Health-care IT: Indiana offers a national model for electronic information exchanges

One of the main stumbling blocks behind electronic health record system adoption is interoperability. Where is the incentive for the doctor to go through the arduous and costly process of installing an EHR system if it can’t communicate with other hospitals or clinics?

A large portion of physicians in Indiana, however, always know about their patient’s tests and treatments in hospitals thanks to a statewide electronic messaging service, which is being called a model for the nation. The Docs4Docs service is an independent, community-based network where test results and other clinical information from hospitals are delivered to physicians and medical providers. The hospitals pay a small transactional fee to send the results to the doctors, who can view results for free.

Until last year, the 10,000 physicians mainly across central Indiana who were connected to the Docs4Docs service just used the web to send and receive about 1.4 million messages each month, according to the Indiana Health Information Exchange, the nonprofit group which operates Docs4Docs. This year, 165 doctors in 52 practices can receive the Docs4Docs service directly to their practice’s EHR system. The IHIE anticipates more practices will connect as EHR systems become more prevalent, says a spokesperson.  Other states are looking to Indiana as a model for regional cooperation.

“Building infrastructure is becoming a key objective for states as well, with many facilitating the creation of regional health information organizations similar to Indiana’s,” wrote Sean Slone, a health policy analyst, in a report last year for The Council of State Governments. “It is hoped these organizations will become the foundation of a national health information network.”

Docs4Docs was developed by Indiana University School of Medicine researcher-clinicians at the Regenstrief Institute. Regenstrief investigators have been working with EHR systems since 1972, says internist Paul Dexter, MD, a Regenstrief research scientist and Indiana University School of Medicine associate professor of clinical medicine.

The Docs4Docs network, as well as the state’s information exchange, is funded primarily through public and private grants.