California HIE Faces Obstacles
By Christine Kern, contributing writer
HIE will need to make business case to insurers, providers.
Blue Shield of California and Anthem Blue Cross, ferocious competitors in the state’s healthcare marketplace, are investing in a partnership to launch a nonprofit Health Information Exchange (HIE). The hope the HIE will contain the medical histories of nine million insured members – about a quarter of California’s population – and improve interoperability across the state by the time it goes live at the end of this year.
The health plans will provide $80 million in seed money for the first three years of the information exchange, known as Cal INDEX. It will launch at the end of the year and adhere to state and federal privacy laws.
The announcement was welcomed by California state officials and advocates for health technology after a federally funded effort to modernize health information known as Cal eConnect fell apart. However, their announcement quickly raised concerns about the privacy of medical data. Consumer groups questioned whether patients’ interests would be sufficiently aired in an organization founded by private-sector insurance companies with the collaboration of hospitals and big health systems.
One consumer advocate questioned the governance and oversight of a privately funded effort. "We'd really like to see robust consumer participation," said Betsy Imholz of Consumers Union.
“The question is, what will providers think?” said Dr. David Brailer, now CEO of a San Francisco venture capital fund after serving as head of the Office of the National Coordinator for Health Information Technology. “California is a very provider-powerful state.”
Two major players offered support on Tuesday. Dr. David Feinberg, president of the UCLA Health System, and Lloyd Dean, president and CEO of Dignity Health System, attended the kickoff press conference where both extolled the virtues of Cal INDEX. Feinberg called it the “next generation health information exchange.” Dean said, “We know it can save money, but most importantly, we know it can save lives.”
Regional health information exchanges are also invited to join the HIE, as are other health plans and any organization willing to share data. The biggest question mark is whether Kaiser Permanente, the largest integrated provider in the state and one which competes with the Blues as an insurer, will participate in the new HIE. Kaiser officials declined to comment Tuesday.
Proponents say the exchange, which is touted as the largest in the United States, can improve the quality of care and reduce health costs by avoiding duplicate lab tests, preventing adverse drug interactions and quickly alerting doctors or nurses who are seeing a patient for the first time to any conditions or prior surgeries they need to know about.
It has the potential to save lives if ER doctors, dealing with unconscious patients, are able to pull up such information immediately and make better-informed treatment decisions. It also puts California front and center in the growing trends towards digitized records and integrated care, which are an important part of the Affordable Care Act, or Obamacare.
“I think this could really be a milestone moment for healthcare in the U.S., simply because of the scale of the collaboration,” said Jennifer Covich Bordenick, CEO of Washington, D.C.-based eHealth Initiative, a nonprofit organization that conducts an annual survey of more than 300 health information exchanges nationwide.