PORTLAND, ME – HealthInfoNet, Maine’s statewide health information exchange, is using the $198,659 grant it recently received from Maine Health Access Foundation to link the HIE with Maine Health Data Organization’s all-payer claims database to better manage patient populations.

"Once you are finally able to marry up the actual clinical outcome with the amount paid, you can take a look on a disease basis, or a provider basis, at the combined impact of what was done, what the outcomes and what the costs were," said Devore Culver, CEO of HealthInfoNet. 

Current risk modeling relies exclusively on claims data, which only measures the amount of resources consumed, he pointed out. "It doesn't really tell you whether it was a good outcome or a bad outcome. You might have somebody who has a therapy that looks like it costs a little more but has significantly better impact. That's what's hard to measure today," he said.

With the trend of hospitals adopting risk models for reimbursement, Culver said it's "absolutely vital" to be able to look at both the dollars and clinical outcomes in order to manage patient populations.

Under grant requirements, HealthInfoNet is responsible for four deliverables over the course of two years. Within the next six months, the nonprofit will line up events of care, and then demonstrate potential benefits in the area of analytics and work with different stakeholders on standards for accessing and using data. It will be well into 2012, however, before the new dataset can be accessed, Culver said.