May 4, 2017 | Health information exchanges are intended to make health records accessible where and when patient needs them. Enabling the electronic exchange of records saves time in an emergency with full access to health history, saves money by avoiding redundant tests, and keeps health records secure and accessible in case of disaster. 

But the very nature of the idea is at the heart of its challenges. Sharing data means getting input and buy-in from multiple stakeholders. It’s healthcare diplomacy at its best.

Angie Bass, CEO of Missouri’s health information exchange, Missouri Health Connection (MHC) is an experienced diplomat. Clinical Informatics News editor, Allison Proffitt, ask Bass to share her experiences connecting health information across the state.

Clinical Informatics News: Tell me about Missouri Health Connection and its history.

Angie Bass: MHC, a private, non-profit, statewide health information exchange network, is one of the largest HIE’s in the United States that provides a secure and private electronic platform to electronically share health information. Since January 2014, the MHC network has been providing the electronic exchange of health records enabling physicians to quickly and securely access patient health records while treating their patients which has improved the quality of health care delivery by coordinating care, reducing preventable errors and avoiding treatment duplication. MHC’s network includes more than 70 hospitals, hundreds of clinics and more than 7,000 physicians treating more than 15 million patients.

What is your primary role in Missouri?

As the President and CEO, I lead and oversee all aspects of MHC’s strategic initiatives, business development, public relations, government relations and service delivery.

What prompted Missouri to launch a health information exchange?

When the American Recovery and Reinvestment Act of 2009 (ARRA) funding was announced for every state to set up an HIE, there was great support from our Governor and the provider community. A year of hundreds of hours of stakeholder planning went into the planning on how to best use these funds to initiate a statewide HIE.

Your website seems balanced between education for both patients and providers. Are they equally important? Is one group harder to get on board than the other?

One does not exist without the other in our model. MHC operates with an opt-in consent model, meaning that no data is accessed without patient consent. So fundamentally, we know that without patient education, awareness, and consent, our HIE cannot provide value to the providers that are treating those patients.

I know many HIEs have struggled to get started and keep going. What have been the biggest challenges for MHC? Were they technical? Relational? What are you doing in Missouri to keep MHC going?

HIEs fundamentally face lots of challenges because of the nature of our business:

• Policy: managing the limitation of technology to enforce privacy policies and patient’s rights is always a challenge.
• Technical: HIEs are tasked with filling the gaps or solving interoperability in the spaces where the EHRs are inadequate. This is costly, but further solidifies the need for HIEs to be technical data solutions for providers.
• Costs: HIEs all manage their operations on very thin margins noting that the members of an HIE don’t have a lot of funds to expend on HIE services. Therefore HIEs often rely on subsidies from State and Federal sources or are reliant upon funders with deeper pockets (i.e. payors). In Missouri, our HIE is fully funded by the provider members that participate. MHC is working to add additional payor members to participate to add additional value to the network as well as pursuing additional funding opportunities.

Where are the biggest opportunities ahead for HIEs and MHC specifically?

HIEs are critical to the goal of providing a full, comprehensive and longitudinal health record for a patient. HIEs are the crux of data aggregation across multiple data sources, which makes HIEs the source of truth on a patient’s health status. Knowing this, there are many services that can be provided to add value to the health care system to reduce costs, facilitate better care coordination and expedite clinical decision making to improve the patient experience and hopefully the health outcome of the patient. MHC is grabbing this opportunity by rolling out additional alerting services while also focusing on finishing the connectivity across our state to be the single comprehensive source of a patient’s health record.

What are you looking forward to for the network?

I am looking forward to becoming one of the premiere HIEs in the country because our sustainability model, the services we provide, and the sheer size of our HIE.

Editor’s Note: Bass will be speaking on a panel on Accessing Analytics Within the Hospital Environ: The Role of Health Information Exchanges in May at the Medical Informatics World event in Boston, May 22-23. Medical Informatics World is organized by CHI, Clinical Informatics News’ parent company.