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February 13, 2006

Louisville health records network aims to be national model


A non-profit group in Kentucky is hoping a plan to give physicians incentives to access a centralized electronic health records network could be a model for other regional health information exchange efforts.

The Louisville Health Information Exchange, a consortium of public health groups, insurers, physicians, hospitals, employers, and other players this month issued a request for proposals for IT vendors to create a local information management system for exchanging medical records.

The group is taking a unique approach to building a medical record exchange network. First, patient records would be consolidated into one access point. Many current regional data exchange efforts leave the information in various hospital, insurer and physician information systems, rather than consolidating it into a single database.

Patients would control what information is contained in the records and who gets access to them. Each patient who wants to participate would be assigned a unique identifier. Eventually, patients might carry this number on something akin to an ATM card that would be presented to their provider to access their records.

And unlike many data exchanges that rely on grant funding or payment from those involved in the exchange, the system would be funded through fees from patients and employers. A spokesperson for the consortium said it could cost about $60 a year for an employer to participate in the network, named the eHealth Trust. Doctors would receive a small fee for using the system, which project officials hope will encourage their adoption of EHRs.

Researchers at the University of Louisville’s School of Public Health and Information Sciences, who began developing the project over the last two years, estimate that the system could reduce healthcare costs more than 2 percent in its second year of operation.

The network could achieve long-term savings of 7.5 percent annually, they say. The Louisville eHealth Trust would be separate from the statewide Kentucky eHealth Network now under development.

The eHealth Trust is in part the brainchild of William Yasnoff, MD, former senior adviser at HHS on the national health infrastructure. Yasnoff envisions communities across the United States creating eHealth Trusts to manage the network, rather than a single network that would connect regional data exchange efforts.

Yasnoff, a consultant to the project, says data exchange networks that rely on distributed models have several problems. First, many of these networks don’t contain data from physician’s offices and don’t offer any incentives for doctors to participate. Second, distributed models have little utility for public health, research and biosurveillace applications because they would take too long to query, Yasnoff says. In addition, he argues that it’s easier to secure and protect data with a centralized access point.

The Louisville eHealthTrust hopes to begin operations by Jan. 1, 2007. In the meantime, the Louisville Health Information Exchange is in talks with local employers to get participation from 100,000 people. Vendors interested in bidding on the process have until Feb. 28 to submit intent to bid letters. By June, the organization hopes to announce the winning bidders.

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.  Last updated: 09/07/08.  LouHie Admin
Research funding for this project provided by the Kentucky Science and Engineering Foundation (2004-6), Kentucky Legislature under SB 2 (2005-6) Kentucky Department for Public Health and the Kentucky Hospital Association (2005-6).   Additional funding, staff and technologies provided by University of Louisville, School of Public Health and Information Sciences and VisPlex Association, Inc.