Chats on Change: Creating a Successful Health Information Exchange

Chats on Change: Creating a Successful Health Information Exchange

Event Date: 
Tuesday, December 3, 2013

Thank you for participating in the Chat on Change held December 3, 2013. During the TweetChat, we were joined by Randy Farmer, Chief Operating Officer for the Delaware Health Information Network (DHIN).

The Delaware Health Information Network (DHIN) was created by the Delaware General Assembly in 1997 as a public–private partnership for the benefit of all citizens of Delaware, to establish a statewide health information network and address Delaware's needs for timely, reliable, and relevant health care information. In 2005, DHIN received funding from the Agency for Healthcare Research and Quality (AHRQ) as one of six AHRQ-sponsored State and Regional health information exchange (HIE) demonstration projects. The network went live in May 2007, becoming the first statewide health information exchange in the Nation.

During the last 2 years, DHIN has accomplished several health information exchange “firsts,” including being the first to enroll 100 percent of acute care hospitals in the State; the first to enroll out-of-state hospitals to participate in the State's health information exchange; and the first to achieve full financial self-sustainability. With all of Delaware acute care hospitals and nearly 100 percent of providers now participating, DHIN is sharing real-time clinical information to improve patient outcomes, eliminating the duplication of service and reducing the cost of health care.




Randy Farmer, MS, MEd

Chief Operating Officer

Delaware Health Information Network

Randy Farmer joined the Delaware Health Information Network in 2011 as Director of Provider Relations. In October 2013, Mr. Farmer was promoted to the role of chief operating officer. As DHIN’s COO, Mr. Farmer is responsible for all customer-facing aspects of the organization, specifically in the areas of new business strategies, marketing, brand development, operational support, and customer service. The core role of DHIN’s COO is to protect DHIN’s Center of Excellence, which is defined as the preferred electronic delivery mechanism for medical results and the community health record of Delaware.

Mr. Farmer joined DHIN after a decade at JP Morgan Chase in Wilmington, where he served most recently as Senior Segment Manager of Strategic Partnerships. He also served as Senior Communication and Public Affairs Manager during his 10 years at Chase. Prior to working in financial services, Mr. Farmer served as the Director of Student Development at Villanova University. He earned a master of science in human organization science at Villanova, a master of education in higher education administration, and a bachelor’s degree in communication from the University of Delaware.


DHIN_HIE: Our TweetChat on Successful Health Information Exchanges is starting in 10 minutes. Please join the discussion! #AHRQIX
AHRQIX: Our Tweet Chat on the Delaware Health Information Network with COO Randy Farmer of @DHIN_HIE is about to begin! #AHRQIX
AHRQIX: We're using #AHRQIX for the chat. Please include it in your tweets
AHRQIX: If you have a question and want to tweet during the chat, be sure your tweets are not protected. #AHRQIX
AHRQIX: We may collect, save, & post transcripts from our chats on our Web site. See our privacy policy at #AHRQIX
AHRQIX: .@DHIN_HIE will be tweeting along with us, so please follow the stream of tweets at #AHRQIX
AHRQIX: If you're having problems viewing the Twubs site, you can also follow the live stream by searching on Twitter for #AHRQIX. #AHRQIX
AHRQIX: This chat will focus on creating successful health information exchanges & @DHIN_HIE. Please be respectful of others during the chat #AHRQIX
AHRQIX: Here we go! Welcome to our TweetChat on the Delaware Health Information Network! I'm Nicole & I'll be moderating the chat. #AHRQIX
AHRQIX: I'm pleased to be joined by Randy Farmer of @DHIN_HIE today! #AHRQIX
AHRQIX: Mr. Farmer is the COO of Delaware Health Information Network @DHIN_HIE. #AHRQIX
AHRQIX: If you're joining us today, let us know what state you're from – we may have information on programs in your area! #AHRQIX
AHRQIX: Please note the Innovations Exchange does not provide advice on health-related issues or experiences. #AHRQIX
AHRQIX: We'll ask/answer Qs w/ @DHIN_HIE & participants, as well as share resources on health information exchanges. #AHRQIX
AHRQIX: Let's get started – Mr. Farmer, what is the Delaware Health Information Network? #AHRQIX
DHIN_HIE: DHIN is like an electronic post office, delivering medical results/reports to our users in the healthcare community. #AHRQIX
DHIN_HIE: DHIN is the first & most mature statewide health information exchange (HIE) in the nation. #AHRQIX
DHIN_HIE: We launched in 2007 and provide electronic, secure, results delivery and patient query functionality. #AHRQIX
DHIN_HIE: For more info visit #AHRQIX
AHRQIX: Tell me about who has access to DHIN. #AHRQIX
DHIN_HIE: 7,000+ users in the state are enrolled, including doctors (MDs, DOs, PAs, etc) and their staff, such as Medical Assistants. #AHRQIX
DHIN_HIE: Almost 100% of Delaware physicians which make orders are enrolled, from over 670 practices and healthcare organizations. #AHRQIX
DHIN_HIE: We grant access to licensed clinical providers and their approved staff with clinical-need-to-know. #AHRQIX
DHIN_HIE: Access is restricted and use of the system is strictly monitored. #AHRQIX
AHRQIX: What information is available in DHIN? #AHRQIX
DHIN_HIE: Enrolled members can access labs, pathology, radiology and transcribed reports in DHIN from 16 current data senders. #AHRQIX
DHIN_HIE: “Data Sender” refers to the hospitals, labs, and imaging facilities which are contributing information to our HIE. #AHRQIX
DHIN_HIE: In November, radiology images from Nanticoke Hospital were made available through DHIN. #AHRQIX
DHIN_HIE: There are many options. Members can log in to ProAccess, a web-based, secure site. #AHRQIX
FieldsTom: @BHarris_HITN @HIEwatch Join @DHIN_HIE for a TweetChat about Health Information Exchanges happening now. #AHRQIX
DHIN_HIE: Within ProAccess, they can search for their patients and/or have an e-mail style Inbox set up, where patient results are delivered. #AHRQIX
DHIN_HIE: We also offer AutoPrint for paper-based practices, where their patients' results print out at specified times throughout the day. #AHRQIX
DHIN_HIE: Finally, we offer EHR interfaces, where results can go straight into the patient's EHR at the practice, seamlessly. #AHRQIX
DHIN_HIE: DHIN is also a bridge b/n users & DE public health, for pharmacies & pediatricians to submit immunization info to public health #AHRQIX
AHRQIX: What are the overall benefits of DHIN? #AHRQIX
DHIN_HIE: DHIN saves time. Healthcare providers have results delivered & can search in seconds instead of waiting for faxes, mail, couriers… #AHRQIX
DHIN_HIE: DHIN saves $ by reducing duplicative tests for patients & is more cost-efficient than traditional paper methods of results delivery. #AHRQIX
DHIN_HIE: 2011 study showed a 33% reduction in labs, 30% reduction in radiology tests since 2009 #AHRQIX
DHIN_HIE: Reducing duplicative, unnecessary tests saves DE's healthcare system about $6MM/yr #AHRQIX
DHIN_HIE: In 2011 one of our hospitals recognized a $1.5 million annual cost savings by sending their information via DHIN. #AHRQIX
DHIN_HIE: DHIN saves lives by making access to patient information easier & because patients' results are in one place. #AHRQIX
DHIN_HIE: DHIN is secure and uses HIPAA-compliant, industry-standard levels of encryption. #AHRQIX
AHRQIX: Here is more info about @DHIN_HIE's statewide #HIE and its success in improving quality & efficiency: #AHRQIX
AHRQIX: If you have questions about statewide #HIEs, Mr. Farmer is available to answer questions. #AHRQIX
AHRQIX: What were the initial challenges in getting DHIN started? #AHRQIX
SHAREarkansas: Christy here, just joining the chat from Arkansas' HIE. Happy to be here! #AHRQIX
DHIN_HIE: Welcome, Christy! #AHRQIX
DHIN_HIE: DHIN was created in 1997, it took 10 years of market research & careful planning to launch in May ‘07. #AHRQIX
DHIN_HIE: One of the biggest challenges was getting the legal framework and protections established in Delaware. #AHRQIX
AHRQIX: Thanks for joining! RT @SHAREarkansas Christy here, just joining the chat from Arkansas' HIE. Happy to be here! #AHRQIX
DHIN_HIE: We also had a lot of technical work to do internally and with our vendor, @medicity #AHRQIX
AHRQIX: .@SHAREarkansas Be sure to let us know if you have specific questions or topics of interest #AHRQIX
AHRQIX: What challenges has DHIN faced more recently? #AHRQIX
DHIN_HIE: Becoming a self-sustaining business and finding new, exciting subscription based products for our users. #AHRQIX
DHIN_HIE: Getting DHIN users to adopt new products, like Medication History and DIRECT Messaging, has been hit or miss. #AHRQIX
DHIN_HIE: Establishing new, revenue generating products and services is also a challenge… #AHRQIX
DHIN_HIE: As well as launching tools that help promote patient engagement with their healthcare. #AHRQIX
AHRQIX: Now that you have every hospital in Delaware sending data into DHIN, have you begun looking at other states? #AHRQIX
FieldsTom: @IndianaHIE TweetChat about HIE's happening now at #AHRQIX. Find out how @DHIN_HIE achieved a 100% physician participation rate.
DHIN_HIE: In healthcare, Delaware borders 50 states. DHIN contains data from at least one patient from every state. #AHRQIX
DHIN_HIE: We're the 1st HIE to connect w. an out-of-state hospital: Atlantic General Hospital in MD; Union Hospital in MD is also coming soon. #AHRQIX
DHIN_HIE: We're the first state to begin connecting with another state's HIE (Maryland's HIE - @CRISPhealth) #AHRQIX
AHRQIX: Here are some ways other states are implementing HIE programs. #AHRQIX
SHAREarkansas: RT @DHIN_HIE: In healthcare, Delaware borders 50 states. DHIN contains data from at least one patient from every state. #AHRQIX
AHRQIX: .@DVHAVermont supports medical homes, lowers costs & improves care by providing easy access to information #AHRQIX
AHRQIX: In Arizona, instant access to info from other providers has helped improve quality & lower costs #AHRQIX
AHRQIX: Read our Q&A with @SiemensHealth on trends in health information exchanges: #HIE #AHRQIX
AHRQIX: .@DHIN_HIE, what is your strategy for success? #AHRQIX
SHAREarkansas: RT @DHIN_HIE: We're the first state to begin connecting with another state's HIE (Maryland's HIE - @CRISPhealth) #AHRQIX
DHIN_HIE: Operational integrity…results delivery is our core function. Our brand reputation is directly tied to how well we deliver results #AHRQIX
DHIN_HIE: When there are issues, we need to be excellent at correcting them & limit recurrence. #AHRQIX
DHIN_HIE: Regular trainings and visits from DHIN reps (Provider Relationship Managers) and open communication #AHRQIX
DHIN_HIE: Taking feedback from and bringing valuable products to our end users #AHRQIX
DHIN_HIE: @SHAREarkansas, how did you get started as an HIE, and what is your focus? #AHRQIX
FieldsTom: @HealthBridgeHIO Tweetchat with @DHIN_HIE about best practices for statewide HIEs taking place now at #AHRQIX
AHRQIX: MT @SHAREarkansas I'd like to hear how DHIN communicates with providers and consumers about the HIE. What worked? What didn't? #AHRQIX
DHIN_HIE: @SHAREarkansas We use multiple channels to build the “echo chamber” #AHRQIX
DHIN_HIE: @SHAREarkansas Directly with enrolled members via email, e-newsletters, in-person visits #AHRQIX
DHIN_HIE: @SHAREarkansas Indirectly, via mass media efforts (eg social media, press releases, TV interviews) #AHRQIX
AHRQIX: @SHAREarkansas Sorry, just saw this. We RTed it with the hashtag so @DHIN_HIE can see & answer! #AHRQIX
RHRC: RT @AHRQIX: Read our Q&A with @SiemensHealth on trends in health information exchanges: #HIE #AHRQIX
DHIN_HIE: @SHAREarkansas No one “magic bullet” - having a comprehensive multi-channel effort is best #AHRQIX
AHRQIX: Learn how technology is improving patients' access to their #health information in our Q&A with @HIMSS: #AHRQIX
AHRQIX: @RHRC Thanks for joining! Do you have any questions for @DHIN_HIE? #AHRQIX
AHRQIX: Mr. Farmer, can you give us a picture of what's coming soon from DHIN? #AHRQIX
DHIN_HIE: Patient engagement tools #AHRQIX
FieldsTom: @AHCA_FL Experts from DHIN_HIE are answering HIE questions in a TweetChat now. #AHRQIX
DHIN_HIE: Event Notification System (ENS), will alert subscribing members when one of their patients has been discharged from a hospital #AHRQIX
DHIN_HIE: This ENS will allow for member practices to be reimbursed under new TCM Medicare codes. #AHRQIX
DHIN_HIE: Image Viewing of Radiology Images-instead of just a report, more hospitals/rad firms to provide this info. #AHRQIX
DHIN_HIE: Electronic immunization reporting through DHIN to the DPH. Currently approximately 73% are now reported electronically in DE. #AHRQIX
AHRQIX: How is DHIN serving as a model to other states? #AHRQIX
DHIN_HIE: DHIN has served as a model and standard for other state and regional HIEs. #AHRQIX
DHIN_HIE: In the last year, we started consulting for the state of Hawaii's HIE launch. #AHRQIX
< AHRQIX: This @RHRC #HIE toolkit includes resources designed for rural providers, hospitals, health networks & others #AHRQIX
DHIN_HIE: @RHRC Like any state, DE features a number of urban and rural practices. #AHRQIX
AHRQIX: Learn to manage the challenges associated with developing, operating & sustaining an #HIE: @eHealthDC #AHRQIX
DHIN_HIE: @RHRC Due to the variations between practice types, we offer multiple results delivery options. #AHRQIX
RHRC: RT @AHRQIX: This @RHRC #HIE toolkit includes resources designed for rural providers, hospitals, health networks & others…
DHIN_HIE: @RHRC We offer Inboxes, AutoPrint, and EMR Integrations as results delivery options to suit every practice. #AHRQIX
AHRQIX: .@DHIN_HIE, what do you see as the future of HIE? #AHRQIX
DHIN_HIE: Diversification of our business model, offering new & diverse revenue-generating products #AHRQIX
DHIN_HIE: Expansion of stakeholders & participants to outside of DE's borders #AHRQIX
AHRQIX: RT @RHRC @AHRQIX Thank you for sharing our HIE Toolkit! @DHIN_HIE We work with rural hospitals nationwide. #AHRQIX
AHRQIX: We'll be closing the live chat in 10 minutes but will continue to answer the questions that come in before 4pm #AHRQIX
AHRQIX: Check out this inventory tool to learn how to identify resources & eliminate redundant efforts @AHRQnews #AHRQIX
AHRQIX: Here's another @AHRQnews toolkit with guidance for conducting assessments on privacy & security of your #HIE #AHRQIX
DHIN_HIE: Check out DHIN's informational video “airing” on American Airlines flights this month… #AHRQIX
AHRQIX: RT @DHIN_HIE: Check out DHIN's informational video “airing” on American Airlines flights this month… #AHRQIX
jwivoda: RT @AHRQIX: This @RHRC #HIE toolkit includes resources designed for rural providers, hospitals, health networks & others…
DHIN_HIE: Please send us links to your organizations' site/videos, and follow up with @DHIN_HIE for any questions or consulting needs. #AHRQIX
AHRQIX: Thank you to everyone who joined & participated in our TweetChat today! You can review the archive using #AHRQIX after the event #AHRQIX
AHRQIX: Feel free to continue sharing questions, info, and what's working for you via Twitter with @AHRQIX & @DHIN_HIE #AHRQIX
AHRQIX: And a special thanks to Mr. Farmer & @DHIN_HIE! We're so glad you were able to join us today! #AHRQIX
AHRQIX: To learn more about AHRQ Health Care Innovations Exchange, visit the ‘About' section of our website: #AHRQIX
DHIN_HIE: Thanks for joining us, and thanks @AHRQIX for hosting this discussion! #AHRQIX
AHRQIX: RT @DHIN_HIE Thanks for joining us, and thanks @AHRQIX for hosting this discussion! #AHRQIX
PamVMatthews: RT @AHRQIX: This @RHRC #HIE toolkit includes resources designed for rural providers, hospitals, health networks & others…
AHCA_FL: @FieldsTom I believe this may have been a typo, but we do have Florida HIE experts at the ready if anyone has questions for us. #AHRQIX

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