April 22, 2010
Chairman DeLuca, Vice Chairman Frankel,
committee members, staff, ladies and gentlemen, thank you for the opportunity
to speak today regarding the benefits of health information exchange
and the proposed legislation in House Bill 2106.
A health information exchange will
allow the secure and reliable exchange of health data between providers,
payers, consumers, public health agencies and other stakeholders.
This will make healthcare delivery in Pennsylvania more cost efficient
and consumer friendly.
There are 193 health information
exchanges across the U.S. in some stage of operation, including one
in Pennsylvania, the Keystone Health Information Exchange. A recent
survey of benefits by those participating in health information exchanges
revealed higher than expected benefits, even in early stages of adoption.
The perceived value of health information
exchange in terms of improved quality and timeliness of clinical
decisions and diagnoses increased 300 percent among those surveyed.
The value of health information exchange in terms of improved
access to accurate patient data increased 12 percent from initial expectations.
The Pennsylvania Healthcare Information
and Management Systems Society (HIMSS) believes a strong Authority is
key to establishing the financial and operational model for a successful
HIE and the fulfillment of obligations associated with the Commonwealth’s
recent commitment from the federal government of $17 million in ARRA
funding.
Pennsylvania HIMSS is comprised of
nearly 2,000 healthcare professionals from medical centers, health
systems, health information technology vendors and consulting firms
representing some of the largest employers in Pennsylvania.
House Bill 2106 puts forward the
establishment of an Authority, which we support. We strongly urge
the Committee to consider amendments to the currently proposed legislation
that will strengthen the Commonwealth’s ability to improve the quality
and reduce the cost of care while at the same time protect the privacy
rights of citizens.
The current bill is written in such
a way as to prohibit the use of data within the health information exchange
to be used for quality initiatives. While Pennsylvania HIMSS recognizes
the importance of protecting the privacy of consumers, the ability to
aggregate health data and conduct analytics that can provide clinical
and business intelligence for utilization management is critical in
order to drive down costs and improve quality.
Other states can serve as an example
to the Commonwealth. The Greater Rochester Regional Health Information
Organization is part of New York State’s HITEC research consortium
that includes Columbia University, University of Rochester, Cornell
University and SUNY Albany. This consortium conducts qualitative
and quantitative research using patient-protected, de-identified clinical
information and claims data that flow through the exchange. Studies
underway include:
- The effects of electronic
prescribing alerts on physician prescription behavior,
- The changes to clinical
workflow efficiency an quality outcomes in standalone versus interoperating
electronic medical record systems,
- The effect of patient
information exchange on ordering patterns and quality outcomes.
Pennsylvania HIMSS strongly supports
the use of de-identified health data for quality improvement initiatives.
The second amendment we urge the
Committee to make relates to the proposed loan preferences for providers.
The current language gives loan preference to applications which provide
direct patient access to healthcare information, which Pennsylvania
HIMSS interprets as personal health records, or PHRs.
We recognize that a key component
of healthcare reform must include consumer-directed care management
and that PHRs are one way that consumers are beginning to get more involved
in their care process. However, we believe the loan program
would have a bigger impact on reducing cost and improving quality if
providers were encouraged to submit loan applications that included
a convincing cost-benefit analysis that did not necessarily require
a PHR component.
PHRs are not yet a proven method
for improving quality and reducing the cost of healthcare. There
are many ways a provider may use health information technology that
are more proven. Examples include computerized physician orders
and electronic prescriptions to reduce medication errors, or the use
of telephony integration (CTI) systems to monitor patients with
chronic conditions at home to reduce hospital readmissions.
Pennsylvania HIMSS supports a focus on loan incentives which are benefits
driven.
Health information exchange is a
critical piece of the healthcare reform puzzle. Most healthcare delivery
occurs in the physician’s office and the typical primary care physician
works with 229 other physicians in 117 different practices on care coordination
issues. We urge the Committee to consider amending House Bill
2106 as suggested today in order to position the Commonwealth for the
greatest potential benefits that health information exchange has to
offer.
Thank you.
