The Vermont Information Technology Leaders, Inc. (VITL) has developed a comprehensive work plan for the remainder of 2008 and the first half of 2009. The work plan is included in the application to go to the state to receive funding from the Vermont Health IT Fund.
Under the work plan, VITL will establish interfaces with up to six hospitals and the Vermont health information exchange will begin clinical data sharing. The work will occur in stages, beginning with the delivery of lab test results and radiology reports from hospitals to physician electronic health records systems.
The second stage will enable physicians to place electronic orders for tests at hospitals. The third stage will develop a bi-directional health information exchange, including sending and receiving the Continuity of Care Document, which is a standardized clinical summary. Additional hospitals will be connected to the exchange under future work plans.
An assessment of specialist physicians needs for HIT and HIE is also proposed as part of the work plan. The assessment would identify existing technology use among specialists, and look at the demand for connecting specialists to the HIE. The plan would also establish a way to evaluate the impact of connectivity, such as decreasing expenditures related to document faxing, courier services, and repeat diagnostic tests.
VITL is also requesting funds to deploy an interface to enable the submission of immunization data messages from physicians with EHRs systems to VITL. These messages would then be sent from VITL’s data center to the Vermont Department of Health’s Immunization Registry.
The biggest component of VITL’s application is the Clinical Transformation Project, which would educate physician practices on clinical process improvement and provide grants to independent primary care physicians for acquiring electronic health records systems. Under the project, training will be provided to help build a network of end-users to serve as resources to other physician practices.
In addition, VITL is making progress on a day-to- day basis and reported in September and October that hospital lab results are now being transmitted to electronic health records systems in physician practices. This live interface now enables Northwestern Medical Center in St. Albans to send lab test results to VITL’s data center in South Burlington. Once the results are received, they are translated in real-time to LOINC, an industry wide standard supported by major electronic health records systems. The lab results are then immediately transmitted via a secure interface to the electronic health records system of the physician who ordered the test.
Primary Care Health Partners the largest independent primary care practice in the state, has contracted with VITL to be the first EHR Connectivity Service customer and will implement the EHR in physician practices in 5 locations throughout the state.
VITL has plans to expand the service to send radiology results electronically from the hospital to physician practices using VITL’s HIE infrastructure. The capability for the physician practice to send electronic orders for tests to the hospital will be added.
In another new development, VITL has added another hospital emergency department to their electronic medication history service. Brattleboro Memorial Hospital is the third customer within
VITLs Medication History Service and service is now provided between VITL and the hospital’s emergency department. Rutland Regional Medical Center and Northeastern Vermont Regional Hospital were the first emergency departments to go live in 2007.
The system begins operating when VITL forwards the request to RxHub. The PBMs databases of pharmacy claims are queried in real-time and then lists all of the patient’s pharmacy claims paid in the last six months. The information is assembled and transmitted to the hospital emergency department via the VITL data center. Clinicians can then go over the list with the patient to verify each medication and add any drugs the patient is taking which may not be on the list. The medication list is then placed in the patient’s medical chart.