Group seeks to fill medical records' communication gap

Penrose-St. Francis Health Services has electronic medical records — when you go to the hospital, all the tests and data and doctor’s notes about you end up in an electronic file. Same at Memorial Health System and Colorado Springs Health Partners and several other physicians’ practices around town.

Here’s the thing: None of those electronic records systems talk to each other. It’s like the bad old days between Windows and Macs, when transferring a simple word processing document between operating systems was a serious hassle. It’s worse, actually, because there are many electronic medical records companies.

In medicine, of course, we’re not talking about losing a term paper or a letter to grandma. Data that’s missing or inaccessible can have serious repercussions. At a minimum, it means patients aren’t getting the best possible care.

Does this seem a little crazy on the cusp of 2012, when information on everything from banking to traffic jams is freely available online? Doctors and health care administrators certainly think so, but fixing the problem isn’t as easy as upgrading your computer.

Making health information freely available — while keeping it secure — has been a seven-year struggle for the Colorado Regional Health Information Organization, or CORHIO, the private-public partnership charged with creating the health information exchange that is intended to fix the communication problem.

Launched as a pilot project in 2004 and formally organized as a nonprofit in 2007 with backing from the federal and state governments and private foundations and health care providers, CORHIO is now finally rolling out its system. Centura Health, Penrose-St. Francis’ parent company and the largest hospital system in Colorado, got all 13 of its hospitals on board in October. Colorado Springs Health Partners hopes to become the first large multi-specialty practice in the state to sign up, likely in early 2012. Memorial Health System also plans to join the system in early 2012. CORHIO’s goal is to have 85 percent of all health care providers in the state to be participating in an information exchange by 2015.

Easier said than done, however, said Phyllis Albritton, CORHIO’s executive director.

“It’s a lot of detailed, technical work to make these systems talk to each other when they have been built not to talk to each other,” Albritton said.

CORHIO is not a giant computer, like HAL from “2001: A Space Odyssey.” Rather, it’s a clearinghouse that allows doctors and medical professionals to access records wherever they’re located.

Centura spent more than 400 hours making sure its system was communicating with CORHIO, said Dana Moore, Centura’s chief information officer. It wasn’t so much a programming challenge, he said, but rather exhaustive testing to make sure information was getting attached to the right person and nothing was lost in translation.

“It’s really normalizing the data,” Moore said. “Outside of lab (results) and a handful of other specialties, there really isn’t standard nomenclature.”

And, because it’s health data being exchanged, it’s important to get it right, said John Sanders, chief information officer for Colorado Springs Health Partners.

“One of the core values in health information exchange is, ‘You can never be wrong,’” he said. “The bar is extremely high.”

So how will this work? Ideally, in the near future, a patient could be in a car accident, brought into the emergency room unconscious and, once identified, the doctors would instantly have access to his medical history, tests and any illnesses or conditions.

“We may spend most of our time in El Paso County, but we also go to Denver, we go to Pueblo, and things happen,” said Dr. Jon Velez, Memorial’s chief information officer. “Disease never takes a holiday. The need for information is going to be critical.”

Albritton said one of her staff waited several weeks for a consultation on a cancer diagnosis that, with better information coordination, might have been handled on an initial visit. That staff member ended up dying of his cancer, Albritton said, and the question of whether a faster diagnosis could have made a difference haunts her.

“If the oncologist had had that information that day, would the outcome have been different?” she said. “That’s what we’re trying to accomplish.”

There are also ordinary benefits for ordinary patients from coordination, said Carol Bruce-Fritz, executive director of the Community Health Partnership in Colorado Springs.

“I’ve been in the position of helping elderly relatives try to navigate the health care system,” she said. “It can be really difficult just to keep track of what procedures you’ve had, what medications you’re taking, which doctor said what to you. Having an electronic record does that for you.”

Having every shred of personal medical data be available anywhere in the state might sound like too much sharing to some people. CORHIO is opt-out — patients can decline to make their records available through the system. Because of how sensitive the data is, privacy and security and core values to the organization, Albritton said.

“We have to be very, very serious,” she said. “This information is vitally important to patients and we are not willing to put that data at risk.”

While many other states are pursuing similar systems to CORHIO, there is no national plan to connect the dots and create a truly universal system — yet. There have already been talks about connecting CORHIO to neighboring states’ systems.

But, one step at a time. For one thing, to exchange electronic records, you first need to have electronic records to exchange. Many practices still don’t, because of the cost and lack of standardization and training involved. Another limiting factor is cost — CORHIO’s $85 per doctor, per month fee is significant, particularly for smaller practices.

“I completely agree with most of the providers, especially small providers, who say, ‘When is this going to be of benefit to my patients?’” Albritton said. “Until recently, there had to be this element of faith that, ‘This is going to make me a better provider.’ I think that’s changing.”
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