EHR to HIE Connections Demystified

A look inside the process of connecting your practice’s EHR with CORHIO’s HIE

Electronic Health Record (EHR) usage is sharply on the rise. In fact, 72% of office-based physicians used EHR systems in 2012, up from 48% in 2009*. As a result, the number of inquiries CORHIO has received from medical offices about connecting their EHR to the health information exchange (HIE) has also increased. CORHIO has made strong headway integrating HIE services with 13 different EHR vendors, with many more in development. (View CORHIO’s EHR Connectivity Report).

Five-Step Process to Connect With CORHIO

When contracts are complete, a five-step phased project is kicked off and involves resources from the practice, the EHR vendor, CORHIO, and CORHIO’s HIE technology vendor (Medicity). CORHIO assigns at least two people to assist practices through the project. The phases include:

• Participant Readiness Assessment – the HIE technology specialists complete paperwork to understand the readiness of the practice and the details of the practice’s system.
• Analysis and Design – Medicity and the EHR vendor assess and plan out the technical work to be completed.
• Interface Build – the technical development work to configure the interface (the mechanism by which data in the HIE can be delivered to the EHR) begins between the EHR and CORHIO.
• Test and Train – the practice has an opportunity to review how the results will look in their system and request changes. Training also begins at this stage.
• Activate and Transition to Support – the practice is transitioned to the “live” stage – or the point when the connection is working properly and they are ready to start using the data.

“Fundamentally, what’s happening here is an interface, or connection, is built from the CORHIO HIE to the EHR and then we configure the flow of data based on the practice preferences,” says Kelly Joines, VP, HIE Program Operations at CORHIO. “The CORHIO staff works with each practice to evaluate necessary changes to workflow, to ensure that the practice understands and is following HIE-specific policies and procedures, and to help test that the right patient information is being received into the EHR.”

Typical Timeline

For a new EHR vendor that CORHIO has not connected to previously, the process takes approximately nine weeks. For an EHR that CORHIO has already connected with, the timeline is less dependent on the technology set up, and more dependent on the practice’s ability to set up policies and procedures and provide the resources for testing and training. This can take anywhere from two to six weeks with a motivated practice.

Success Factors

Successful EHR to HIE integrations include a few key elements. When the practice has a committed person to take the lead, the project moves faster. There is some behind-the-scenes work on policies and procedures related to patient consent that needs to be done, and having one person leading those efforts is beneficial.

Contracts need to be in place between the practice and the EHR vendor that detail resources, fees, timelines and other items needed for the integration. Some EHR vendors, such as Greenway, NextGen, Allscripts and Amazing Charts, have developed an integration approach for working with HIEs, and have these processes in place already.

“Integrated connectivity and interoperable data exchange capabilities to HIEs have been core elements of Greenway’s electronic health record solution since we were founded more than a decade ago,” says Joseph Bush, Greenway Regional Sales Manager, Colorado, Montana and Wyoming. “This leadership position benefits practices, health systems, and patients and communities. We’re proud to have the first practice in Colorado to connect with the Colorado Regional Health Information Organization (CORHIO).”

Alternative to Full EHR Integration

Some EHR vendors are unable to do the technical work necessary to allow for connectivity to an HIE. To address this, CORHIO has a web-based alternative to full EHR integration called PatientCare 360®. This allows the practice to access the patient information through a Web-based software tool, but is in a separate system and workflow.

The Future of EHR/HIE Integration

Today, providers on the CORHIO network are receiving ADTs, lab results, pathology results, transcriptions, and radiology reports directly into their EHRs. They are also able to send immunizations directly to public health, and are becoming more and more able to send care summary documents (CCD) and lab orders out of their EHRs. In the future, there will be opportunities to query public health directly, view diagnostic-quality images, populate registries and data analytics tools, as well as be able to directly access clinical analytics – all directly from the EHR.

Integrating your EHR with CORHIO’s HIE will help you meet Meaningful Use Stage 2, which means you could earn incentive funds. CORHIO suggests practices interested in EHR integration contact us soon, as the process takes time. Contact us at info@corhio.org or 720-285-3200.

* Hsiao CJ, Hing E. Use and characteristics of electronic health record systems among office-based physician practices: United States, 2001–2012. NCHS data brief, no 111. Hyattsville, MD: National Center for Health Statistics. 2012.