Q&A: We have an obligation to share what we have learned

St. Francis Hospital, a 395-bed healthcare facility in Wilmington, Del., has long been involved in the Delaware Health Information Network (DHIN). DHIN, the first statewide health information exchange (HIE) in the U.S., went live in the spring of 2007; last month, St. Francis began sending data to the network. Brian McDonough, MD, CMIO of St. Francis, recently talked with CMIO about the effort to exchange information, bring physician practices on board and share the HIE experience with other healthcare organizations.

When did St. Francis connect to DHIN, and was this a lengthy process?

St. Francis officially began feeding results to the DHIN in September. There are still several hospitals in the state that have yet to join, but the goal is to have active participation from all hospitals to provide data. St. Francis was involved from the beginning and wanted to make certain that there was a safe and efficient system of delivery to the DHIN.

As a hospital CMIO, what were the biggest integration issues for your facility?

My biggest issue is bringing practices on board while making certain that we do not fail in providing all data to the practices we serve. For instance, each practice will receive our data through the DHIN and also receive faxed results. When the individual practices are comfortable that they are receiving all of the information through the DHIN, they will sign off and ONLY at that point will we cease faxing (or sending results in the method that they are used to).

What technology did you use to connect?

The DHIN uses Medicity’s technology platform. St. Francis uses the Meditech platform for inpatients, and the actual interface comes from our Openlink Interface Engine via a point-to-point connection. Our hospital-owned outpatient practices are using AllScripts.

What information is being exchanged, and how much?

At this point we are feeding admission/discharge/transfer, laboratory, pathology and radiology results. The advantages are fast results: clinicians get results as soon as they are available; standardized information: results and reports are delivered based on the individual practice's workflow or in one standard format, private and pass-coded: The DHIN is HIPAA-compliant. The network is secure.

Do you believe the standards and technology currently exist to enable a single, nationwide information exchange?

I think the DHIN can serve as a template for a NHIN, but there is no doubt that this is a complex process where there is a need for numerous checks and balances. I think the experience of hospitals like St. Francis with the DHIN can serve as models for hospitals in other states. We have an obligation to share what we have learned—our successes and our failures. We are all walking down a new path and those who are in the lead need to help others along the way.

Personally, I believe that as CMIO at St. Francis it is my duty to share what I have learned, not because I have a greater background or knowledge base, but because I am working in a system that is ahead of the curve. We will all need to join forces in a similar manner to succeed.