Indiana HIE enrolls 1,500 docs in quality program

By Diana Manos
10:19 AM
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The Indiana Health Information Exchange (IHIE) -- the largest HIE in the nation -- announced Wednesday that enrollment in its Quality Health First Program has reached 1,500 physicians in 50 communities, improving care for more than one million patients throughout Indiana.

The program is helping to improve screening rates for diseases and support the management of medical conditions such as diabetes, heart disease, asthma and breast cancer, leaders at IHIE said.

Patients needing interventions are flagged in reports to their primary care physician, enabling the physician to make the best care decisions possible before, during and after patient visits. Participation is open to any primary care practice in Indiana, regardless of its size or number of physicians, and is not restrictive to practices that do not use electronic health records.
 
The reports are based on over three billion pieces of clinical information, along with claims information, to provide the most up-to-date, robust and relevant information available, officials said. The program allows physicians to review and verify the data, and to reconcile missing or inaccurate data.

"The reports we receive help us to find patients who are not getting regular care for either routine services or chronic disease management," said Louis Winternheimer, MD, medical director of the Raphael Health Center in Indianapolis. "As a result, we mail reminders or make phone contact with the patients based on the reports."

Providing early interventions and consistent follow-up care to patients with chronic diseases is a critical step to capping healthcare costs, according to IHIE. As such, the program provides a structure for health plans to reimburse physicians based on improvements in patient outcomes. 

[Read about lessons learned by attendees of the HIMSS11 HIE Symposium in Orlando.]

According to IHIE, Anthem Blue Cross Blue Shield of Indiana awarded bonus payments totaling $3.4 million to participating primary care physicians in Indiana in 2009, based on improvements in overall patient health. The amount of bonus payments from Anthem for care delivered by participating physicians in 2010 is expected to exceed that amount. Anthem, United Healthcare and Unified Group Services, Medicare and Medicaid all participate in the program.
 
"Our practice elected to participate in the Quality Health First Program because of the standardized measurement of  medical quality and outcomes across health plans," said Sandy DeWeese, RN, an administrator of Southern Indiana Pediatrics in Bloomington, Ind. "This comprehensive program gives us a practice-wide view of care needed for all of our patients, rather than just a segment of our patient population."

According to IHIE, the program can help providers meet certain meaningful use criteria by linking the use of health IT to achieving measurable outcomes in patient engagement, care coordination and population health. It is also the foundation for the $16 million Central Indiana Beacon Community, a cooperative agreement program funded by the American Recovery and Reinvestment Act and led by IHIE, designed to support communities at the cutting edge of secure health information exchange attain a new level of healthcare quality and efficiency.

[See also: Beacon Communities shine light on economic improvement .]