eLINC: Mass HIway First HISP to HISP Connection

The Massachusetts Health Information Highway (Mass HIway) has reached a new milestone with its first HISP to HISP connection, an achievement that immediately benefits patients and providers at a group of Winchester, Mass.-area health care organizations and lays the groundwork for similar connections across the Commonwealth that can improve care quality through the secure and efficient transfer of electronic patient information.

On May 20, eLINC, the private health information exchange (HIE) that services Winchester Hospital and Winchester Healthcare Associates IPA, went “live” with the Mass HIway. A Health Information Services Provider (HISP) delivers a set of services to its users and issues anchor certificates and Direct addresses so they can securely send and receive patient information electronically. Secure Exchange Solutions (SES) serves as the HISP for Winchester Highland Management, the organization that administers and manages the eLINC HIE for Winchester Hospital and Winchester Healthcare Associates IPA; Orion Health is the HISP for the Mass HIway, which is administered and managed by the Massachusetts Executive Office of Health and Human Services (EOHHS).

The pioneering connection between eLINC and the Mass HIway enables several health care provider groups that collaborate with Winchester Hospital, including specialist practice group Excel Orthopedics, to access the HIway. Providers and organizations using eLINC will have access to all other providers using the Mass HIway. The Winchester Hospital departments that share patient information electronically with eLINC users – pre-admission testing and Winchester Home Care – are using secure Mass HIway webmail accounts to send and receive messages.

Additionally, Salter Healthcare, a group of post-acute care facilities that receives about 40 percent of its patients from Winchester Hospital post-discharge, is also an eLINC member and expects to begin transacting with Winchester Hospital through the eLINC and Mass HIway connection this month.

Winchester Hospital is participating in two grant programs that facilitate connections to the Mass HIway with the goal of using the secure and efficient transfer of electronic patient data via an HIE to reduce the number of patients who may unnecessarily utilize high-cost post-acute care services. In 2013, the Massachusetts eHealth Institute (MeHI) awarded more than $2.3 million in HIway Implementation Grants that are helping 80 organizations across the state connect to the Mass HIway.

Under one of the programs, Excel Orthopedics (which is already on eLINC) identifies a patient in need of joint surgery and schedules the procedure with Winchester Hospital. After receiving patient consent, Excel sends the hospital an electronic patient record along with the referral. If appropriate, Excel informs Winchester Home Care via the Mass HIway that home care services upon hospital discharge are an option for the patient. The patient will be encouraged to enroll in informational classes that educate him or her on all facets of surgery and hospitalization as well as the option of using home care as an alternative to rehab facility care. The home care option contributes to efforts to provide the right care at the right place for the patient while also decreasing overall costs and sustaining high-quality clinical outcomes.  For patients that select home care after surgery, Winchester Hospital will send a continuity of care document (CCD) as an attachment via the Mass HIway to Winchester Home Care.

After a patient has surgery, an evaluation will be done to determine the care transition plan. Patients who are referred to Winchester Home Care after their inpatient stay will be followed along a specific care path and, upon discharge from home care, a nurse will use the Mass HIway to send a care summary document back to the specialists at Excel that informs them of the patient’s condition.

“The ability to have secure electronic communication capabilities will enhance care transitions between facilities. This will result in the provision of high-quality care which is cost-effective, safe, and results in improved clinical outcomes for the patient,” said Karen Keaney, executive director of Winchester Home Care.

Under a second HIway Implementation Grant program, Winchester Hospital is collaborating with Salter Healthcare to integrate and improve the delivery of CCDs for patients transferred from the hospital to Salter facilities for services. Providers at Salter will be able to receive patient information electronically before the patient arrives and be better prepared to handle medical issues associated with the patient.

The electronic connection facilitated by the Mass HIway will enable Salter and similar organizations to improve care coordination and care transitions, reduce medical errors, redundancies in care and costly hospital readmissions.

“The implementation grant has been a great opportunity for our internal teams at Winchester Hospital and Salter Healthcare to flesh out workflow implications, which would normally include paper-based transactions, but will now be electronic,” said Eddy Rospide, eLINC HIE director at Winchester Highland Management.  “The grant has also allowed us to enhance the work within our own HIE (eLINC) and will contribute to the ultimate goals of reducing readmissions and improving transitions of care.”