gain secure, instant access to patient records, wherever they reside. hospitals. These systems would let at least some rural patients get care from specialists in Shreveport without making the long trip, and without over-burdening LSU’s facility. Although they liked this plan, physicians pointed out one major obstacle. Doctors at LSUHSC-S would need to see patients’ medical records. Shipping paper records from one facility to another is a notoriously slow process. “It usually takes weeks,” said Welch, who is also CIO of the LARHIX. The group conceived the LARHIX to solve that problem. In 2007, Louisiana’s legislature provided $13 million for a pilot implementation of the Exchange, incorporating seven of the Coalition’s 41 member facilities. These hospitals installed the telemedicine infrastructure and started converting their patient files into electronic records. At each hospital, administrators could implement whichever electronic hospital information system (HIS) they felt best fit their needs, as long as that HIS met the minimum criteria put forth by the Coalition. CA served as prime contractor for the LARHIX implementation. Its partner, Carefx of Scottsdale, Ariz., developed a Web portal for the Exchange. A second partner, Chicago-based Initiate Systems, developed a master patient index. The system is built on a federated architecture. Instead of extracting data from each HIS, converting it to a common format and storing it in a central repository, it leaves the data in each hospital’s own information system. Physicians use the portal to get a readonly view of patient information. Privacy Requirements While making it convenient for physicians to view patient records, of course the system also needs to comply with all the privacy provisions of the Health Insurance Portability and Accountability Act (HIPAA). “The consequences of “Once the patients understand that they can get that service, they can begin doing what they need to do on a regular basis.” — Jamie Welch, CIO, Louisiana Rural Hospital Coalition hen Hurricane Katrina closed hospitals in New Orleans in 2005, that left the Louisiana State University Health Sciences Center in Shreveport (LSUHSC-S) for a time Louisiana’s only level one trauma center. The hospital also is one of the few in the state that offers specialty care to uninsured and underinsured patients — about one-quarter of Louisiana’s residents. With so many patients arriving for care, LSUHSC-S has been under stress. “For a couple of years, they had to run above capacity six days a week,” said Jamie Welch, CIO of the Louisiana Rural Hospital Coalition. Based in Baton Rouge, the Coalition is a nonprofit organization that provides consulting and lobbying services to 41 small, rural hospitals across the state. The situation wasn’t healthy for patients, either. People in rural areas, where local hospitals don’t offer specialty services, travel up to 268 miles round trip to get care at LSUHSC-S. A low-income patient can ill afford to W miss a day’s work and run through a tank of expensive gas just for a test or a brief consultation. In the past, though, these patients had no choice. Another challenge Louisiana hospitals faced was that patients who evacuated north after Katrina often showed up in emergency rooms where they had never been seen before. Hospitals seeing patients for the ﬁrst time had no records for them, and many of them couldn’t remember all their medications, allergies or medical histories. Without such information, hospitals were forced to give tests that the patients might already have received in other hospitals. To meet both of these challenges, hospitals in Louisiana have created the Louisiana Rural Health Information Exchange (LARHIX), a system that gives physicians Web-based access to patient records no matter where that information resides. In 2006, officials at LSUHSC-S and the Coalition started to discuss installing telemedicine systems in rural 5

Table of Contents Feed for the Digital Edition of Government Technology - January 2009

Government Technology - January 2009 Contents Point of View On the Scene Big Picture Four Questions for... Stemming the Retirement Tide Getting the Picture Fact of Matter Money Trail Rays the Roof Trick or Tweet? The Modern Way to Vote Products signal:noise

Government Technology - January 2009

For optimal viewing of this digital publication, please enable JavaScript and then refresh the page. If you would like to try to load the digital publication without using Flash Player detection, please click here.