Arlington’s Surescripts looks to share health information over ‘the last mile’

August 18, 2013

Over the past few years, the health-care industry has been moving toward a digital age, starting with a transition from paper charts to electronic health records.

That first step is well underway, but analysts say the next phase, actually sharing those digital files between doctors or between insurers and hospitals, is just getting started as technology firms step in to complete what some call “the last mile of connectivity” for health-care providers.

One local company has begun to lay the groundwork for that next step — but on a scale some experts say the industry may not be ready for just yet.

Surescripts, an Arlington firm that operates a data network for physicians to send prescriptions and medical records electronically, last week announced the largest-ever expansion of its network, adding 19 new state and regional health-information groups from across the country as part of a broader effort by the company to build a nationwide data hub for health-care professionals.

Many of those new clients are consortiums of hospitals and insurers, known as health-
information exchanges, that sprouted up in the last few years to improve the way the players in their local health systems share information. Most were born out of a law signed in 2009, which authorized the federal government to spend about $25 billion on grants and other incentives to encourage health-care groups to start digitizing patient records and, later, to start sharing them electronically.

“There was all this government money that went out to put fancy electronic records in doctors’ offices and wires in the ground, but we’re at the point where that stimulus funding is running out, and you have this space to do the last mile of connectivity, to plug it all into the wall and start sharing those records,” John Kelly, one of the original architects of the health-information exchange in Massachusetts, said in an interview.

Some health-information exchanges have started tackling that step among their own hospitals and physicians, said Kelly, now a principal business adviser at Edifecs, a health-care technology firm based in Bellevue, Wash. However, the more difficult challenge, and the one Surescripts is trying to address, is sending those files from one region’s health system to that of another.

“All of this information is now automated and computerized, but the problem we see is that physicians and hospital systems in different areas can’t communicate with each other,” Surescripts chief executive Harry Totonis said in an interview.

Retooling the network

Originally focused on helping doctors send prescriptions electronically, Surescripts started retooling its existing network a few years ago, anticipating demand for a national record-sharing service for health information.

It would function much like a wireless Internet service but be specifically tailored for doctors, pharmacists and other health professionals, he said.

“Instead of each regional network trying to build connections to every other one, we are enabling them to just build one connection to us, and we process and deliver the information where it needs to go,” Totonis said.

In the three years since the company started branching out beyond prescriptions, it has grown from 100 employees to 450.

One of Surescript’s new additions is the Maryland health-
information exchange, called the Chesapeake Regional Information System for Our Patients (CRISP), a nonprofit collaboration between several of the state’s insurance providers, public-health groups and hospitals, including Johns Hopkins, MedStar and the University of Maryland Medical System.

CRISP recently started implementing a new electronic messaging system that allows physicians across the state to communicate more quickly and securely.

Jesse Sadikman, who works in a small primary-care practice in Germantown, said the new technology, coupled with an electronic records system his team installed six years ago, is saving his office time and improving the quality of care his team delivers.

“We can quickly gain access to important information, whereas before, we would have to call the hospital, get patients to sign a release, get the hospital to fax these records to our office,” he said. “This makes us much more efficient, more thorough.”

A similar electronic communication system recently was installed in the District; however, the two regions are using two different technologies, and “it takes some extra work” to send messages between the two systems, CRISP President David Horrocks said.

“What Surescripts is doing is establishing a large trust partnership between all these different regions so we can all communicate,” Horrocks said in an interview.

A more immediate concern

Still, linking up with outside networks is a “down-the-road” concern, he said. Right now, his team’s top priority is connecting all the health-care providers in Maryland.

“It would be great to get that communication working between regions, but most of what needs to happen is between providers who are close together, and getting that working has been hard enough,” Horrocks said. “Our focus is making this work locally.”

Sadikman agreed that statewide interactions should take precedence, but he said building a larger network is “a critical next piece of the puzzle.”

“Our patients go to Georgetown, go to the beach in Delaware, and some of them spend half the year in Florida,” he said. “Eventually, we all need to be able to communicate.”

That is the long-term plan, according to Totonis. But his firm is not the only one jockeying for that role. Kelly said there are a number of competitors trying to build information-sharing webs, each using different technology.

“There are probably a hundred different flavors, and everybody is betting on their own flavor,” he said. “It’s probably going to mirror the way e-mail and the Web rolled out, when people initially had to connect a lot of pieces together, and nowadays, you just go out and buy a computer, plug it into the wall, and bang, you’re connected. We’re just not there yet.”

Follow On Small Business and J.D. Harrison .

J.D. Harrison covers startups, small business and entrepreneurship, with a focus on public policy, and he runs the On Small Business blog.
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