Michigan HIE Bright Spots: Improving Quality and Health Care Efficiency —One Doctor’s Experience with Exchanging Information and Capacity Building
Dr. Brian McCardel has been a practicing orthopedic surgeon in Lansing, MI, for more than 20 years. As both a physician and a son with caregiving duties for his parents, McCardel has witnessed how health care efficiency can reduce the frustration patients and their families feel when navigating today’s healthcare system. In a recent discussion with ONC, McCardel described his parents’ reaction to a follow-up appointment for a CT scan of his father’s sinuses. When they arrived at the doctor’s office, they were surprised to learn the doctor was unaware of the reason for their visit. Consequently, his parents had to wait in the exam room for the doctor to both request and then review the results of the CT scan.
“My father felt like it was a waste of his time, and didn’t want to go back again to see someone who was so clueless about their patient. Health care is a thing of trust – and once lost, it can be difficult for a provider to earn that trust back.”
Improving Health Care Efficiency with HIE
As a native and lifelong Michigander, it’s no wonder McCardel is committed to making sure that excellent and efficient health care is an everyday occurrence for his extended family and friends in the Lansing area and across Michigan. As he sees it, one vital component to ensuring that quality and efficiency is the exchange of health information.
For the past two years, McCardel’s practice has been a member of the Great Lakes Health Information Exchange (GLHIE), using HIE information exchange services to replace mail and fax for sending and receiving information about each patient he treats.
GLHIE is one of five sub-state entities that received funding from the State of Michigan Department of Community Health and the Michigan Health Information Network (MiHIN) Shared Services, as a result of their ONC State HIE Cooperative Agreement. Expanding on previous investments made in health IT and HIE, the State used a portion of its cooperative agreement funds to help existing Michigan HIE entities expand services such as:
- electronic delivery of lab results
- exchange of care summaries, and
- public health reporting.
Michigan is also using these funds to help defray costs for Critical Access Hospitals (CAHs) and Federally Qualified Health Centers (FQHCs) to connect to Michigan HIE service providers. This strategic approach to expanding and enhancing exchange activity by funding or otherwise supporting existing exchange resources has been described by the Michigan HIE Program as “capacity building.”
Since Michigan’s capacity building program began in May 2011, GLHIE has given an additional 2,000 providers, rural hospitals, FQHCs, and free clinics in Michigan the ability to share patient information with unaffiliated providers for free, reducing the financial barriers for these providers to exchange, and ultimately helping to improve health care efficiency.
So far the capacity building program has been a great success. Carol Parker, Executive Director of GLHIE asserts,
“Connecting providers to our HIE infrastructure was by far the best thing we could have ever done with the funding we received from MiHIN’s program. For providers that are currently investing their money in certified EHR software, allowing them to connect to exchange services for free helps them get one step closer to Stage 1 meaningful use.”
Achieving Stage 1 Meaningful Use and Dr. McCardel’s Story
According to a November 2012 report by the Michigan HIT Commission, more than 60 meaningful use eligible hospitals and 2000 eligible professionals have utilized sub-state Michigan HIE entities to achieve exchange requirements and attest to Stage 1 meaningful use.
One of those providers who is benefitting from this program is Dr. McCardel. As EHR users, McCardel’s office staff has integrated exchange into their workflows by looking up relevant patient information through GLHIE prior to patient visits and by requesting that results be delivered to his electronic inbox. This information includes imaging results and radiologist readings that could have an impact on his orders and recommendations for patients. Once a visit is complete, McCardel’s nurses and staff update patient information via GLHIE so it can be shared with other exchange participants.
“When care coordination comes together with timely health information exchange services, there is a level of efficiency created that allows for people to feel those caring for them are on top of their game. And that matters.” – Brian McCardel, MD
According to McCardel, this process not only allows him to have a more complete picture of each patient he cares for, but it saves him time, as well as the time of his patients, his staff, and staff at other medical facilities, and ultimately improving the quality of care the patient receives from all providers and in all delivery settings.
For more information about the HIE’s capacity building approach that each state is taking and how that can lead to healthcare efficiency, check out the State HIE Program’s Bright Spots synthesis. More information about Michigan’s strategy and success to date is also available in a recently released implementation brief.
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