Western Nebraska Health Information Exchange

Health information sharing has been identified as the key goal for the providers involved in this project. Their vision is a system that:

• Collects data from multiple sources
• Is used by providers as the primary source of information at the point of care or service
• Provides evidence-based decision support
• Is viable and sustainable
• Operates within the established networks of rural hospitals, clinics, public health providers, behavioral health providers, and others

We envision a regional electronic health information exchange system that will enable providers, patients, and others to share information, communicate orders and results, support evidence-based decision-making, streamline public health disease surveillance and reporting, and enable data management for non-clinical purposes (e.g., billing, quality management). Information will be patient-centric (i.e., available where the patient and his/her provider needs it regardless of where the information was originally gathered). Transmission and access of information by authorized individuals will be through secure systems. Technologies and connectivity options will continue to evolve. We intend to create a technology that will enable all partners with basic technological infrastructures to participate.

Implementation Process

Beginning October 2005, the partnering organizations began moving toward implementation of health information exchange. This project will continue to contribute substantially to achieving an improved, sustainable system of collaborative healthcare that respects the autonomy of hospitals and creates a compatible, shared, unified paperless system that has the capability to seamlessly share patient information among hospitals and providers in real time, which will tie into national standards for integration into national networks.

The partners' vision for shared electronic health information has a long-term goal of connecting all health and human services providers and ancillary services in the Panhandle, as well as those that connect to others in the multi-state area, to share patient information and provide a high-quality system of care for rural residents.

The goal of this regional partnership of hospitals, behavioral health providers, public health, and health and human services providers is to improve quality of care and patient safety by:

• Enabling the exchange of health information between providers;
• Contributing to the viability of partners by identifying and promoting collaborative wins;
• Ensuring that all hospitals and providers have the capacity to participate in electronic exchange;
• Continuing to promote the vision of a system of care for Panhandle residents;
• Building capacity within the workforce.

The intermediate goal is health information interoperability between hospitals, clinics, private physicians' offices, pharmacies, and behavioral health providers.

The goals are to establish:

• Electronic health records that will integrate with other functional systems (decision support systems, CPOE/e-Prescribing, results management, laboratory) in Critical Access Hospitals, rural health clinics, community health centers, regional mental health provider clinics, private practices, and long-term care facilities through a common process and shared resources, in order to enhance local and regional capacity development toward health information exchange.
• Efficiencies in public health services reporting systems.
• A health information exchange system that will provide current information, from all hospitals and rural health clinics, at the point of care.
• An operational entity and incorporated RHIO that will provide the sustainable infrastructure necessary to support regional health information exchange and common developments in the Electronic Health Records.

The implementation is being funded, in part, by grant number 1 UC1 HS016143-01 from the Agency for Healthcare Research and Quality and grant number D06RH06884 from the Health Resources and Services Administration, Rural Health Network Development Program

Public Health Reporting

The flow of public health information is a particular focus of the Western Nebraska Health Information Exchange. As part of this project, the partners documented the flow of public health information reported by providers and organizations in Western Nebraska which is required by the state. The report, Western Nebraska Health Information Exchange Network Public Health Reporting- Schematics and Matrix (May 2007), includes:

• Communicable Disease
• HIV/AIDS
• Nebraska Newborn Screening Program
• Newborn Hearing Screening
• Chronic Disease
• Nebraska Cancer Registry
• Nebraska Trauma Registry
• Immunization

Planning Process

The implementation process is proceeding, based on the yearlong work undertaken from October 2004-September 2005. In September 2005, the partners issued The Panhandle Regional Health Information Exchange Plan *. The Plan describes how the partners plan to move forward and also describes the planning process. The Plan may be of particular interest to small hospitals across the nation because it describes the wide variability in technological capacity and readiness represented by the partnering organizations. The Plan focuses on:

1. Delineating a standards-based, coherent, scalable and achievable technology solution
2. Articulating the value proposition for individual organizational partners, the critical access network and the regional community
3. Including all hospitals within a regional critical access health network and extend to all health clinic and behavioral health providers
4. Including participation from all levels of leadership from participating partners
5. Working within existing collaborative and information channels to ensure scalability and extensibility to other key health care providers, such as bioterrorism, public health and other safety net providers

*You must have Adobe Acrobat installed on your computer to view this file. If you do not, you can download the program by clicking on the icon below. This is a free software available to all internet users from Adobe Software, the makers of Photoshop.

This planning project was funded, in part, by grant number 1 UC1 HS016143 from the Agency for Healthcare Research and Quality.

The Public Policy Center is providing the Principal Investigator, Nancy Shank, and Lead Evaluator, Mark DeKraai.

News Articles and Reports

• Healthy Decisions. (October 28, 2007). Omaha World Herald.
• Western Nebraska Health Information Exchange Closer to Reality (2007, October). Access, Newsletter of the Nebraska Office of Rural Health
• Western Nebraska Health Information Exchange Network Public Health Reporting-Where Does All The Data Go? (A short introductory brochure). (August 2007).
  (Updated 11/12/2007)
• Western Nebraska Health Information Exchange Network Public Health Reporting-Schematics and Matrix. (May 2007).
  (Updated 11/12/2007)
• Pioneering a New Route to Better Healthcare. (2005, October). Access, Newsletter of the Nebraska Office of Rural Health
• Regional Health Records for Frontier Communities Final Report. (September 2005).
• Another Step Toward Shared Electronic Patient Records. (May 2005). ACCESS Newsletter, Issue 40, p. 5-6.
• Healthcare's Strategy Against an Ever-Lurking Pitfall. (February 2005). ACCESS Newsletter, Issue 39, p. 4, 10-11.