HIT and HIE is Critical to Patient Safety

by Patrick Miller

A critical component of health care reform nationally and locally is the implementation of health care information technology (HIT) and health care information exchange (HIE). Examples of HIT include electronic medical records for hospitals and doctors, home health monitoring equipment, telemedicine, videoconferencing, electronic prescriptions, personal health records, and high speed data infrastructure. HIE includes technology and standards to allow disparate systems (lab, pharmacy, inpatient, outpatient) to communicate with one another and share information.

All of these technologies are being implemented in order to improve patient safety, quality outcomes, patient access, and reduce costs. The concept of a longitudinal medical record that would contain all of a patient’s information over the course of their lifetime is one of the holy grails of investment in HIT and HIE. Imagine being able to move around the state or the country during various times of your life and having your information available to you and your treating clinicians. Or being able to access your own medical record, make updates to it, or request prescription refills. From a patient safety perspective, technology can reduce medication errors, duplicate tests, and missing information from paper charts. Technology can also be used to bring health care into remote or rural areas using telemedicine and videoconferencing technologies.

In terms of progress:
• In New Hampshire, a strategic plan on HIT and HIE, facilitated by the NH Citizens Health Initiative, was delivered to Governor John Lynch in January 2009.
• The NH Department of Health and Human Services is applying this fall for Federal funds for the planning and implementation of a health information exchange.
• In the past eighteen months, electronic prescribing adoption has increased in NH by 560% with almost 900 prescribers now using the technology.
• Federal funding for the adoption of hospital and physician electronic medical records will be received in New Hampshire over the next three years.
• The Federal government has developed a grant program to develop regional extension centers to assist providers with HIT adoption. New Hampshire is exploring this opportunity with other New England states.
• A series of state laws were enacted by the NH Legislature and signed by the Governor in the last three years pertaining to health information technology and exchange.

• HB 134 (2007). An act relative to electronic prescribing for prescription drugs. This bill established procedures, including privacy provisions, for electronic prescribing for prescription drugs and devices.
• HB 619 (2009). An act relative to medical records and patient information. This bill established procedures for access to health care information that is in the possession of health care providers and business associates of health care providers.
• HB 542 (2009). An act relative to a health information exchange. This bill establishes procedures for access to health care information that is in the possession of health care providers and business associates of the health care providers by a health information exchange. Under this bill, a health care provider or a business associate of the health care provider may only disclose certain health care information if an individual so requests.
• SB 138 (2009). An act relative to insurance coverage for telemedicine services. This bill established the New Hampshire telemedicine act, which requires insurance coverage for telemedicine services if the health care service would be covered by the insurer if it were provided through in-person consultation between the patient and provider.

In summary, investment in HIT and HIE will continued to be made in New Hampshire to support health reform efforts. This investment will come from Federal, State, and private sources. This blog will provide updates on a regular interval on New Hampshire’s progress.

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