Health network leaders pursue big dreams: Advocates: Statewide system for transmitting patient records would improve care

June 12, 2006

Technology experts, doctors and politicians this week will discuss the possibility of interconnecting the handful of computer networks in Indiana that allow doctors to exchange patient information.

They say a network reaching every corner of the state could save money, boost care and reduce medical errors while keeping Indiana at the front of the national pack for this technology.

However, none of the health-information network leaders who will convene for a summit this week in Indianapolis expects the network to be developed soon. Financial and political realities are among the obstacles.

"There's just so many opportunities and so many speed bumps," said John Kansky, a consultant with Indianapolisbased Health Evolutions.

Indiana is home to several secure computer networks that allow doctors to receive patient records like lab tests or exam results. Two are based in Indianapolis: the not-for-profit Indiana Health Information Exchange and the Indianapolis Network for Patient Care, which began in the mid-1990s as a way for emergency rooms to share patient data.

IHIE went live in 2004 and now delivers results to more than 3,100 central Indiana doctors. It encompasses every Indianapolis hospital network outside Wishard Health Services, which could join this summer, according to Tom Penno, IHIE's chief operating officer.

Outside Indianapolis, Fort Wayne's Medical Informatics Engineering runs a network largely in northeastern Indiana, and the Michiana Health Information Network operates out of South Bend.

Bloomington Hospital also started a network involving its doctors last fall.

Advocates say these systems give doctors more information and deliver it faster than conventional couriers.

"My favorite line is, physicians live in a world of incomplete information and all we're trying to do is give them more complete information on their patients," Penno said.

The networks also save money. Studies show about 20 percent of laboratory and X-ray work is unnecessary, said state Sen. Gary Dillon, R-Columbia City, a retired dermatologist. In some cases, doctors order additional tests because they can't find originals or don't have the data they need at hand.

The General Assembly last year approved legislation Dillon sponsored that sets up a commission to study creation of a statewide network. It's examining possible funding options and what role the state should play. It will report to the Legislature in November.

One could "write a small novel" on all the concerns that need to be addressed before such a network ships its first record, Kansky said.

The technology exists to pull it off, thanks in no small part to the Regenstrief Institute, an Indianapolis not-for-profit and a pioneer in medical informatics research. Penno said the life sciences initiative BioCrossroads also played a large role in his network's development.

But organizers need to figure out how to make such a network financially selfsustaining. Most survive on user fees, grants and foundation money.

Someone also has to pay for the network's creation. Experts say it's too early to estimate a cost, but that it surely would stretch past $1 million.

Organizers of a statewide network also must make certain all parties are comfortable with the format. For instance, doctors in Bloomington would be wary of giving up complete control of their data to a centralized storage site in Indianapolis, said Dr. Todd Rowland, Bloomington Hospital's director of medical informatics. He also doesn't want to see data misused by insurance companies.

"It's a very politically hot issue," he said.

Nevertheless, many believe it's one worth pursuing.

"My personal opinion is that it's absolutely feasible, but it's going to be difficult and a lot of work," Kansky said.
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