Medical information network starts to roll out

A crew of volunteer actors demonstrated to an audience Tuesday how personnel in a hospital emergency department could learn important information about a patient's past care and current medications by tapping a statewide database.

The skit was a way to introduce VITL Access, a secure health provider portal to a database into which doctors and hospitals across the state have fed patients' medical information.

Vermont Information Technology Leaders began rolling out VITL Access last month, and officials intend to have it operational throughout the state in 2015, John Evans, VITL president and CEO, told an audience of 300 at the organization's annual summit.

It has taken nine years to get to this point.

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VITL first had to help physicians and hospitals move from paper to electronic medical records. All 14 hospitals have made the switch as have 97 percent of primary care practices.

The organization also had to determine what data would be extracted from medical records and sent to a statewide database. Data includes demographic information, medication history, lab test results, radiology and pathology reports.

The organization also had to build the interfaces that would allow hospitals, doctors' offices and laboratories to send patient information into a central database. The connections are operational for 93 percent of hospitals and 64 percent of primary care practices.

Vermonters have also had to give their consent to have some of their medical information added to the statewide database. "Higher than 90 percent of patients consent," Evans said.

Dr. Karen DeSalvo, coordinator for health information technology at the U.S. Department of Health and Human Services, said national surveys have similarly shown public acceptance of the medical information networks.

"People are willing to share their data if it will improve their care and will help others, as long as it doesn't lead to discrimination against them," DeSalvo said.

VITL's health information exchange has moved slowly to launch its functions — unlike the state's other exchange for health insurance, known as Vermont Health Connect, that has struggled to achieve full functionality since launching last October.

"This is not a big bang approach," Evans said. "We do training, education" before adding a new group to the network.

VITL Access is just one of three innovations that the organization is launching over the next 12 months.

Another is called VITL Direct, a secure messaging system that allows one provider to share important information about an individual patient with another provider. In another skit, volunteer actors showed how information about a hospital patient could be sent in an encrypted format to a rehabilitation facility where the patient was transferring.

This message function has begun at Northwestern Medical Center in St. Albans and Northeastern Regional Medical Center in St. Johnsbury.

The third innovation, scheduled for later in the year, is a notification system called VITL Notify. When patients are admitted, discharged or transferred from hospitals, the system would send alerts to their physicians.

"The work that VITL is doing, to be sure, is really the foundation of Vermont's future," Gov. Peter Shumlin said when he stopped by the summit. He told the medical audience that the exchange of patients' medical information is one of the ways "we take one of the best health delivery systems in the country and find a way to spend less money and get better outcomes."

Paul Harrington, executive vice president of the Vermont Medical Society, asked the national health information technology director, how the new networks in Vermont and elsewhere could be sustained financially. They have been largely set up with grants.

Vermont has used a small assessment on insurance claims to supplement federal grants, but the assessment sunsets in 2017.

DeSalvo, who only recently assumed the national position, said that is one of the questions she wants to try to answer. "We have to think of other financial models," she said. "The solution doesn't just lie with the health care system," she continued, noting, "It is the whole community's responsibility to create health."

DeSalvo, an internist, suggested that the transition to electronic records should leave room for consumers' voices. "Information coming from patients should be welcome in the note."

Dave deBronkart of Nashua, N.H., also known as "e-patient Dave," was on the summit's schedule to deliver the same message about the importance of listening to patients.

"Patients are the most underused resource," deBronkart said in an interview. "You are the expert in your own life."

He said patients should have access to their electronic records. They often catch mistakes.

More importantly, he said, when people read their records they get involved in their own care.

"It doesn't make us doctors," deBronkart said. "It makes us more informed. People perform better when they are informed better."

Contact Nancy Remsen at 578-5685 or nremsen@freepressmedia.com. Follow Nancy on Twitter at www.twitter.com/nancybfp