As the largest medical center in the world, the Texas Medical Center is a city within a city. TMC’s 7.2 million patient visits per year far outstrip the population of the entire greater Houston area. This bustling medical metropolis represents a world of possibility, but coordinating vast numbers of patients and the often-lengthy medical records that accompany them can be daunting. Since its creation in 2010, Greater Houston Healthconnect has been committed to making patients’ health information available to caregivers wherever they are seeking care.
Healthconnect is a network of electronic health records, known as a health information exchange (HIE). It links providers not just in the medical center but in 20 counties throughout Southeast Texas, with networks across the state and around the country. The nonprofit organization is entering 2015 under new leadership: in October, Nick Bonvino was named chief executive officer. Bonvino is new to Healthconnect, Texas’ largest HIE, but he is familiar with the world of health IT. He has been an advocate of HIEs for years and spent the last decade starting and operating HIEs throughout the U.S.
“I began my career as a semiconductor engineer for IBM. Engineers solve problems, and I saw the HIE space as a critical problem to be solved,” said Bonvino. “In terms of the Houston market, there’s not anything unique other than size, so the challenge really is scale. I don’t see that as an obstacle, but an opportunity to make a greater impact and to deliver more value.”
HIEs offer increased quality of care, efficiency, and patient safety by giving a caregiver access to all of their patients’ medical records. Those records include diagnosis history and test results, active medications and allergies—all the vital information to ensure a patient receives the best care. HIEs can also cut costs by eliminating duplicate or unnecessary medical tests, for example, because each provider a patient sees would have access to previous test results.
“Providers need a 360-degree view of the patient,” said Bonvino, “and the only way that can happen is if all providers are connected, communicate and collaborate.”
Healthconnect’s service begins with an event, such as a patient checking in at his or her doctor’s front desk or registering at a hospital or emergency care. This can generate an automatic query to Healthconnect.
“What we do then is make sure the patient has given their informed consent to share their health information,” said Bonvino. “Once the patient is matched and the consent is confirmed, we go out to all connected caregivers and pull that patient’s information, aggregate it, and present it back to the requesting provider integrated with their electronic health record system.”
Currently Healthconnect has about 35 percent participation among hospitals in its service area and 38 percent among physicians. Major participating providers in the Texas Medical Center include Houston Methodist Hospital, Texas Children’s Hospital, Harris Health System, MD Anderson, Baylor College of Medicine, and UT Physicians, as well as outside entities that refer patients into the TMC. As CEO, Bonvino hopes to expand those numbers. Projected engagement by 2017 is 80 hospitals and 7,000 physicians.
“A great job has been done up to this point. We need to continue that progress, and that is exactly our goal,” Bonvino said. “To connect every venue of care throughout our community.”
In addition to expanding its member base, Bonvino said the organization is expanding offerings to members. To that end, Healthconnect recently rolled out a new diagnostic imaging exchange service, which means participating providers can now share CT scans, MRIs, and other images.
The increased drive to make medical records more easily accessible through electronic health records can be traced all the way to the White House. In a 2004 State of the Union address, President George W. Bush outlined a plan to make electronic health records more available to American patients.
“By computerizing health records,” Bush said, “We can avoid dangerous medical mistakes, reduce costs, and improve care.”
Medicare and Medicaid have put this directive into action by offering incentive programs for providers making meaningful use of electronic health records. For Healthconnect, success is not measured in dollars.
“This is not a moneymaking endeavor. We’re a nonprofit,” Bonvino said. “Our governance allows us to serve the community in an unbiased way, representing all stakeholders— large and small hospitals, small and large practices, pharmacies, laboratories, imaging centers, all the venues of care.”
Connecting all providers in the greater Houston area, from the massive hospitals in the medical center to small family practices, Bonvino said, is integral to providing patients with the best quality of care.
“The medical industry is very large, and Houston attracts patients not just from across the U.S. but from around the world,” he added. “You can’t collaborate in paper form very well. Once patient health information is digitized and we have these connections, then surely we can go anywhere.”