Imagine the following scenario: It's 3:00am, and you're in a serious automobile accident. You arrive at the local trauma center—alone, unconscious, and in critical condition. During the "golden hour" after the accident, the trauma staff want to assure you aren't allergic to the drug they are about to give you, or that it doesn't interact dangerously with prescription drugs you are taking for an unrelated condition. So the nurse types your information into the trauma center's electronic medical record system, and the search returns zero results, because your prescriptions were written by a different provider and filled in another city, county, or state. Without a complete picture of your health and medication history, will the drugs given to you in the trauma center help you—or cause irreversible harm?

In the real world, the above scenario—injured and treated in one location, medical records somewhere else—plays out in trauma centers, emergency rooms, and doctors' offices everywhere, every day. In situations such as these, there is no link between the health information collected during the current episode and older information that is electronically stored in one or more remote locations.

To assure better, safer care for all, disparate players in the healthcare system—such as hospitals, doctors, and pharmacies—must be able to quickly and securely find, understand, and act on your medical information.

This is done through what is known as electronic health information exchange. In Pennsylvania, such connections are enabled by the Pennsylvania Patient and Provider Network, or P3N, a service of the Pennsylvania eHealth Partnership Authority.

How does it work? Individual healthcare providers connect to a health information organization (HIO), which in turn connects to the P3N hub across which information flows to other HIOs and their participating healthcare providers. In the Philadelphia region, HIO services are provided by HealthShare Exchange of Southeastern Pennsylvania (HSX). HSX is expected to connect to the statewide P3N by the end of the year.

The Pennsylvania eHealth Partnership Authority is working with HIOs to bring to fruition the promise of true statewide electronic health information exchange. St. Luke's University Health Network's eVantageHealth HIO connected to the P3N last year, and HIOs in central and western Pennsylvania are expected to connect by the end of the year. The Authority also is pursuing interstate connections, which is particularly important for people who live and work in or near the Delaware Valley.

Why is electronic health information exchange so important? Well, we know from numerous studies that the United States ranks at the top worldwide in per capita healthcare spending, but improvement is needed in terms of healthcare outcomes.

Electronic health information exchange will help move the needle in the other direction—to restrain the growth in healthcare spending, without rationing care—while also improving the quality of care. Electronic health information exchange has been proven to increase the speed and accuracy of diagnosis for individuals and populations; reduce readmissions and redundant tests; and increase patient satisfaction by reducing the time spent in the healthcare system and reducing frustrating duplication.

For electronic health information exchange to achieve intended benefits, it is crucial that the P3N be as robust a network as possible, with maximum participation from doctors, hospitals, pharmacies, and others in the healthcare system. The next time you visit your family physician, ask, "Are your electronic medical records connected to a regional health information exchange or the statewide network?" If the answer is "yes," thank your doctor. If the answer is "no," encourage your doctor to learn more. As your first hour in the trauma center draws to a close, it could mean the difference between life and death.

In a future blog post, I will discuss concerns about HIOs and answer some common questions.


Alexandra Goss is executive director of the Pennsylvania eHealth Partnership Authority.


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