Healthcare Collaboration in Whatcom County—HInet

The Community Health Information Network is alive and well in Whatcom County. The timing of events leading up to HInet include the 1990 – Vision of Seamless Care and the 1994 Whatcom Integrated Delivery System (Community Health Improvement Consortium). In 1995, St. Joseph Hospital went “live” (computer-wise) with its Community Health Record and in 1996, the Whatcom Health Information Network (HInet Program) was established. I wish to thank Lori Nichols, Director of Whatcom Health Information Network (HInet) for her assistance in providing information (via personal interview and use of her PowerPoint information).

What is HInet? HInet is a private intranet connecting health professionals and patients in Whatcom County. Currently, this private self sustaining Health Information Intranet includes: 180 thousand citizens, one hospital (St. Joseph Hospital), 400 physicians (99% of total physician population in Whatcom), all nine skilled nursing facilities, Community Mental Health, Medic One, the Medical Society, and Home Health. There are over 100 locations with over 2700 personal computers and over 2500 network users. HInet connects to St. Joseph Hospital’s network. Any provider in Whatcom County can be on the network. Since it costs approximately one million dollars each year to provide services and to operate, providers are assessed a fee to connect to the system. Various practices use their own electronic systems (e.g., Family Care Network and Madrona use their own systems for their providers). HInet encompasses the following:

• Hospital online robust installation of GE Carecast EMR is accessible to all physicians

• Labs and images can be obtained online

• Specialty practices (Gastroenterology, vascular labs, nephrology [kidneys], and surgery centers can import notes

• E-mail - internet access – virus & spam protection; Helpdesk phone and onsite service

• LAN consulting and implementation

• Medical reference resources online include: Micromedex; MD Consult; Medical Journals, databases, etc in electronic library; Krames Patient Education Materials; Zynx Evidence

• 40+ doc family practice using Logician EMR

• 70+ doc multi-specialty group implementing Better Health Record EMR

• Integration of practice EMRs with Hospital record & PHR

• 1200+ Shared Care Plans, Personal Health Record in use

What patient information is included and how secure is it? Practices and the hospital use their electronic medical record systems to document your care, and to support their billing records. There is a record that is designed for patients to keep track of their own information. The fact that we have a private network adds another layer of security onto already rigorous policies and procedures regarding role based access to medical information. All users undergo training about confidentiality and sign confidentiality agreements annually to ensure ongoing awareness of the need for careful and appropriate access. Electronic Health information systems actually afford a higher degree of security owing to the ‘fingerprints’ left by users viewing of the information. Access to records is routinely audited according to specific parameters, and is also audited ‘for cause’ if a breach is suspected. The Shared Care Plan Personal Health Record logs all access, and is a secure site with all transmissions encrypted. You can see the audit trail of access to your Shared Care Plan and control who has access to it. What is the Shared Care Plan? It is “a free, easy-to-use, personal health record that lets you organize and store vital health information.” “It can help you manage chronic conditions, coordinate the care of others, and improve your health” (www.SharedCare Plan.org). “Whatcom County is also working to integrate their Shared Care Plan with the Microsoft Health Vault Platform which will enable devices like glucometers, heart monitors and scales to populate one’s personal Health Record and Health Vault account. It will also simplify the process of connecting health information systems” (Lori Nichols, Seattle Mayor's Senior Newsletter, Feb 08).

How can a consumer find out about his/her own medical record? Patients can request access to their own records housed in clinic or hospital archives by completing a Request for Release form and sending it to their Medical Records Person or Health Information Management Department. Assistance with the Shared Care Plan Personal Health Record can be obtained at the Chestnut Building Lower Level where there is a small library and computers available for patient use in the Shared Care Plan Office.