Information Technology Reference
In-Depth Information
exchange, people are not guiding the agents to perform each instance where data
should be exchanged. In the example given, all laboratory tests ordered by Dr. Smith
would end up in the appropriate charts with no further manual effort on the part of
Dr. Smith or her staff.
In addition to this process automation, the grid is also an approach to health
information exchange. If every clinical system in a health enterprise had the agents
installed the resulting “grid” could become an HIE. This was exactly what Novo
developed and successfully deployed in a large number of hospitals and health sys-
tems. The company claims that the technology is so simple to implement that they
could often deploy it without physically visiting their client. Later on the company
recognized that the grid could be a “platform” upon which healthcare “apps” could
operate and have access to the underlying clinical data. The platform is called
iNexx. It's somewhat analogous to the app platforms on a Smartphone which typi-
cally do, if the owner of the phone allows it, have access to the underlying data
stored on the phone.
Medicity, a major supplier of traditional health information exchange technolo-
gies, acquired Novo in 2009 and, in 2010, the combined company was acquired by
Aetna, the giant health insurance company. What's going on here? Why would an
insurance company want to own advanced tools for health information exchange?
The answer is in large part, the grid, its platform and the apps. Earlier we said
that the major private health insurance companies are following Medicare's lead
and are offering outcome-based plans structured somewhat like ACOs. This means
that if care providers in a network can deliver superior outcomes for less money they
get to share in the savings. The details don't matter and are certainly subject to
change given how new this is but one problem is clear from our earlier discussion in
this chapter - those providers need new tools. Figure
5.3
shows the Aetna Care
Collaboration Coordinator, an iNexx app.
As the name implies, this app is designed to facilitate a collaborative and
informed approach to care across multiple provider offices
no matter what EMR
they have
. Someone in each patient's primary care provider office - this would
likely be a care coordinator in a patient-centered practice - indicates what providers
are part of this patient's virtual care team. For a patient with multiple chronic dis-
eases this might include their endocrinologist, if they have diabetes, their cardiolo-
gist, if they have congestive heart failure, and so on. These providers need not be
part of the same practice. To participate, each of these practices must download the
free iNexx platform. The download would likely be posted by a Medicity connected
health system for providers using its HIE or who are in its provider network.
Medicity also contracts to provide the technology to state HIEs so, in that situation,
the iNexx platform might be posted for download by any provider connected to the
statewide HIE.
Whatever the source, someone is responsible for setting up a local “node” that is,
in essence, the master agent through which everything is coordinated. The node
automatically finds the iNexx installations in the network to which it is connected
creating a local “grid”.
