Hospitals take the lead in health info exchange


    Grand Rapids’ three hospitals are taking the lead in implementing the foundation of a Health Information Exchange for West Michigan.

    With all three using Medicity Inc., a Salt Lake City company, the hospitals are forging ahead with software that allows doctors’ offices and hospitals to order and receive laboratory, radiology and transcribed test results.

    Robert Connely, Medicity senior vice president, said these hospital-based HIEs are mushrooming across the country.

    “This is more about what hospitals and practices want to do to solve their day-to-day work-flow challenges, which is the reason we think this type of HIE is gaining so much traction,” Connely said. “It’s not designed to create the next generation of applications. It’s designed mostly to solve work and save tons of money, and that’s the reason they’re willing to pay for it.”

    Clinical messaging is the first step toward a broader HIE that could include other health care providers such as smaller hospitals, nursing homes and home health agencies, and distribute additional types of information.

    Spectrum Health previously announced it was using the technology with its employed and affiliated physicians.

    But CIO Patrick O’Hare announced at an Alliance for Health meeting last week that Spectrum Health, Metro Health and Trinity Health, owner of Saint Mary’s Health Care in Grand Rapids and Mercy Health Partners in Muskegon, have collaborated to produce an application called an agent that combines information from each into a single solution on the desktop at the physician’s office. It is now in use at 120 practices in the area.

    “The three individual organizations have been deploying this technology, which is, in essence, clinical messaging,” O’Hare said. “We wanted to make sure we had enough traction and make sure that the promise of the use of the technology was understood enough before making any joint public statements.”

    The hospital-based HIE collaboration has overtaken the first efforts toward a stand-alone, community-based HIE that had completed the planning stages at the Alliance for Health.

    The Alliance for Health, a nonprofit health care planning agency serving 13 West Michigan counties, received a $600,000 grant in 2007 from the Michigan Department of Community Health to plan for a regional HIE. The department handed out a total of $5 million in grants to nine regions, most for planning but two for implementation.

    Under its Health Care Vision 2020 program, the Alliance for Health convened subcommittees and hired former Republican state Rep. Gary Newell to lead the regional HIE planning effort. The result was a business plan issued last fall that called for charging fees for membership, governance board seats and usage to pay for the system.

    Information technology executives from the local hospitals say they decided to team up after it became apparent that enthusiasm was weak for a community-based HIE organization that would impose those charges. They said the hospitals were moving forward with computer connectivity with their own physician bases and saw no reason to pay for a separate HIE, as well.

    “Spectrum Health does not want to commit to funding another entity to provide oversight to activities already underway in the region, and for which we have the intention of expanding to other providers, as well,” O’Hare said.

    In addition, the Michigan Health Information Technology Commission, chaired by Saint Mary’s Medical Director of Informatics Dr. Greg Forzley, has backed away from earlier plans to establish nine regional HIEs. The commission is in the process of hiring a consultant to help decide whether the state should move ahead with centralized functions, such as a master patient index, Forzley said.

    “It’s still a vision that’s out there,” he said of the community-based HIE. “There’s nothing prohibiting having those kinds of things in the local area too.”

    Alliance for Health President Lody Zwarensteyn said any HIE in West Michigan needs to include the breadth of health care providers that exist outside of hospitals, such as nursing home, mental health care agencies and public health.

    “What he’s saying is that the three systems are taking the lead in first stage development of the HIE. That’s wonderful, as long as they keep the target in sight. The target has to be a comprehensive exchange — that’s all parties,” Zwarensteyn said.

    The hospitals started working with Atlanta-based Novo Innovations — which merged with Medicity in December — as long as three years ago. During that time, Novo developed Internet-based software that moves information across the Internet, Connely explained. He said the technology was developed by the military for use in war zones where connectivity to a central database is unreliable.

    Trinity Health has committed to the approach for all 45 of its hospitals, he added.

    Connely said the level of collaboration in Grand Rapids has been unique for his company, which has products in 700 hospitals nationwide. It’s an instance of collaboration in a health care market that is generally highly competitive, Metro Health CIO Bill Lewkowski said.

    “We compete on certain things when it comes to certain service lines and so on,” Metro Health CIO Bill Lewkowski. “When it comes to sharing information and patient care, the patient really comes to the forefront. They are No. 1 and the physicians are No 2. We need to be working cooperatively.”

    Find the text of the hospitals’ joint statement online at View the HIE business plan from the Alliance for Health’s Health Care Vision 2020 committee at

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