Camden hospitals to create health-records exchange

In a model that could be copied by other cities, the three major health systems serving Camden are joining with local doctors to share health records of patients who give their permission, enabling doctors to give more timely and informed care.

Cooper University Hospital, Our Lady of Lourdes Medical Center, and Virtua Health - normally fierce competitors - plan to join with most primary-care providers in the city of 70,000 to create an exchange giving doctors access to such records as hospital discharge summaries, lab results, medications, and X-rays.

The system, called the Camden Health Information Exchange, is the furthest along of five similar projects in New Jersey, and is expected to be formally announced at a news conference this morning. It could be operating by this winter.

In Camden and elsewhere, the exchange would solve a well-known problem: Doctors often see very sick patients for the first time and have no idea what past treatment they have received.

"With a crowded waiting room and busy staff, it can take a week to collect all of their records from local hospitals," said Jeffrey Brenner, the doctor who has spearheaded the initiative through the Camden Coalition of Healthcare Providers. "This is not acceptable in 2009."

The exchange will cost $210,000 in the first year, and an additional $85,000 for each of the next two years, Brenner said. Coalition projects are funded by hospitals, foundations, and the government.

No similar program exists in Southeastern Pennsylvania, where doctors also struggle with balkanized records. A similar exchange is being spearheaded by the Geisinger Health System in the state's central and northeast regions.

Pennsylvania officials are in the early stages of creating a statewide exchange. The Rendell administration expects to begin its software development by spring or next summer, said Philip Magistro, deputy director of the Governor's Office of Health Care Reform.

Delaware has a working statewide exchange that includes the state's nine hospitals.

In Camden, emergency-room doctors are "very excited about being given a tool that is really long overdue," said Anthony Mazzarelli, medical director of the emergency department at Cooper University Hospital.

"In order to provide the best possible care, every physician at every health system wants as much information as possible," Mazzarelli said. "If you are taking care of a patient who has a complicated health situation and you can't get that data, you are flying blind."

Brenner said the exchange grew out of an initiative to better care for diabetic patients, often some of the heaviest users of the heath-care system.

A citywide database of hospital discharges shows that 13 percent of patients are responsible for 80 percent of the cost, Brenner said.

The exchange hopes to cut those costs by reducing unnecessary tests and helping doctors and others better manage patient care.

Patients would have to give permission before their data could be viewed. Only about 200 doctors and other caregivers would get passwords for the system.

The health data will be collected and made available through Noteworthy Medical Systems of Cleveland. In the initial phase, the exchange would allow providers to see up-to-date information, but not add to it, except through Noteworthy.

"Down the road, it could easily evolve" to allow doctors and hospitals to add data and integrate their electronic health records through the exchange, said Al Campanella, Virtua's chief information officer.

New Jersey Health Commissioner Heather Howard is expected to participate today in the exchange's announcement at 11 a.m. at the Fairview Village Community Center in Camden.

In a statement, she touted the exchange as the "first of its kind in the state," although four other similar efforts are being developed, including one led by AtlantiCare.

All these efforts are being spurred by nearly $49 billion in federal stimulus funds for health-information technology.

Joe Carr, chief information officer at the New Jersey Hospital Association, said the collaboration among competing hospitals and health systems has impressed him.

"This is a once-in-a-lifetime opportunity to really move the ball down field . . . to show not only ourselves, but the public, that we really can improve the quality of care."