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Small, Rural Company Center Stage in Data Exchange

Will Ross speaks geek, but doesn’t consider himself one.

“I’m bilingual. I understand conceptually enough of health IT to be able to be a translator. I can figure out how to get things done.”

Ross is project manager for Redwood MedNet, a small company in rural Mendocino County about to launch California’s first contribution to the national Direct Project for electronic health information exchange. Involved since the project began March 1, 2010, Ross said the Direct Project — an updated, distilled version of the Nationwide Health Information Network — offered his company a rare chance to participate with the big guys.

The Direct Project’s primary goal is to help health care providers with limited resources meet meaningful use criteria. Under the 2009 economic stimulus package, health care providers who demonstrate meaningful use of certified electronic health records can qualify for Medicaid and Medicare incentive payments.

“This was a unique opportunity,” Ross said. “This was not a standard procurement project by the government. Instead of procuring services or goods in the standard way, this project invited the private sector to participate on their own dime. This was essentially a community improvement project and you had to donate what you develop as community intellectual property.”

Coalescing around the open source philosophy of sharing resources, competitors came together to collaborate. Direct Project participants include Google, IBM, Intel, Microsoft, Allscripts, Cerner, Epic, General Electric — and Redwood MedNet.

“Because the process was inherently open and level from the start, it allowed a small outfit like MedNet to participate as an equal,” Ross said.

Demonstration Project at HIMSS

According to Direct Project organizers, there was one goal for Redwood MedNet’s pilot demonstration: “to deploy directed secure messaging for production data delivery in support of meaningful use measures.”

MedNet concentrated on three specific kinds of messages called for in federal meaningful use guidelines:

  • Receipt of structured lab results;
  • Immunization reporting; and
  • Sharing patient care summaries across unaffiliated organizations (including both referral to a specialist and discharge summary to a patient centered medical home).

MedNet’s standards-based system for sending authenticated, encrypted health information directly to known, trusted recipients will be demonstrated later this month in Florida at HIMSS11, the annual conference of the Healthcare Information and Management Systems Society.

“The Direct Project was about addressing and transport only,” Ross said. “From the start, the idea was to remove questions of content or consent. Because those are two of the thorniest issues in health care right now, it made the scope of what we’re trying to do narrow enough to actually get it done.”

The manner in which senders and recipients exchange data — whether they have EHRs — is not within Redwood MedNet’s purview.

“Our energies were directed almost entirely to care transitions between facilities that currently use faxes. If we can get hospitals and clinics and physicians to communicate electronically — whether it’s sending a PDF or through EHRs — we will be making significant progress toward meaningful use. This project represented an opportunity to take out the fax machine from the health care equation,” Ross said.

Building on National Exposure

Based in Ukiah, Redwood MedNet serves mostly rural North Coast clients, including community clinics, small hospitals and physicians. But its newly developed expertise may soon have a statewide application.

Ross is proposing to build “an immunization listener” for the statewide organization collecting data on childhood immunizations.

A “listener” is a sort of electronic drop box into which participating organizations can send data in a variety of forms using a variety of electronic delivery methods. The listener’s function is to allow disparate information to be collected, collated and standardized.

California’s Immunization Registry — or CAIR — is a collaboration of state and local systems formerly known as Statewide Immunization Information System. CAIR’s goal is to provide authorized users with comprehensive immunization records for any California child.

Ross Founding Member of Collaborative

Although his is a relatively small company with limited reach, Ross is no stranger to the health IT community in California.

Ross was one of the founding members of the California eHealth Collaborative, an organization formed a year ago to play a part in the creation of a statewide entity to help California’s health care system move into the digital age using federal stimulus funding.

The new organization played a vital role in California’s decision to form Cal eConnect, which is overseeing the development of a statewide system for hospitals, clinics, physicians and other health care providers to communicate with each other in a secure, private, electronic way.

And Ross, through Redwood MedNet, is doing the same.

Efforts of Cal eConnect and individual health information exchanges, such as Redwood MedNet, will help California health care providers meet data exchange criteria to qualify for incentive payments from the federal economic stimulus package. Over the next decade, health data exchange efforts could generate as much as $3 billion — the biggest state allotment of federal stimulus for health IT — for California.

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