Regional HealthShare Exchange To Improve Quality, Lower Costs

HealthShare Exchange is being funded by more than 90 percent of the acute care hospitals in the Philadelphia region, the area’s largest health insurer Independence Blue Cross (IBC), AmeriHealth Caritas, one of the nation’s leaders in health care solutions for the underserved, Health Partners, a Philadelphia-based, not-for-profit health plan owned by a group of local hospitals, and state and federal grants.

“HealthShare Exchange represents a significant opportunity to produce meaningful benefits for our entire health care system,” said Martin Lupinetti, HealthShare Exchange’s Acting Executive Director. “Because our region has no dominant health system and a large concentration of systems in the region, the investment in this exchange has the potential for significant return on investment.”

While doctors and hospitals have made great strides in developing electronic health records, HealthShare Exchange goes a step beyond that, providing a way for health systems to communicate more efficiently with each other,” said Karen Thomas, Main Line Health’s Chief Information Officer and Vice Chair of HealthShare Exchange. “The transfer of vital patient information between hospitals and primary care physicians will greatly improve transitions of care as patients may seek services at different health systems during a given period of time.”

According to an analysis of claims data by IBC, up to 50 percent of patients that require a hospital readmission within 30 days of discharge return to hospitals other than those where the patient was first treated. More often than not, the treating providers do not receive a timely discharge report as hospitals often do not know all of the treating physicians.

“Lack of information about hospital stays and ER visits can hamper primary care physicians’ ability to provide the most effective follow-up care for their patients,” said Dr. Richard Snyder, Chief Medical Officer at IBC and Chair of the HealthShare Exchange Board of Trustees. “Comprehensive patient care information will help doctors make more informed decisions that lead to higher quality care.”

HealthShare Exchange will begin by providing two important clinical service areas focused on improving quality of care and reducing healthcare costs in the region:

  • Sending timely discharge information to all treating physicians and other care coordination team members. This will improve the transition of care from hospitals by “pushing” information from the hospital to the patient’s providers that could include primary care physicians, specialists and other care coordination team members within a few hours of a patient’s discharge. Today, many primary care physicians only learn of a discharge when the patient calls for a follow-up appointment, if the patient calls.
  • Delivering clinical activity and medication history to physicians, hospitals, and other care providers on demand at the point of care. This will improve care and reduce medication errors by making timely and accurate patient clinical activity and medication history available to authorized providers.

“What makes our region’s exchange unique is the collaboration among hospitals and insurers, which was the basis for how this exchange began,” added Lupinetti. “Insurers provide added information that hospitals don’t have such as all the doctors a patient sees, medications, and tests. This collaboration will be even more important in the future as the need to control health costs increases.”