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RHIO Interoperability Case Study

 
Author: David Kaplan

The Philadelphia Health Information Exchange

Overview

The Philadelphia Health Information Exchange (PHIE), the nation's first diagnostic imaging exchange was launched in 2003. The network links healthcare providers in one of the largest and most demanding US healthcare markets encompassing some 4 million patients, 55 hospitals and 30 competing health systems.

In linking unaffiliated, even competing, medical facilities together, the PHIE enables the private, secure and seamless movement of patient digital medical records to speed and improve care across the region.

The exchange is based on Hx Technologies' patent-pending iHistory? platform. iHistory features a distributed ('federated' or 'peer-to-peer') architecture, a design that is optimized for collaboration among competing enterprises and capable of interoperability with other regional exchanges and the anticipated nationwide health information network (NHIN).

The PHIE has focused initially on the sharing of diagnostic imaging data (both images and reports) with expansion to other clinical domains slated for later expansion.

Scope and Expansion

PHIE currently connects patient medical information across multiple disparate institutions, enabling interoperability across many different legacy systems. Initial participants include:

* The Hospital of the University of Pennsylvania
* Thomas Jefferson University Hospital
* Albert Einstein Medical Center
* Children's Hospital of Philadelphia
* Presbyterian Medical Center
* Pennsylvania Hospital
* UPHS Community Radiology
* Philadelphia Department of Public Health

Expansion to additional data providers and clinical users continues on a daily basis.

Usage

To date, the exchange enables physicians at participating facilities to securely access some 5 million imaging studies (which represents over 200 million total images) across 300,000 unique patients.

The PHIE effort has dual clinical and research tracks. On the clinical side, the exchange supports collaborations on patients shared between disparate organizations across departments including radiology, neurosurgery, fetal surgery, plastic surgery, neonatology, neurology, and obstetrics and gynecology. On the research side, investigators from participating sites and Hx Technologies are evaluating the impact of health information exchange along financial and clinical dimensions.

Recognition

Forrester Research recently completed a study of the Regional Health Information Organization (RHIO) market. Forrester defined a functioning RHIO as one that is that is in active clinical use across a broad cross-section of competing provider institutions. According to Forrester's study, PHIE is one of only 7 functioning health information exchanges in the US. Of the seven identified by Forrester, the Philadelphia Health Information Exchange was one of only two functioning exchanges operated by a for-profit venture and unique in targeting the largest regional population of all functioning exchanges.

The National Institute of Biomedical Imaging and Bioengineering (NIBIB) and the National Cancer Institute (NCI) continue to recognize the importance of the exchange through their continued financial support of some $2.3 million to date.

Author Bio:

Hx Technologies (HxTI) is a technology-based provider of healthcare services dedicated to managing the cost of diagnostic imaging and other medical procedures whose unattended growth threatens patient access to affordable, high-quality care.

We work with healthcare payers, providers, and regional health information organization (RHIOs) to eliminate the redundant procedures responsible for 15% of total spend on diagnostic imaging and which expose patients to unecessary raditation.

Further, we enable patients?? medical information to follow them privately and seamlessly wherever they receive care to ensure that their physicians are equipped to provide the most accurate diagnoses and timely interventions.

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