Effective March 20, 2012
List of California HIOs
- ACCEL (Health Access El Dorado) – Operational
- Alameda / contra Costa Health Information Organization (ACCHIO) – Planning
- Eastern Kern County Integrated Technology Association (EKCITA) – Operational
- Fresno Health Communities Access Partner – Planning
- Inland Empire HIE (IEHIE) – Planning
- Los Angeles County / Los Angeles Network for Enhance Services (LANES) – Planning
- North Coast Health Information Network - Operational
- Orange County Partnership Regional Health Organization (OCPRHIO) – Operational
- Redwood Mednet – Operational
- San Diego Beason Community– Planning
- Santa Cruz Health Information Exchange– Operational
- Western Health Information Network - Operational
List of California IDNs or IDSes
- Hoag Memorial Hospital Presbyterian Health Information Exchange – Operational
- John Muir Health Information Exchange – Operational
- Kaiser Permanente HealthConnect® – Operational
- Sierra Nevada Memorial Hospital/ Greater Sierra Health Information Organization– Operational
List of HIOs
1. ACCEL (Health Access El Dorado) – Operational
ACCEL’s Health Information Technology Program is implementing electronic services that support interagency systems integration for the improved delivery and coordination of care and ultimately a Health Information Exchange (HIE) connecting public and private health care providers.
Following the successful implementation of the framework to assure the privacy and security of shared health data, ACCEL brought Care Pathways online and tested an Electronic Master Patient Identifier (EMPI) that will help providers identify patients across a County-wide HIE. The federal Agency for Healthcare Research and Quality and Blue Shield of California Foundation have awarded grants to enhance local health care technology in El Dorado County.
ACCEL is moving forward to select and implement appropriate Web-based technology to link participating agencies in an HIE that shares essential clinical data among El Dorado County providers. This will include the capacity for disease surveillance, public health communicable disease reporting, and urgent community health alerts.
2. Alameda / Contra Costa Health Information Organization (ACCHIO) - Planning
The mission of the Alameda Contra Costa Health Information Organization is to facilitate the secure exchange of patient health information throughout all healthcare delivery modalities in Alameda and Contra Costa Counties to improve patient care.
The Alameda / Contra Costa Health Information Organization (ACCHIO) has collaborated with the San Francisco Health Information Exchange (SFHEX) to propose an exciting new service for the storage and retrieval of patient documents in a secured manner. The service would allow authorized caregivers to post documents that only patients and their designees can retrieve. The service specification has been included in the ONC Challenge Grant application from the State of California for theme #3: Consumer-Mediated Information Exchange.
The participants of the ACCHIO will be the front line beneficiaries of the ability to securely share data electronically as follows:
- Ability by the end of the first full year of operation to exchange lab results between all participants
- Provide the technology by 2013 to achieve stage 1 MU HIE criteria – labs, CCDs, etc.
- Master Patient Index and Record Locator Service
- Connection to the NHIN and State Entity and Services Registries
- EMR Lite for those who need it
- Care and business benefits:
- Reduce costs associated with duplicate testing
- Reduced ED visits and Inpatient LOS through availability of patient information
- Ability to create ACOs
- Connectivity to State initiatives
3. Eastern Kern County Integrated Technology Association (EKCITA) – Operational
The East Kern County Integrated Technology Association (“EKCITA”) is a 501(c)(3) not-for-profit organization, formed via a federal research initiative and through a grassroots community effort in 2006. Under the management of Believe Health, LLC, the purpose of EKCITA is to demonstrate secure and appropriate sharing of electronic health files and clinical data for public health, patient care, and research; and to develop, improve, and assist in the implementation of health information technology for all physicians, caregivers, health-related institutions and consumers in, but not limited to, SE Kern.
EKCITA is not a typical Health Information Organization (“HIO”) in that it also holds the licenses for the electronic health record (“EHR") software solutions installed at various rural health clinics and private practices in the region; holds the license for a custom designed, web-based personal health record (“PHR”); and is responsible for the open source health information exchange (“HIE”) system designed by the local providers. EKCITA’s HIE will allow for not only the secure transmission of data, but will also support population based quality improvement and research studies.
At this time, EKCITA is comprised of a local critical access hospital, medical group, 6 private provider offices, and 3 rural health clinics. EKCITA is exchanging patient demographic information, encounter data, lab results, radiology transcription reports, and medication and allergy lists.
4. Fresno Healthy Communities Access Partners – Planning
Fresno Healthy Communities Access Partners (FHCAP) is a seven year old non-profit organization consisting of twelve health care and community organizations working together to improve access to health care for medically underserved communities in Fresno and the San Joaquin Valley. The Fresno HCAP partners are:
- Central California Faculty Medical Group, Inc.
- Central Valley Health Policy Institute
- Children’s Hospital Central California
- Community Regional Medical Center
- Fresno/Madera Medical Society
- Fresno County Department of Community Health
- Fresno Metropolitan Ministry
- Kaiser Permanente, Fresno
- Saint Agnes Medical Center
- UCSF Fresno
- Valley Health Team
5. Inland Empire HIE (IEHIE) – Planning
The Inland Empire Health Information Exchange (IEHIE) is a self-funded collaborative of Riverside and San Bernardino county hospitals, medical centers, medical groups, clinics, IPAs, physician practices, health plans, public health and other health care providers. IEHIE was established in 2010 as a joint effort between the Riverside County Medical Association, the San Bernardino County Medical Society, and the Southern California Hospital Association.
In January 2012, the IEHIE launched Phase I of its project and anticipates the HIE to go live by April 2012. Once it goes live, the IEHIE will be one of the largest HIEs in the nation, covering a geographic region nearly the size of Maine with a population of 4.1 million. About 14 participants (6 hospitals, 7 medical groups, and 1 health plan) and 2,000 doctors are expected to participate in the health information exchange. IEHP manages health care plans for nearly 500,000 low-income residents in Riverside and San Bernardino counties. Its membership is expected to expand to approximately 900,000 residents by 2014 when federal health care legislation passed in 2010 is fully in place.
6. Los Angeles County/Los Angeles Network for Enhance Services - Planning
(No website for LANES at this time)
LANES is a public and private collaborative which seeks to improve healthcare delivery in Los Angeles County and surrounding areas by ensuring that health information is available when and where it is needed in a safe and secure manner. LANES is developing a long-term health data highway project which includes hospitals, physicians, community health clinics, laboratories, vendors and payers. It is starting with adoption of EHRs towards the meaningful use goals and making community-wide data available to participants.
In January 2011, LANES selected the Western Health Information Network (WHIN) as the LANES Technology Partner.
7. North Coast Health Information Network – Operational
North Coast Health Information Network (NCHIN), is a new California nonprofit and the successor organization to a community collaborative hosted by the Humboldt Del Norte IPA and Foundation (HDN). NCHIN’s purpose is to provide information exchange in Humboldt County and has as staff a group of dedicated and experienced Information Technology and management professionals drawn from the sponsoring organization.
The parent organization HDN is a community leader, initiating the expansion of Information Technology project in conjunction with local health care providers in community collaboratives. HDN has been the recipient of over 10 major grant awards for clinical and information technology projects.
This project helps to build a Health Information Organization with the capacity to provide lab results interfaces with data from local hospitals. It also will provide a method for creating and transporting Continuity of Care Documents (CCDs) by adding functionality to the existing electronic referral system widely adopted in the community.
8. Orange County Partnership Regional Health Organization (OCPRHIO) – Operational
OCPRHIO is a community collaboration of health care providers whose mission is to facilitate health information exchange in Orange County. OCPRHIO is working collaboratively to electronically connect providers across Orange County so that patient records can be easily accessed at the time and place they are needed for care. Many of Orange County’s leading health care organizations currently participate in OCPRHIO, representing physicians, hospitals, health plans, and public health..
OCPRHIO received an 18-month, $795,000 grant from Cal eConnect to build an HIE infrastructure. Initially four OCPRHIO members will be connected, with additional organizations to be connected in later phases. The infrastructure created will be used as the foundation for an operating community-wide HIE.
For health information exchange to be valuable and consistently used, a large number of medical records must be available to providers. The grant will stimulate access to more data. It also will help revive the emergency department project, which went live in 2009 but suffered from insufficient data sources.
The four data-sharing partners under the grant include three large hospitals systems and the county’s largest medical group:
- Monarch HealthCare -- the county’s largest IPA with more than 2,300 primary care and specialty providers serving180,000 HMO patients and 32,000 ACO patients);
- IHHI -- comprising Chapman Medical Center, Coastal Communities Hospital, Western Medical Center Anaheim, and Western Medical Center Santa Ana, which together annually provide 157,000 inpatient days and 151,000 outpatients visits in areas with the highest concentration of low-income populations;
- St. Joseph’s Health System – 14 facilities, 140, 511 discharges and 3,437,195 outpatient visits.
- University of California, Irvine Medical Center -- with16,390 annual inpatient admissions and 407,000 outpatient visits.
9. Redwood Mednet– Operational
What started as a community-based steering committee in 2004 which included the Alliance for Rural Community Health, Mendocino county Public Health, and members of the Mendocino-Lake County Medical Society evolved into the non-profit health information exchange Redwood Mednet in 2005.
The purpose of Redwood MedNet is to investigate and support optimal workflow solutions for the secure and appropriate sharing of electronic health files and clinical data, and to develop, improve and assist in the implementation of health information technology for health care providers, their business associates, and health care consumers.
Redwood MedNet builds and operates health data interfaces to enable interoperability between separate health care facilities throughout Mendocino, Sonoma, and Marin counties. Redwood Mednet’s health information exchange (HIE) service allows electronic health record (EHR) software to send and receive clinical messages, such as imaging orders, laboratory tests, care summaries and patient referrals. For example, this service allows hospitals, laboratories and imaging centers to push electronic results into the EHR used by the provider who ordered the test. The HIE service can also send records to a patient's HealthVault secure online personal health record (PHR).
10. San Diego Beacon Community – Planning
San Diego is one of only 17 communities across the country chosen as a Beacon community to lead the nation in advancing health information technology (health IT). SD Beacon community has been awarded a three-year, $15.3 million federal grant from the Office of the National Coordinator for Health Information Technology to spur improvements in the community by fostering innovation and adoption of health IT.
An important aspect of the Beacon program will be to measure outcomes and changes during the three-year period as a result of the health IT innovations and community-wide Health Information Exchange (HIE) as envisioned. The San Diego Beacon HIE will link patients, healthcare providers, ambulances, clinics, and hospitals electronically to improve communication and share medical information important for providing the best medical care to all San Diegans. As the HIE and other innovative technologies are developed, the San Diego Beacon will assess how these technologies improve healthcare. To that end, the San Diego Beacon has set 4 key metrics to measure improvements in care quality, population health, and cost-efficiency and effectiveness. These metrics include reducing unnecessary hospital readmissions, improving childhood immunization rates, enhancing the care of heart attack patients, and reducing unnecessary computed tomography (CT) scans.
11. Santa Cruz Health Information Exchange - Operational
The Santa Cruz RHIO in Northern California, is the longest running successful Health Information Exchange (HIE) in the United States. Spearheaded in 1996 by Physicians Medical Group of Santa Cruz County (PMG), a large independent physician association, the RHIO utilizes a virtual ‘Clinical Network’ powered by Axolotl Corp. to connect nearly 80% of the regions physicians and staff as well as competing hospitals, labs, radiology centers, Safety Net Clinics, county health clinics and other healthcare entities.
Clinicians electronically receive clinical information directly into their tool of choice – existing EMRs, Axolotl’s EMR Lite with ePrescribing and ordering, or via fax, for paper based charting. Clinicians securely communicate electronically with one another, sharing referrals, patient memos, progress notes, consult letters and other patient data instantly – speeding the process of care for the patient. Pre-treatment authorizations are automated. Lab orders are done electronically. Disease Registries are populated with lab information easing the ability to take care of a chronically sick population and supporting pay-for performance initiatives and, physicians ePrescribe over the Pharmacy Health Information Network, electronically sending prescriptions and receiving renewal requests and drug history information for the patient.
County Wide Master Patient Index with over 500,000 patient entries.
- 2 Hospitals: CHW Dominican Hospital and Watsonville Community Hospital
- 10 Safety Net Locations (including 3 Santa Cruz County Clinics)
- 2 Outpatient Surgery Centers
- 1 Santa Cruz Mental Health provider
- 7 Laboratories including: Quest Lab, Labcorp, Hunter Lab, Santa Cruz County Lab, APMG (Pathology Lab), Dominican Hospital Lab, and Watsonville Hospital Lab
- 5 Radiology Imaging sites – Radiology Medical Group and the two hospitals
- 700 electronic users
- 80 connections to third-party EMR systems (e.g., McKesson Practice Partner, Allscripts Touch works, Epic Care, Office Practicum, eMDs, meridianEMR), and more under development.
12. Western Health Information Network - Operational
Western Health Information Network (WHIN) is a dynamic non-profit health information services provider dedicated to improving healthcare delivery; by collaborating with providers and consumers to deliver accurate and timely clinical information at the point of care. WHIN's goal is to create a healthier community by providing health information tools that improve health care quality, enhance chronic disease management, and advance public health reporting.
In 2010 WHIN became the health information service provider for the two Southern California health information organizations -- the Los Angeles Network for Enhanced Services and the Orange County Partnership Regional Health Information Organization.
WHIN is an industry leader in the practice of protecting the privacy of consumers and supporting the need for healthcare providers to share data in support of a patient’s care and their own business practices. WHIN is a California Privacy Demonstration Project engaged in fact-finding and developing best practices for patient privacy protection in California.
List of California IDNs or IDSes
The following is a partial list (not exhaustive) of Integrated Delivery Networks or Integrated Delivery Systems in California:
1. Hoag Memorial Hospital Presbyterian Health Information Exchange - Operational
The Hoag Memorial Hospital Presbyterian HIE currently distributes laboratory, radiology, pathology, transcribed reports and face sheets to both paper-based practices and those using electronic health records (EHRs). Community providers without EHRs can access and print patient information securely via a web-based application.
The Hoag HIE has already integrated electronically with Allscripts and eClinicalWorks EHRs and will soon integrate with NextGen, with other ONC-certified EHRs to follow. The hospital has connected 250 providers to its health information exchange (HIE) five months after beginning rollout. The goal is to connect 500 providers by October 2011. They plan to keep connecting physicians and integrating with EHRs. They will have comprehensive health records available to community physicians. This HIE effort is part of an ongoing commitment to provide the highest quality services to their community.
2. John Muir Health Information Exchange - Operational
The John Muir HIE (JMHIE) is a proprietary but open data sharing network sponsored by John Muir Health (JMH) and financed partially through JMH funding, and partially through the subscription fees of other providers who have subscribed to the data sharing network. Their vision statement is to “Securely provide relevant clinical information from the JMH inpatient and ambulatory clinical information applications to improve patient outcomes and safety and promote better transition of care.”
JMHIE offers subscribing members 2-way clinical messaging between the providers who have signed up for the service. In addition, they provide outbound results for laboratory, radiology, transcription, clinical notes, and discharge summaries. They also provide outbound transmission of visit summaries for those physicians whose EHRs have outbound feeds to the exchange. They have results interfaces from the HIE into several provider EHRs. In addition to the result and messaging data feeds, JMHIE also provides a semi-tethered PHR for those physicians who want to offer that to their patients.
In 2005, the data exchange started with the pilot electronic distribution of results from their laboratory system to their primary care group, the John Muir Physician Network, and have added additional functionality as our vendors have developed it. Our exchange is powered by vendors Relay Health and InteHealth. Today, JMH operates one of the largest hospital-based reference laboratories in California, and has customers throughout the Bay area and from as far as Fresno to Eureka. The reference laboratory results are made available to submitters through the exchange either via portal or direct consumption into the EHR.
Current data distribution customers include the John Muir Physician Network, Muir Medical Group IPA, Hill Physicians, Washington Hospital, Doctor’s Hospital, most of the skilled nursing facilities and long-term care facilities in the Contra Costa area, and Sonoma Valley Hospital with whom we are also piloting an inter-HIE exchange of laboratory orders and results between JMHIE and Redwood MedNet who is the primary exchange for Sonoma Valley Hospital.
John Muir Health is also one of the HealthShare Bay Area (HSBA) founder health systems together with California Pacific Medical Center and the County Health Services and Safety Net clinics in San Francisco and Alameda counties. As HSBA spins up its operations in 2012, JMH will begin transition of the proprietary components of its HIE into HSBA. JMH is committed to the appropriate, secure, and timely sharing of patient clinical data at the point of care when and where needed to promote better outcomes and to assure safe and knowledgeable transition of care as patients enter and leave their facilities.
3. Kaiser Permanente HealthConnect® - Operational
Kaiser Permanente HealthConnect® is Kaiser Permanente’s comprehensive health information system, which includes one of the most advanced electronic health records available. It securely connects 8.6 million people to their health care teams, their personal information, and the latest medical knowledge, leveraging the integrated approaches to health care available only at Kaiser Permanente. In March 2010, Kaiser completed the implementation of KP HealthConnect in each medical facility — 454 medical offices and 36 hospitals. The system facilitates communication between members and Kaiser Permanente professionals to help make getting well and staying healthy even more convenient.
KP HealthConnect coordinates patient care between the physician’s office, the hospital, radiology, the laboratory and the pharmacy — and it helps to eliminate the pitfalls of incomplete, missing, or unreadable charts. KP HealthConnect directly or indirectly supports the majority of their hospital and health plan operations nationwide.
Kaiser Permanente has implemented a secure health information exchange that is going to be expanded nationwide. Kaiser Permanente and VA engaged in first Nationwide Health Information Network (NHIN) production exchange for treatment purposes on December 17th, 2009 in San Diego, CA.
Kaiser Permanente is nearing the launch of a nationwide information exchange, giving its 9 million members an opportunity to have their medical records shared over the Internet with public- and private-sector partners. Kaiser’s membership includes about 500,000 veterans, who receive care at Kaiser facilities and Veterans Affairs Department hospitals.
The software that allows providers to view and extract medical record data uses the standards and specifications set by HHS. The data is encrypted, and patients have to give their consent before their health information is shared.
4. Sierra Nevada Memorial Hospital/ Greater Sierra Health Information Organization - Operational
In 2006, Sierra Nevada Memorial Hospital (SNMH) embarked on a comprehensive, community-wide electronic health record project — the Greater Sierra Health Information Organization (GSHIO). The project allows a host of health care providers to efficiently and securely transit patients' records, paving the way for easy-to-use electronic communications between patient, physician, pharmacy and facilities such as skilled nursing homes.
While SNMH spearheaded GSHIO, the project will eventually stand alone in its goal of maintaining an electronic health record system available to all physicians at an affordable rate. There are different vendors available for implementing electronic health care records. GSHIO uses a product called eClinicalWorks, and is essentially a super-highway of information.
Participants in GSHIO, including the County Department of Public Works, can successfully share records; providers such as Yuba Docs, who use a different program, can only view records. The next challenge is getting different programs to effectively communicate with one another to open up information sharing on an even larger scale.
A Health Information Exchange project is being developed, and will strengthen sharing between providers as well as between different vendors. A patient portal also is being created, where data can be remotely accessed and questions asked.