When Tomas Gregorio of the New Jersey Innovation Institute spoke to ROI-NJ last year about his organization’s massive project to connect data across all Garden State hospitals and other health care centers in a statewide exchange, his go-to metaphor was plumbing.
It fit for the time, when there were just rumblings from below about how essential it might be one day to the state’s health care sector. Not long before, NJII had received $1 million in state funding and another $2.7 million in federal funding, a recognition of how huge this invisible information infrastructure could end up being.
Gregorio now goes above-ground when he talks about the project.
Now? Health care data is like the New Jersey Turnpike. Gregorio wants everybody — especially the hospitals that data would drive to and from — to know it’s there.
He’s not the only one.
NJII’s government grant-funded New Jersey Health Information Network got a great deal of help in that recently from New Jersey Commissioner of Health Shereef Elnahal. The commissioner gave a serious nod to the program in mid-January testimony in front of the state Assembly.
Elnahal even went as far as to call the developing network “a pillar of the governor’s vision for an innovation economy.”
The project, which began several years ago, now has a total of $6.6 million in funding from the state health department as part of a four-year agreement. In partnership, the state and NJII — a part of New Jersey Institute of Technology in Newark — are building a platform that will electronically exchange patient data across different health care providers and health information sources.
Currently, according to the commissioner’s testimony, six health information exchanges, about 6,000 physicians, 91 long-term care providers and three federally qualified health centers joined the New Jersey Health Information Network.
Along with that, 62 hospitals agreed to participate — up significantly from the two participating at the same time last year, when the program was being piloted in the Newark region.
“We’re supposed to have all 62 online by May … and we will,” Gregorio said. “When that happens, this exchange — this highway of information — becomes more regional and relevant.”
Gregorio, who serves as senior executive director of the Healthcare Delivery Systems Innovation Lab at NJII, envisions many more hospitals being linked up to the infrastructure that’s being built. But the construction of that highway has its own bumper-to-bumper frustrations.
“There are all sorts of legal barriers — which, quite frankly, have been our nightmare — to move forward,” he said.
It turns out, the technology is the easy part. What’s hard, Gregorio said, are the legal issues surrounding consent to share.
“It’s about who has the right to consent to information being shared, whether it’s being used for treatment or operations and who has access,” he said. “All of those aspects require a lot of negotiations between attorneys and (health care providers) figuring out what insurance requirements they need.”
Gregorio admits that something like a hospital, busy as it can be with its individual priorities, might struggle to see the value in the resources required to connect up to this new network. As he puts it — the Turnpike has a toll booth.
For that reason and others, interoperability across the state has long been limited to various point-to-point connections across providers. But the more institutions that join NJII’s network and start moving information through it, the more it becomes in the best interest for others to join.
That’s where Elnahal comes in: He’s doing a lot to convince state leaders in health care that the network is needed. It can improve safety, reduce medical errors and duplicative testing, he says. To that last point — Gregorio expects that hospitals could reduce blood panels or other unnecessary testing due to the network’s connectivity. Part of the argument for a larger adoption is that hospitals might be able to leverage the network to reduce operating expenses.
Above all, the data can be life-saving. In his testimony, Elnahal spoke to why that’s true.
“Say you have a medical emergency and you are rushed into the emergency department unconscious — providers won’t be able to take your full medical history,” he said. “However, if the hospital is connected to other providers through the network, they will have the critical health information they need to treat you. Therefore, if a provider attempts to order a medication that you should not receive, an allergy alert pops up and anaphylactic shock is avoided.”
Gregorio, other NJII leaders such as Thomas Bartiromo and John Novak, and their state partners have argued that an improved system of information sharing may help coordinate efforts involving the opioid crisis by better communicating data about substances associated with abuse across different providers.
If the implementation of the network goes smoothly, the benefits of its expansion over the next few years could start to be noticed by those being treated in hospitals or other facilities. Less filling out of the same doctor office forms would be a good start, Gregorio said.
“Because it’s a very interesting time: The consumer aspect of health care is becoming more like Amazon or Uber all the time — it’s all driven by consumers, and making it as express as it can be,” Gregorio said. “So, to keep up with that — to make it kind of like the EZ Pass on the highway — we have a lot of work to do.”
And the wheels are turning.
“We’ve started to be able to get our hands around the topic of barriers to implementation, so I’m very excited,” Gregorio said. “I’m happy with the progress we’ve made; and we’ll continue to make a lot more.”
Reach Tomas Gregorio of NJII at: firstname.lastname@example.org or 973-596-5857.
Reach the New Jersey Innovation Institute at: email@example.com or 973-596-5800.