The North Carolina Hospital Association and North Carolina Medical Society are working with two delivery systems to pilot and launch a statewide health information exchange.

The North Carolina Healthcare Exchange is not the entity that has received HITECH Act funding to establish a state-level HIE. That entity, called NCHIE, is only creating a backbone infrastructure and not a full service HIE. It also will establish statewide policies, such as HIE standards and definitions for minimum data sets and role-based access. The new provider-led HIE and others in the state, such as Data Link that connects 16 hospitals in western North Carolina, will link to the state backbone.

The new exchange will use the underlying technology of the North Carolina Hospital Emergency Surveillance System as the starting point for its HIE platform, says Mark Bell, CIO at the North Carolina Hospital Association. The hospital association and state Department of Public Health created the system in 2004 to capture near real-time clinical data from 114 hospital emergency departments for public health surveillance purposes.

Ann Arbor, Mich.-based Thomson Reuters is the lead vendor for the new HIE, responsible for linking participants with each other, the platform and the backbone infrastructure, among other tasks. Dexter, Mich.-based Care Evolution, a Thomson partner, will create a single virtual patient record that will include a continuity of care document and additional patient information.

Proponents of the North Carolina Healthcare Exchange expect it to be operational in the fourth quarter of 2010. That quick timetable is achievable because off-the-shelf software is being used and the vendors have done similar work in South Carolina and Indiana, Bell says.

Greensboro-based Moses Cone Health System and Raleigh-based WakeMed Health & Hospitals soon will conduct pilot testing by taking data feeds and integrating them into the exchange platform. A second pilot phase then will bring in about 60 owned and independent ambulatory practices.

The technology partners are paying the costs of the pilots, Bell says. The HIE is looking for grants and other funding options, but providers also will pay to use the services. Funding options will be tested during the pilots.

The state Medicaid program, public health agencies and safety net providers have shown interest in participating and contributing data, Bell adds. North Carolina has 14 regional Medicaid networks that combine case management and the medical home model to provide services to beneficiaries. The medical home model relies heavily on the exchange of information to coordinate patient care.


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