Pope Francis’ visit to the U.S. this month will prompt progress on many fronts including, now, international exchange of patient medical information. A long-sought capability for international visitor care and in case of emergencies or crises, this function would permit electronic access to medical records across borders for informed healthcare wherever on the globe an individual needs it.
In preparation for the papal visit, HealthShare Exchange of Southeastern Pennsylvania (HSX) has led a project to open gateways for clinical information transfer with partners in Italy and Canada, using mock patient data. The effort takes advantage of the same technical standards needed to enable this type of information sharing across the state of Pennsylvania and at a national level. HSX is a health information organization — the nonprofit health information exchange (HIE) established by the hospital/health systems and healthcare insurers of the greater Philadelphia/Delaware Valley region. HSX seeks to improve care by making individual clinical information available across health systems not just in its own service area but beyond. The testing that it has accomplished this month for cross-national medical record exchange sets a national lead and establishes precedents for this activity.
Establishing Gateways with Overseas Partners
Due to the number of visitors from Italy and the volume of foreign citizens from Canada in Philadelphia for Pope Francis’ visit, HSX chose these two nations to partner with for advancing the cause of international health information exchange. “In this project, we established forward-looking relationships with entities and vendors key to access of this information in those countries,” says John Donnelly,who, in his role as HSX’s health information technology (IT) architect and domain expert, has led the initiative.
HSX simulated requests for patient information from its member hospitals via its IT vendor, Mirth, directing the requests to Dedalus, a prominent Italian healthcare IT and interoperability vendor, and to Forcare, a health information exchange vendor chosen by Ontario — both of which returned simulated patient health information to be made available to Philadelphia area hospitals.
The testing uses standards accepted across the European Union and those developed for the U.S. by IHE International. In preparation for eventual use of real patient information, the test data will be encoded and encrypted for security, according to industry and national standards. The information will provide a snapshot of each patient’s recent clinical activity, including medication lists, disease conditions and primary diagnoses, as well as allergies and, soon, recent procedures and results of imaging studies –– all of which guide providers in prompter, safer, and more effective and efficient care. “This important project, championed by HSX, has the potential to greatly benefit foreign travelers to the U.S, who may need their medical information available from abroad,” says Leonard Karp, President & CEO of Philadelphia International Medicine.
Martin Lupinetti, Executive Director of HSX, explains, “This was also important for us to do because we are using the same technical approach to pilot bidirectional global exchange with our partners in Rome and Toronto that we will use to connect to other HIEs in Pennsylvania, and to the national eHealth Exchange, over thePennsylvania Patient & Provider Network (P3N).” The need for both routine care and disaster preparedness with international visitors, pointed up by preparations for the Pope’s visit, has helped to drive this initiative.
“These pioneering tests are laying the groundwork for international exchange and real-time access to critical patient information, such as medications, across borders. When visitors and travelers need our emergency care, we will be able to gather needed clinical information globally, to help our physicians provide better, safer, and higher-quality care. It nicely leverages the work already done and the proven success of HSX in exchanging this type of information for the patients we care for locally.” says Don Reed, HSX Board Member and Vice President and CIO, Crozer-Keystone Health System, in Delaware County, Pennsylvania.
HSX looks forward to this activity promoting further international health information exchange, at some point using actual patient data. As with all such sharing of clinical information, member and partner policies (determined by contractual agreements) will dictate the retention/persistence of any patient health information among participating parties. For the testing conducted to date, no real patient data has been used and no data has been saved by any of the receiving parties.