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DoD turns to Colorado HIE for coordination

'The nature of a transient population for uniformed military service members and family members provides a unique challenge for our beneficiaries'
By Mike Miliard
08:08 AM
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The Colorado Springs Military Health System had some challenges when it came to providing connected care for its 172,000 beneficiaries.

Caring for service members and their families is crucially important, of course, but there are some aspects of military health that are different from civilian care.

For one thing, the structured nature of the Defense Department, especially its rigorous information security protocols, can lead to some hurdles to moving seamlessly across the care continuum.

"I don't think that the safeguards we have in place prevent care coordination, but we have to ensure our infrastructure remains secure and we appropriately protect the information of our patients," said Lt. Col. Francisco Dominicci, RN-BC, chief information officer and director of health IT of Colorado Springs Military Health System.

Nonetheless, he added, the technical safeguards within the DoD can "create a natural barrier for the sharing of information." And for a patient population that needs care continuity more than most, that’s not ideal.

"The nature of a transient population for uniformed military service members and their family members provides a unique challenge for our beneficiaries as well as healthcare providers," said Dominicci. "In many instances, they are dependent on availability of information in order to get a full picture of the patients. Furthermore, the nature of our patients requires that as much information as possible is available to the healthcare providers in order have a medically ready force."

On April 14 at HIMSS15, Dominicci will co-present a session titled "Using HIE to Improve Care for Military Personnel.” He'll be speaking with Morgan Honea, executive director of the Colorado Regional Health Information Organization.

CSMHS joined the CORHIO health information exchange in two phases. At first, qualified military health personnel were given access HIE information to better care for military patients that have been seen by civilian providers. The second phase lets the military share data with civilian providers caring for service members.

Dominicci and Honea will discuss the specific healthcare needs of active duty personnel and contrast them with those of civilians – not least different ways health IT has traditionally been brought to bear for each.

They'll also talk about the clinical and financial returns CSMHS has realized since signing on with the regional, public CORHIO network, and discuss ways civilian providers and IT teams can work in tandem with DoD to improve care.

Signing on with the HIE was "a natural evolution for CSMHS, as this partnership will improve the quality and reduce cost of patient care in the network," said Dominicci.

Benefits such as reductions in duplicate diagnostic exams (radiology, labs), easier referrals and a decreased demand for health records requests are already leading to efficiencies, he said.

"As a not-for-profit, CORHIO became a great partner," said Dominicci. One boon was having the state-designated entity provide access, early on, “to information that was extremely difficult to obtain for our organization.”

On the flip side, “I believe that for CORHIO, it was an interesting process to learn of all our requirements and safeguards that needed to be in place in order to solidify our partnership and improve our relationship."

Still, Dominicci said, despite the clear benefits, there were some challenges in this endeavor.

Within the CSMHS, “ensuring our providers and staff adopted yet another system required some change management strategies,” he added. Thankfully, that change in workflow soon proved its worth: “The value was seen almost immediately by the users.”

The session "Using HIE to Improve Care for Military Personnel" takes place on Tuesday, April 14 from 2:30-3:30 p.m. in room S100A.