610-277-9100 Solutions for RHIOs
It is estimated that more than 500 Regional Health Information Organizations (RHIO's) are under way across the U.S., all with the goal of providing the real-time exchange of health information across the continuum of healthcare and payment. The challenges that must be overcome to achieve this level of interoperability are daunting, and the expectations for cost, time frames and level of effort are generally underestimated if not misunderstood. Furthermore, most of these initiatives are underfunded and have not demonstrated a sustainable economic model. Halfpenny delivers a highly differentiated, proven and sustainable economic model for the RHIO.
Diversity in laboratory source data Each year an estimated 7 billion laboratory tests are performed in the U.S., influencing 70% of medical decisions. The federal government has certified over 180,000 different laboratories to perform testing in the US. Approximately 55% of laboratory testing is performed by 6,000 different hospitals, and the balance by national and independent reference labs, and a small but growing portion by physician office labs. The types of information systems and test methodologies these labs employ are extremely diverse, complicating an already massive problem in size and scope. It is estimated that laboratory data constitutes as much as 94% of the objective data in the clinical record, so achieving a method of consistent data capture and normalization from the thousands of sources systems plays a central role in both individual and population based health care.
Challenges with lab data capture Despite today's technology advances, most laboratory results are still delivered on paper or in proprietary system formats that do not get shared beyond the ordering physician. In the vast majority of cases, this laboratory data does not find its way downstream into health plans, disease management vendors, and wellness providers. The majority of individual hospital and laboratory service providers are simply not providing the data to other healthcare constituents. To do so, most would require significant upgrades in their ability to provide data aggregation, normalization and formatting that health plans and disease management companies would require. Additionally, for many of the same reasons, laboratory clinical data does not makes its way into the increasingly available Personal Health Records (PHRs) systems. These combined issues result in lower quality of care and drive higher costs through redundant testing, lack of information for care management and lack of outcomes data.
PartialSolution 1 Part of the federal government's HITECH initiative is attempting to address these specific problems by requiring that two key criteria of "meaningful use" certification require laboratory vendors to; 1) support ambulatory CPOE from a plethora of EMR vendor applications; and 2) to drive more structured data lab results back into physician EMR/EHR systems. Another meaningful use criteria is for the EMR to provide reporting to for public health and other care management purposes.
Partial Solution 2 In conjunction with the above initiatives, it is hoped that the providers of laboratory services will participate on a large scale in the developing RHIO/ HIE and NHIN networks. By most accounts, there are over 500 regional health information organizations or health information exchanges (RHIO/HIEs) either in formation or already operational in the US.
Problem with these Solutions. Currently there is no government-mandated data format for laboratory transactions. Clinical labs already incur substantial incremental expenses to deliver lab results to a wide range of information platforms, including over 300 different electronic medical record system vendors (EMRs), potentially dozens of patient health records (PHRs), and the evolving health information exchanges (HIES) in their markets. At present, each laboratory vendor must work with every EMR, PHR and HIE vendor on a "point-to-point" basis. This already has a substantial impact on laboratory service providers both from a cost and resource standpoint. Because interfaces between labs and EMRs are generally one-to-one relationships (i.e. with each physician practice representing a unique connection), the legacy stand-alone proprietary systems in place today are not equipped to enable the EMRs to address the new HITECH requirements. This is true for a host of operational, technical and economic reasons.
Bridging the gap with a lab clearinghouse Halfpenny Technologies, Inc. is an HIE vendor that drives efficiencies by allowing multiple lab service providers to deliver results to many disparate physician EMRs and other HIE participants through an Integration Technology Framework (ITF) platform for HIE ("ITF-Hub") without the need for individual data connections. This neutral HIE gateway is where national reference labs, hospital labs, physician / clinic office labs, and independent regional or specialty laboratories can send data to one centralized organization that can then efficiently share a consolidated stream of normalized data to the other of constituents for all other particular HIE initiatives, including health plan, HEDIS, PQRI and other reporting.
Halfpenny is an independent entity established to provide clinical data exchange services for hospitals and laboratories to physician EMRs, health plans, and other stakeholders in the healthcare continuum. Today, Halfpenny provides a comprehensive solution to facilitate laboratory data exchange using a combination of data and terminology standards such as HL7 and LOINC on ITF-Hub, a proven technology platform.Halfpenny supports multiple formats and continues to work with laboratory industry stakeholders on issues related to standardization of lab data, including employing an entire Clinical Data Services department staffed by credentialed Medical Technologists dedicated to Test Code Dictionary and LOINC mapping. It is this combination of technology-enabled data aggregation, normalization through LOINC mapping, and cost-effective translation, conversion and routing that enable Halfpenny to establish a true clearinghouse concept for all laboratory transactions.
Key benefits that Halfpenny Technologies, Inc. offers are improved availability of results in physician EMRs, reduced expenses by providing consolidated transmission of lab transactions through a centralized standard interface and improved quality of care for patients by providing a comprehensive laboratory data set from all laboratory service providers with integration to hundreds of physician EMRs and downstream care management / disease management systems.
Summary The scope and volume of laboratory medicine represents many potential opportunities for laboratory service providers, physicians, payors, employers and patients to improve outcomes and reduce costs through better management of laboratory data. Among major studies in medical errors, 50 % were in failure to use indicated tests, 32 % were failure to act on results of test or findings, and 55 % involved avoidable delay in diagnosis. Two issues in particular have been identified that are highly relevant to laboratory medicine: 1) the prevention of misidentifications of patients and specimens using bar coding and 2) the transfer of information to care providers about abnormal results. HEDIS and other performance measures can also be expanded to address many other conditions for which laboratory tests serve as indicators. Laboratory services play a central role in both individual and population based health care, and a Laboratory Clearinghouse represents the most effective and economic means available to capture and manage this crucial data.