PORTLAND, MAINE – Maine's culture is to "get things done" - and when it comes to improving the quality of care through IT, the state has positioned itself well, said its director of the Office of the State Coordinator for HIT, James Leonard at a regional extension center (REC) educational forum this week. 

The Office of the National Coordinator (ONC) granted the state of Maine $6.6 million to create a statewide health information exchange (HIE) by the year 2015. Leonard says 72 percent of these funds go to supporting the exchange and the remainder are for updating privacy and security issues around personal health information (PHI). He says these PHI issues are being addressed by a Legal Working Group that was created by the state HIT Steering Committee. For example one issue they are working on is how HIV patients can benefit from the exchange; currently because of state law, conditions such as HIV are not included.

Having HIV records as part of the exchange could be life-saving, says Jill Devereaux, RN, health population nurse at Martin's Point Health Care in Portland, Maine. She was part of a project in Louisiana that involved deploying and EMR for HIV patients in seven clinics. Not long after this project went live, Hurricane Katrina hit, she said. "It saved a lot of lives to have those patients' medication lists," Devereaux said. "You don't know the unexpected benefits you will find."

Leonard said one of the goals of the exchange is to coordinate public health information and identify patterns for early warning – something he says would have been helpful last year with the H1N1 cases.

Leonard offered this example of what the exchange aims to achieve: When HHS services takes a child into protective services there are no medical records that follow that child when they go to a foster family, he says. For example there may be no immunization history. This may seem like something small in the scheme of things, but for a child who has already been through a traumatic experience, this can be especially difficult. "The exchange will bring children's records in state custody in front of providers who are treating them. These are the kinds of outcomes, goals that we hope that the HIE and HIT plan in our state will achieve," said Leonard.

Maine's state health information exchange (HIE), HealthInfoNet, is operational, something few states can claim, said its COO Shaun Alfreds. There is about a 40 percent adoption rate of EMRs in the state, and 70 percent of practices in the state are affiliated with larger health systems, the largest of whom are participating in the HIE.

HealthInfoNet is a centralized model, says Alfreds, that takes information in from providers and standardizes it to meet national standards before sending it back out. He says right now information for 780,000 Maine residents is within its central repository. HealthInfoNet's goal is to have all 30 hospitals in Maine and 80 percent of all ambulatory care providers connected by 2014, he said.

HealthInfoNet also serves as the state regional extension center, which was created to help providers achieve meaningful use of HIT. Vendors supporting providers enrolled with the MEREC are eligible for up to $3,550 per provider. As part of the REC's service it is negotiating discounted prices for EMRs. "We are trying to get the lowest cost out to providers for EMRs. The vendor has to demonstrate that they are the lowest price in the market and if they go lower with some other organization or REC, that we will get that price," says Alfreds. 

The session was part of regional forum series being held by the Maine Regional Extension Center (MEREC), overseen by HealthInfoNet, and Quality Counts.