Better Health Through Information Technology

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• Better Health Through Information Technology
• March 21, 2003
• David J. Brailer, M.D., Ph.D.
• Chief Executive Officer, CareScience
• Principal Investigator, Clinical Data Sharing
  Project

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Health Consumers are Mobile, but Their Clinical
Information is Not
Consumers use different physicians and
providers, depending on needs
Physicians need all of a patients data, but
rarely can get it from others
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Clinical Data Islands UnderlieMany Quality of
Care Problems

• 1 in 10 tests were ordered on the same patient by
  more than one physician
• 1 in 4 prescriptions taken by a patient were not
  known by the treating physician
• 1 in 7 admissions resulted from missing
  ambulatory information
• 1 in 5 lab and xray tests were ordered because
  originals could not be found

Santa Barbara County Care Data Exchange
Feasibility Study. 1998.
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The Santa Barbara CountyCare Data Exchange
(SBCCDE)

• Formed in 1998 by regional health care
  organizations and physicians
• Aimed at improving the health status of all Santa
  Barbara County residents
• Endorsed by the LeapFrog Group as a desired means
  of improving quality
• Americas best-known example of a data exchange
  platform for patient information

Fostering Rapid Advances in Health Care.
Institute of Medicine. November 2002.
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What is the Santa Barbara County Care Data
Exchange?

• A regional public-private partnership
• A secure data sharing utility
• A cost-effective way to improve quality
• A replicable model for other regions

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A Public-Private Partnership Among Competitors
Leads the SBCCDE

• Sansum - Santa Barbara Medical Foundation Clinic
• Catholic Health Care West Marion Medical Center
• The Santa Barbara Regional Health Authority
• The County Public Health Department
• Santa Barbara Medical Society
• The Lompoc Valley Hospital
• Cottage Health System
• Pueblo Radiology
• MidCoast IPA
• UNILAB
• UCSB
• VHA

gt75 of care delivery in Santa Barbara County
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SBCCDE Technology Secure Data Access Without
Central Data Storage
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The SBCCDE Pays for Itself and Improves Quality
and Service
Quantifiable Benefits

• Lab savings
• Lower cost of lab results delivery
• Less staff time spent handling lab test results
• Radiology savings
• Lower cost of radiology results delivery
• Less staff time spent handling radiology results
• Less time spent fulfilling external requests for
  information
• Payor transaction costs

Connecting any one constituent
Value to constituents

• Fewer admissions from the ED
• Fewer readmissions
• Fewer medical errors
• Fewer readmissions
• Shortened hospital length of stay
• Enhanced revenue from proper coding
• Test duplication avoidance
• Staff saving- less time spent requesting
  information
• Payor transaction costs

Networking multiple constituents
California Healthcare Foundation analysis. 2002.
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Lessons from the SBCCDE for Other Regions in the
U.S.

• Competitors need a third party enabler to begin
  collaboration (hence, the utility)
• Loosely coupled technology (forgiving to a
  variety of data formats) is a requirement
• Focus on getting information to physicians and
  consumers
• Clinical data sharing accelerates enterprise
  adoption of EMRs and CPOEs
• Clarification of certain legal barriers will
  advance regional interoperability

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