CIO Interview: Delivering HIT & HIE Services to California’s Independent Physician Practices

Date: 08.16.2013 | Rob Waters">Rob Waters

CIO Interview: Delivering HIT & HIE Services to California’s Independent Physician Practices

Bill Beighe, CIO, Santa Cruz Health Information Exchange sat down with HITC’s Rob Waters to discuss the delivery of HIT/HIE services to a diverse group of stakeholders in rural Santa Cruz County  helping them participate in new care delivery models and also how the California Association of HIEs (CAHIE), a group of as many as 30 HIEs are collaborating on Statewide health information exchange efforts. Bill has been the CIO with Santa Cruz Health Information Exchange since 1998.

Rob Waters:
Santa Cruz Health Information Exchange is recognized as one of the oldest and most advanced Health Information Exchanges (HIEs) in the country, what’s been the secret to your success?

Bill Beighe: We launched as a multi-stakeholder HIE and were funded from the beginning by member contributions, and we are sustained by monthly member contributions. Everyone has skin in the game and they only pay if they receive value. Providers follow the data and we work hard at constantly bringing more data and more connections into the HIE. Beyond results delivery and transitions of care one of the biggest satisfiers is a longitudinal patient record so that users, with the appropriate patient consent can gain access to care delivered across the many unaffiliated entities in our HIE.

RW: Independent physician practices, in may commentators view, face an uncertain future as the ACA is fully implemented, is this message being voiced by docs is the exchange helping physicians participate in new care delivery models such as ACOs and PCMH? Health Care Reform and Value Based Pay present a necessary but challenging transition that our providers need to navigate.

BB: We are part of 2 commercial ACO efforts and have been in long enough to show considerable progress. The HIE has been instrumental to helping make the ACO work however some of the early gains came about simply by collaborating on what workflow changes and what simple data we can we provide to make an impact.  We are just beginning to scratch to surface on how the HIE can help improve care and reduce overall health costs. A number of our clinics are pursuing PCMH and the success of those efforts will rely of tight integration between the multiple EHR systems using of course the HIE. We are also planning on leveraging Direct, especially to include those members of the extended care team that do not have an EHR.

RW: Sustainability is often seen as major challenge to HIE, particularly those in rural areas. How is Santa Cruz charging for your services and how do you see this evolving over time?

BB: For the last 17 years, we charge a limited number of stakeholders a monthly fee for a set of services. We believe that all stakeholders need to pay based on the value received. I see the entire HIE / HIT market evolving to offering technology and services that go way beyond what we are doing today. Our solutions need to be measureable and offer real benefits of value to those that benefit from the service. Specific kinds of stakeholders vary from place to place depending on the mix of hospitals, the payer mix, large groups or IDN’s, IPA presence, Managed Care, etc. HIT/HIE service providers need to be treated more like physicians and subjected to getting  paid for value. And be paid by the stakeholders that receive the value.

RW:  California Health eQuality (CHeQ) recently announced the Rural Health Information Exchange Incentive Program, what’s this about and how will impact SCHIE and your participants?

BB: Our organization was awarded a contract to deliver HIE services to rural Californians along with 5 other HIE service providers. We intend to offer our expertise to rural organizations that can leverage our HIT and HIE offerings. Only one clinic in our home service area of Santa Cruz County was in the designated rural area and ironically that clinic already has a robust bi-directional connection with the rest of the providers in the SCHIE. We look forward to assisting providers in rural areas outside of Santa Cruz.

RW:  The California Association of HIE’s (CAHIE) just arrived on the scene, can you tell us what this new organization is all about and how it is different from other efforts?

BB: This effort launched in March 2013 during an all-day problem solving session of a core group of HIE and IDN organizations from across the state. California being a large  and diverse state already had numerous private and public HIE efforts up and running. Full disclosure, I am a co-chair for this group. Our mission is to enable safe secure data exchange ACROSS what appears to be as many as 30 HIE efforts, both private and public that are happening in California. We are leveraging NwHIN standards and have work groups working on DURSA adoption and testing the technical and policy implications of statewide exchange. We are promoting and leveraging model multi-party agreements to enable trust and thus facilitate exchange. Membership is open to any individual or organization that has an interest in furthering the mission including vendors, HIE’s, provider organizations as well as individuals. CAHIE works cooperatively with other eHealth efforts and we are narrowly focused on enabling trust and technology to facilitate HIE-to-HIE exchange.

Bill Beighe will also be presenting at the up and coming 2013 Accountable Care & Health IT Strategies Summit held at the Hyatt Fisherman’s Wharf San Francisco September 10-12, joining a keynote panel of west coast HIT leaders as below:

Wednesday September 11th, 10.45-11.45 a.m. Keynote Panel: Health Reform, HIT and Care Innovations

Scott Whyte, VP IT Connectivity, Dignity Health, Marcy Cheadle, Director of Advanced Clinical Applications, Inland Northwest Health Services, Pam Lane, Deputy Secretary for Health Information Exchange, Director for Health Information Integrity, CA HHS, Bill Beighe, CIO, Santa Cruz Health Information Exchange

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