CHICAGO – CareSpark began a health information exchange covering 17 counties in the Tri-Cities Tennessee and Virginia area in November 2008 to improve the health of its residents.

As a mature HIE, CareSpark has a lot to offer emerging HIE efforts, said executive director Liesa Jenkins.

In their education session, “CareSpark: Collaboration, Sustainability and Commitment, a Real-World HIE Example,” Jenkins and Wesley Easteridge, MD, a family practitioner at Mountain Region Family Medicine, present a realistic picture of what it takes to get operational.

Creating an environment for building trust through fairness and an open process among providers, patients, employers, payers, government and IT companies is critical, Jenkins said. “You have to get everybody comfortable with data-sharing agreements,” she said.
Data sharing will go nowhere if patients don’t participate, so HIEs need to ensure patient buy-in and participation.

CareSpark understood that until the payment system is reformed it needed to develop a gain-sharing plan that recognizes that purchasers are the main beneficiaries and providers have no incentive to participate, Jenkins said. Therefore, HIEs need to develop a financial sustainability plan that benefits providers and users, Jenkins said. HIEs need to determine what role states and the federal government can play, she said.

Before it went live, CareSpark spent six months in testing mode and ensuring data quality, Jenkins said. As provider data came in, CareSpark audited the records for accuracy. “You have to make realistic estimates for how long each step takes,” she said.

ARRA federal stimulus funds being funneled through states presents a problem for HIEs that are not statewide but regionally focused, Jenkins said. “The funding puts heavier emphasis on state-led HIEs,” she said. Because CareSpark covers counties in Virginia and Tennessee, getting at those dollars requires doubling the work. “They’ve built the walls even higher,” she said.

Luckily, the National Governors Association, which hosted a conference for state-level HIEs, examined how states can work together and leverage their collective resources, she said.