By Michael L. Gagnon, Special to bizNEVADA
The Nevada business community is strong, and I’m sure as seasoned as many
of us are, it’s probably been several years since anyone has used a fax machine
to send messages on a regular basis. Unless, perhaps, if you work in the health
Just a few months ago, Seema Verma, Services Administrator for Centers for
Medicare and Medicaid, addressed the crowd at the ONC Health Information
Technology Interoperability Forum in Washington, D.C. She asserted a call to
action that might have surprised a lot of people.
“…help make doctors’ offices a fax free zone by 2020, ” Verma said to applause.
Why did the audience meet this statement with such enthusiasm? Because that
crowd – comprised of Health IT developers, policymakers, technology staff, and
consumer advocates – understands unequivocally how slow the health care
industry is to change. And it is about time we caught up with everyone else.
While other industries like banking, education and even agriculture have been
able to utilize electronic technologies and other innovations to streamline and
advance their operations, health care lags due to several reasons – one being
the fact that physicians can be risk-averse, or feel that technology slows down
their work rather than improves it. In addition, many providers are still
compensated on a fee-for-service basis rather than being paid for providing
value. So most first generation electronic health records were focused more on
improving provider billing than sharing patient data with other providers caring for
the same patient. They were not, in a word, “interoperable.”
That’s where a health information exchange (HIE) comes in.
In a nutshell, HIEs securely collect clinical data from a provider’s electronic health
records, aggregate the data, index it and catalog it by type. Kind of like what
Google does for web content but in a much more secure manner. The data
includes patient events like emergency department or hospital admissions,
doctor’s notes, laboratory results, radiology reports, medications, medical images
and care summaries. It then makes this data available to treating providers,
payers, public health and others based on state and federal laws or with patient
consent. The treating provider either uses the HIE portal or their EHR which can
query the HIE directly.
An HIE, such as my organization HealtHIE Nevada, provides a secure statewide
network of a patient’s clinical data, saving time and money while providing the
best care possible. One of our primary goals at HealtHIE Nevada is to provide
the right data, to the right provider at the right time, ultimately creating a secure
network that can help reform the health care delivery system. Imagine a situation
where the patient information that care providers need is zapped over in an
instant, providing everything in one place via electronic means. We are able to do
away with sluggish and cumbersome delivery methods such as courier services,
archaic data storage devices, and dare I say – the infamous fax machine.
The benefits are numerous, and most importantly improve the quality and safety
of patient care by reducing things like medication and medical errors.
Unnecessary, or redundant testing can be eliminated. Care is more efficient
when alerts such as emergency department visits or inpatient admissions can
immediately be sent to their care team. Even the amount of paperwork typically
required at a standard doctor’s visit is limited, and more time for discussion can
be spent during actual appointments, stimulating health literacy and a patient’s
appreciation of his/her own wellbeing.
The health care industry as a whole might be slow to adopt innovation, but at
least we have several opportunities to transform that system right here in
Nevada. While some things feel like we’re caught in the 1980s, significant shifts
including the newly opened UNLV School of Medicine offer a chance for
substantial and positive change within our community. We hope that training
young medical students and residents is a well-established method for keeping
care providers local. Let’s welcome those fresh minds not with old relics of the
past, but with sound solutions that truly offer what’s best for patient care.
Michael L. Gagnon, CPHIMS is the Executive Director of HealtHIE Nevada the
statewide health information exchange in Nevada and the former Chief
Technology Officer of Vermont Information Technology Leaders, the state HIE in
Vermont. Michael also serves as the Chair of the Western Member Council of the
Strategic HIE Collaborative’s Patient-Centered Data Home initiative. Michael has
been involved with health information technology for over 27 years and focused
on health information exchange for the last 15 years. You can contact Michael at