Health Information Exchange could lead to more efficient care, but questions over security arise

State officials have announced the creation of the Louisiana Health Information Exchange, an online records exchange linking the state’s health care providers together with the goal of increasing efficiency and care in the health care industry. The funding for the exchange comes from $10.5 million in federal funds from the 2009 Stimulus Bill. However, long-term financing will come from within via subscription rates to the exchange.

The 2009 Stimulus allocated money for states to improve their information technology systems, with the ideal result being enhanced care, readily available patient information, and up-to-speed communication between providers across the state. Governor Jindal selected the non-profit Louisiana Health Care Quality Forum to get the Exchange up and running. In turn, the Forum has contracted with Orion Health to oversee the technological specifics of the Exchange.

In addition to facilitating communication, a technologically advanced exchange will allow hospitals to satisfy mandatory reports to the state in a timelier and cheaper manner than currently exists. Another benefit of this technological advance is that hospitals can gather and generate data at a vastly accelerated rate than in the past, where data frequently was outdated and inaccurate. This will ease the regulatory burden on providers which wastes valuable time and resources.

Currently, only the Lafayette General Medical Center and Opelousas General Health System are officially participating in the exchange, but that will likely change as the Forum is reaching out to the state’s largest providers, such as Ochsner, the LSU system, and the Franciscan Missionaries of Our Lady. For the exchange to be self-sustaining, it would require the participation of these large providers as well as of patients statewide so that the subscriptions are seen as a worthwhile investment. Says Health Secretary Bruce Greenstein, there is “no intention of this becoming a direct appropriation” in the budget.

Serious questions have emerged, however, over the security of online patient records and the violation of privacy which new government regulations constitute. Despite the assurance that it’s “as safe as paying credit cards online,” prospective patients may very well be deterred by the threat of having their records hacked or exposed, which would hurt efforts to attract patients to the Exchange.

An editorial in the Wall Street Journal by Deborah Peel illustrates the serious questions underlying these policies. Under President Bush in 2002, she notes, the Health Insurance Portability and Accountability Act eliminated “the right of a patient to control his most sensitive personal data- from prescriptions to DNA.” Now, the allocation of $36 billion under the Stimulus to developing online records could further jeopardize the sanctity of private information, especially as 45 million health records were stolen, lost, or illegally accessed in the last 5 years.

Another questionable facet of the exchange is that, by the Forum’s own admission, less than 10 percent of the $10.5 million went to launching the program. The rest has been diverted to developing and instituting a Rural Health Information Exchange, which will exist separately to link rural hospitals and providers. This raises the question of how exactly the remainder of the grant money- the majority of it- will be used, as a rural exchange will likely cost less to establish. Whether leftover grant funds will be returned or left to the state’s discretion is a question which should be answered.  

Surely, increasing the capacity of hospitals and providers to communicate between each other and replacing outdated methods of information technology is crucial towards both increasing care and cutting costs.  However, patients and consumers have serious and valid concerns over the safety of their personal information. Whether the benefits of this technology outweigh the potential of encroaching on privacy remains to be seen.