Massachusetts HIway demo

Mass HIway lets health providers easily swap medical records

Healthcare providers across Massachusetts can now locate, request and retrieve medical records from other providers on a secure, interconnected system and with a click of a button, according to state officials.

In January, Gov. Deval Patrick launched the next phase of the Massachusetts Health Information Highway (Mass HIway), joining health care leaders at Beth Israel Deaconess Medical Center (BIDMC) to demonstrate the new technology in a simulated medical setting.  In the scenario, doctors worked to help an unresponsive patient by retrieving the patient’s health information from other, separate health care organizations in real- time and treating the case with greater speed and safety.

The statewide health information exchange, launched in October 2012, is a collaboration between the Massachusetts Executive Office of Health and Human Services and the Massachusetts eHeatlh Institute.  Massachusetts was the first state in the nation to receive federal funding through the Center for Medicare & Medicaid Services to develop the exchange, leveraging up to $22.3 million in funds, state officials said.

The first phase of the project allowed health care providers to push information out to each other.  Now providers and other organizations can request and receive patient information in a query-based exchange.

At last month’s event, emergency department clinicians at BIDMC using the Mass HIway  discovered the patient had medical records at Atrius Health, Holyoke Medical Center and Tufts Medical Center. Doctors used the Mass HIway to request and retrieve these records. By having a comprehensive medical history on the patient, the care team avoided drug-to-drug and allergic reactions, duplicative testing and delayed diagnosis. 

Massachusetts has taken an ‘opt in’ approach to the Mass HIway, meaning patients must provide consent to their health care organization to publish their relationships to the health exchange. Most organizations have experience obtaining patient consent to release medical information, using fax, mail or flash drives.   But officials have enhanced Mass HIway with additional security measures. Those include “message encryption end to end so messages can only be read by the intended recipient, built-in audit logs to track users who have accessed a patient’s relationship list and user authentication through unique IDs and strong passwords,” said Manu Tandon, secretariat CIO at Massachusetts’ Executive Office of Health and Human Services, in an interview with Health IT Connect. 

The Mass HIway does not store any personal health information. Storage of health records remains with the patient’s institution, Tandon said.  Additionally, all participating organizations using the exchange must sign an agreement to comply with all security and privacy requirements required by law.  Plus, patients can also speak with their health care providers to discuss security measures in place at the site level, Tandon said in the interview.

Mass HIway also helps health care providers measure and report clinical quality measures, which can be used by MassHealth and private insurers as part of new bundled payment approaches to compensating healthcare providers, state officials said.

The Mass HIway has also been extended to let clinicians electronically submit required information to the Massachusetts Department of Public Health directly from their electronic health record systems. Submissions include immunization data, cancer case information, and other material required to further the goals of monitoring and improving public health.

Currently, the HIway offers four connection methods. The state’s goal is to connect all providers, so connection options are designed to account for varying technical capabilities and resources among the organizations. In some cases, the requirements can be as simple as a Web browser and Internet connection.  Healthcare organizations are currently not required to connect to the HIway. However, Massachusetts law requires all organizations to connect to by 2017.

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