Santa Cruz HIE succeeds by serving as 'telephone system' for patient data

Believe it or not, there's a health information exchange that's been in business since 1995. It's a "virtual clinical network" in Santa Cruz, Calif., that links a large IPA, the Physicians Medical Group of Santa Cruz County, with hospitals, laboratories, imaging centers, safety-net clinics, county health clinics and an estimated 80 percent of the physicians in the HIE's service area.

"In 1993, I was medical director of our IPA and we had so much administrative money left that we decided to use it for connectivity and electronic medical records. We took the email model for business and made a business decision to tie all the docs and providers together," Dr. Robert Keet tells Healthcare Informatics.

Keet got Axolotl--a company where he now informally serves as CMO--to build software to connect his practice, Dominican Medical Foundation, with labs, radiology practices, and affiliated hospitals. "All the providers agreed to build the network, pay for it and become data suppliers," Keet says. "In 1995 we went live and started getting all the data delivered. Over the years it grew. In 1999 we added prescription writing. It grew to add automation. So people began to use EMRs."

And yet Keet isn't sold on the idea of EMRs. "I'm not an EMR fan, because the EMR and its tools tend to create silos," he says. "We need a whole new nomenclature, because the ability to get the data will depend on the interoperability of the network. What you're seeing in the HIE is that some people view it as an EMR, and it meets meaningful use." He believes that every physician participating in the Santa Cruz HIE meets most, if not all, of the proposed standards for meaningful use.

"HIEs are like the telephone system," Keet explains. "EMRs are these big fancy things you attach to them. It's all going toward electronic data exchange management."

To learn more:
- take a look at this Healthcare Informatics story