Maine health-record network prepares for launch

Maine health-record network prepares for launch


New system aims to improve care, lower spending
By Meg Haskell
BDN Staff

Maine’s pioneering statewide health records network will go live later this month, connecting 15 hospitals, three health clinics and the Maine Center for Disease Control and Prevention to a pipeline of patient information.

The two-year demonstration of HealthInfoNet aims to prove that maintaining clinical access to a continually updated stream of electronic patient information can improve care and lower health care spending. In addition, the system is expected to help detect and track outbreaks of infectious diseases, including tuberculosis, Lyme disease and the 2009 H1N1 swine flu.

“This really is not a health information technology project,” said Devore Culver, HealthInfoNet’s executive director. “This is a health care delivery project. What we’re doing is trying to deliver better care.”

Only Delaware has implemented a similar statewide network, Culver said, but that state’s system is limited to laboratory data only.

Health information about more than 400,000 Maine patients already has been loaded into the HealthInfoNet system from affiliates of Eastern Maine Healthcare Systems in Brewer, Central Maine Healthcare in Lewiston, MaineGeneral Medical Centers in Augusta and Waterville, and MaineHealth in Portland. In addition, medical practices affiliated with Martin’s Point Health Care in Portland — including practices in Bangor, Brunswick and Portland — are participating, along with the public health laboratory of the Maine CDC.

Beginning at the end of this month, the information will be made available to key clinicians at participating sites, Culver said Monday. Those “clinical champions” — doctors and other providers who are assigned to integrate the system into the patient-care setting — will be the first to make use of the data, he said, and will help others start using the system in their practices.

The primary goal is to allow a doctor in Portland, for example, to treat an unfamiliar patient from Presque Isle with ready access to that patient’s updated medical information such as chronic illnesses, allergies, prescription medications, recent laboratory and imaging test results, surgeries and more.

Mental health diagnoses, substance abuse treatment and HIV status are not included.

Patient information from participating clinical sites was added to the HealthInfoNet system starting in December. The information is added and updated unless individual patients “opt out” — formally decline inclusion. Culver said information about HealthInfoNet — and how to opt out — continues to be provided in waiting rooms, at registration desks and in other patient areas.

“Our goal has been to make consumers aware, to provide them with enough facts to make a good decision about whether this is for them or not,” Culver said. The decision to opt out can be exercised at any time, he added.

“If you wake up tomorrow and tell us you don’t want to be in, we remove any clinical data that’s already there and block any new data from going in,” he said. About 2,000 Mainers have opted out of the system so far.

Dr. Dora Anne Mills, director of the Maine CDC, said Monday that the ready availability of laboratory results that confirm reportable diseases will help doctors take better care of their patients. HealthInfoNet, she said, promises to reduce the lag time between the confirmation of a specific disease or organism and the patient being placed on appropriate therapy.

In addition, Mills said, the technology promises to improve the reporting of infectious diseases, facilitating the state’s job of detecting and tracking outbreaks of food poisoning, sexually transmitted diseases and other public health concerns. Such illnesses often are underreported, she said, because individuals at local clinics and laboratories do not always take the time to report them.

“So if all cases of [the food-borne illness] salmonella, for example, are automatically reported to the state lab, we reduce human error, patients get better care, and the Maine CDC gets better details about the outbreak,” Mills said.

“The biggest and best step the health care system in the U.S. can take is to assure that more people’s records are attainable electronically,” she said.

Funding for HealthInfoNet includes $1.7 million from the cash-strapped General Fund in the current biennium. Culver said the hard-won appropriation represents the state’s recognition of the project’s potential to improve care and reduce spending throughout the health care system, including in the publicly funded MaineCare program. MaineCare is the name of the state’s Medicaid program for low-income and disabled residents.

At the federal level, the Obama administration has dedicated $2 billion for state-level projects such as HealthInfoNet, but Culver warned that the federal funding will be used up swiftly. Other funding for HealthInfoNet has come from contracts with participating providers and from grants through the Maine Health Access Foundation, a philanthropic organization founded with the proceeds of the 1999 sale of Maine’s nonprofit Blue Cross and Blue Shield programs to Anthem Insurance.

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Comments
6 comments on this item

There's going to be hell to pay when this thing gets hacked.

I thought there was a thing called "Right to Privacy" and adding someones name with out written consent is illegal. You can't even call and get information on yourself.

Although it was not mentioned in the article, Franklin Memorial Hospital in Farmington is also a participant in this innovative project. This facility is the only independent rural hospital to be involved.

http://www.hinfonet.org/part.html

Why would drug abuse information not be included? Many, many of the "frequent flyers" seen in hospital ERs are there looking for drugs. Wonder how many of the 2000 who have "opted out" of the system are also druggies who think being in the system will make it harder for them to get prescriptions for pain meds?

Zonc

It's a good idea in theory.

Electronic health care records in theory should improve care while decreasing costs. Unfortunately the devil is in the details. It looks like there are several major problems with how it is being rolled out/handled.

Opt Out: Any system that truly benefited us would be OPT-IN. They should present you with an opportunity to opt-in, either through the mail or at your next doctor or hospital visit. No one should be 'enrolled' without being told what it is, who gets to see their records, and what benefit it provides for them. Usually, when a system is 'opt-out' it means that the main benefit is for someone else and they are afraid of not getting enough people enrolled if they had to ask first.

Data-Sharing: Their web site says that only your health care providers will see your medical data, but they then mention that no personally identifiable information will ever be shared. This means that they ARE sharing your health information with third parties. Even if they believe it's been anonymized, it can still be traced back to you. Every large data set that's been anonymized has been matched back to the individuals it referred to. If this data was ONLY for your health care providers, then it should simply say that. It doesn't because they don't.

Data Ownership: Who owns your medical data? You should own the medical data about yourself, but when this data gets into the hands of the pharmaceutical companies, insurance companies, etc. good luck getting it back. It should clearly state that any medical data about you is owned by you, can be shared with anyone without your express consent, and can be ordered destroyed by you should it 'get out'.

Real Penalties: They spend time talking about passwords and protection, but as we all know if your data is in a database, someone at some point is going to get a copy of it when they shouldn't. So what are the penalties? What happened when thousands of ATM records were stolen from Hannaford? Millions of credit card details stolen from T.J. Max? Pretty much nothing. T.J. Max offered a special 'sale day' to effected people. Companies routinely offer 12 months of credit protection service. Most judges won't award "anything" unless you can PROVE you were personally harmed. Good luck meeting that threshold when some insurance company 'mysteriously' denies you coverage, or your doctor is pressured by some pharmaceutical company to prescribe their favorite drug based on their review of the drugs his 'anonymous' patients are taking.

If they want EMR (electron medical records) to live up to their potential they need to be OPT-IN, they need to be only shared with YOUR MEDICAL PROVIDERS for the purposes of treating you (any other use needs to get your explicit consent). Your medical records must be OWNED BY YOU and finally misuse by anyone should be PUNISHED SEVERELY. It should involve expunging the misappropriated data, invalidating any actions taken with that data, and PRISON TIME for everyone culpable in the chain that used your data and lead to it getting out.

Until that happens, count me out. I would advise you to do the same.

Just another way for big brother to collect jnformation on every body and control your life .

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