Chris Belmont

Ochsner Health System has launched a health information exchange (HIE) that will allow physicians regionwide, whether affiliated with the organization or not, to access patient records.

Ochsner has eight hospitals and 35 clinics and employs more than 750 doctors.

But Ochsner wanted physicians who were neither affiliated nor employed by the system to be able to see what was going on with their patients who had been admitted to Ochsner facilities, said Chris Belmont, Ochsner chief information officer and system vice president.

“The complaint we got was, ‘I send the patient to Ochsner, and we (Ochsner) kind of lose them,’” Belmont said.

It’s not that Ochsner doesn’t give the patient back, he said, it’s just that the physicians don’t understand what happens inside the health system.

The Orion Health HIE is giving Ochsner a way to provide that information, Belmont said. The exchange also allows doctors to choose how they want to be notified of updates in their patients’ status.

Belmont said he wanted to free physicians from having to go through Ochsner’s information systems department to find out what was going on with a patient.

“We wanted the user to be in control of how much information they get from us,” Belmont said.

The Orion system allows physicians to choose what sort of notifications they receive, Belmont said. A notification might be that the doctor’s patient has been admitted to an Ochsner emergency room or that a lab result is now available.

In addition to choosing the types of notifications, the physician can pick how he or she wants the information delivered, Belmont said. The doctor can tell Ochsner’s HIE to send the notice by mail, a secure e-mail, by fax or even through the physician’s electronic medical record system.

Say the physician wants an e-mail alert, Belmont said. A message arrives in the doctor’s personal e-mail saying a patient that he referred or that he is associated with has been admitted to the Ochsner emergency department.

No patient information is exposed in the e-mail, Belmont said. But the message includes a link to the portal; by clicking on it, the physician is taken right to the sign-on page and from there to the patient information.

If a physician’s fax number or e-mail address changes, the doctor can go into the Ochsner portal and amend that information, Belmont said. The doctors don’t have to call the help desk and wait 24 hours for someone in information systems to make the change.

And if a physician is out of town and wants the fax or e-mail to go to a partner, the physician can enter that information, too, Belmont said.

Ochsner invested approximately $1 million to license and implement the portal, Belmont said.

Initially, Ochsner’s HIE is focusing on lab results, meds and radiation exams, Belmont said. Ochsner has added a few other things, such as a link to the system’s document imaging system.

Physicians can view the legal medical records as well as the patient’s face sheet, Belmont said. Ochsner also added a link to its picture archiving and communication system, or PACS.

One benefit of the Orion system is that it had a nice, Web-based viewer that displays the image and its interpretation on the same screen, Belmont said. Ochsner’s PACS viewer didn’t have that capability.

Belmont is quick to add that Ochsner’s HIE is a work in progress.

“It’s not in its perfect state,” he said. “There are still some pieces we want to add in future phases, but rather than wait and get everything, we thought it was important that we get something out there right away to our community physicians.”

This is Ochsner’s second attempt at establishing a health information exchange.

In 2008, Ochsner contracted with Carefx Corp. for a system that was supposed to allow up to 15,000 users to get a detailed and unified view of patient data from multiple clinical sources.

Although Belmont was careful not to name the system, he described Ochsner’s first effort as “kind of a false start.”

The system, he said, didn’t work quite as planned.

However, Ochsner learned some important lessons through that work, Belmont said. One of them was aggregating patient information into a data repository instead of trying to hit all the different hospitals and clinics and hoping to get all the records.

“That from the beginning, scared me to death,” Belmont said. “My experience tells me that partial information is worse than no information.”

Belmont said Orion’s staging database aggregates the data, which eliminates that worry.

So far, Ochsner’s HIE only has a few dozen users, Belmont said, but he expects that number will grow over time.

Ochsner has not really marketed the Orion product because of the problems with the first exchange, Belmont said. Ochsner is now in the process of letting physicians know that the HIE exists.

Belmont said Ochsner views the Orion product as a bridge until the health system can get its electronic medical record out into physician practices.

“At that point the exchange is really seamless because it’s all about the patient record and not about whether it’s an Ochsner record or a physician practice record,” Belmont said.

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