Bridging The Gaps: How One HIE Is Uniting Communities to Improve Care

When a region’s leading healthcare providers come together to form a network to share information, millions of patients benefit. That is ultimately why a group of healthcare leaders came together to create ClinicalConnect HIE, western Pennsylvania’s first and largest health information exchange.

The passage of the HITECH Act in 2009 was the primary force driving organizations to work together. But for ClinicalConnect HIE, key relationships were formed a few years earlier when six hospitals began to regularly collaborate on clinical issues. The group referred to itself as the “Six Bridges,” a reference to the fact that Western Pennsylvania has hundreds of bridges connecting the geographically diverse landscape. This pre-existing relationship serve us well in creating our health information exchange.

With the HITECH Act in play, more discussions ensued. Over the course of the next year, weekly phone calls and face-to-face meetings brought the CIOs of nine healthcare organizations together. We addressed security, privacy, policy and operational aspects of an exchange. Subject matter experts from each member were engaged as necessary to assist this group, and temporary work groups were created around specific tasks.

We quickly focused on three topics:

1. Technology — how were we going to exchange this data?
2. Finances — how would we fairly pay for this and make it sustainable?
3. Governance — how would we ensure collaboration while recognizing the competing market forces in western Pennsylvania?

The technology part was pretty easy. You’re talking about a group of highly experienced technology leaders working together to solve a problem with a solid technology solution. For the financial piece, we brought in our CFOs to figure out a fair and proportional model which ensured everyone had financial “skin” in the game, regardless of size or scale. The last and most daunting challenge was figuring out just how we were all going to work together on an ongoing basis to make our vision a reality.

I wish I could say that it was easy to form a governance model and lay out a simple five-step approach that could easily be replicated. But it was not so simple. Each organization had different — and in most cases, competing — relationships with each of the other eight hospital systems. The “Six Bridges” certainly helped, but it still took time, lots of discussions, documenting models, changing those models, and ultimately finding common ground.

Throughout this process, I witnessed such tremendous passion for what each and every one of my colleagues does in his or her daily work: providing the best possible care to the people in our communities. That passion, I truly believe, was the critical factor in overcoming the many barriers faced in the origin of ClinicalConnect HIE. That passion enabled collaboration. That passion held our attention through a very iterative process to figure out just how the exchange would be formed. That passion led to the trust. That trust led to the formal founding of ClinicalConnect HIE in 2011 as a Pennsylvania non-profit corporation. Nine months later, in June of 2012, the exchange went live with the first users accessing patient records from another member organization.

ClinicalConnect HIE was built on sound principles, processes and trust; it leverages the expertise of its founders for their use of electronic health records, interoperability technology and information security. It is led by a dedicated Board of Directors; several subcommittees of the Board have been established and report directly to the Board on a quarterly basis. They address ongoing items like privacy, security, finances, membership, quality and emerging matters.

Each member of ClinicalConnect HIE has governance representation. For example, members are asked to participate in the Operations, Quality and Advisory Committees to ensure all organizational views, issues and concerns are addressed. ClinicalConnect HIE ensures our executive, clinical and technology leaders are actively engaged to expand its thought leadership and direction.

Today, ClinicalConnect HIE’s membership includes ACMH Hospital, Butler Health System, Excela Health, Heritage Valley Health System, Pediatric Alliance, P.C., Presbyterian SeniorCare, St. Clair Hospital, The Children’s Institute of Pittsburgh, UPMC, and Washington Health System. It has grown to include more than 7.5 million unique patient records with greater than 23,000 users. Currently, 2.5 million patients are participating in this health information exchange, with patient consent based on an “opt-out” model.

ClinicalConnect HIE continues to grow at a regional level and is a participant in the eHealth Exchange, the national network of trading partners that securely share clinical data using common standards. The addition of new healthcare members continues to demonstrate the success of ClinicalConnect HIE’s governance and vision for improving the health of our geographically dispersed healthcare community.