DHIN: Changing Health Care in Delaware ... and Beyond

May 1, 2014

For Joshua Vaught, CEO of Delaware Orthopaedic Specialists – a large practice with 15 doctors and five offices across the state – there is no doubt that time really is money. So when he realized that each of his administrative staff members was saving up to an hour a day by not having to hunt for records and avoiding ordering duplicate tests, he knew the Delaware Health Information Network (DHIN) was making a difference.

“Operational workflow is key for us, and DHIN smooths the process in ways nothing had before,” said Vaught. “In Delaware we have over 20 websites to log into in order to obtain lab and image results and there are multiple electronic medical record (EMR) platforms that would require direct integration. Having DHIN replace all that by being a centralized location for lab and imaging results has provided a tremendous opportunity to save both time and money. By avoiding duplication, it allows our physicians to treat more efficiently, not waste the patient’s medical dollars and improve our overall patient care.” 

DHIN – pronounced “din” by those in the know – is the nation’s first and most mature health information exchange (HIE); a huge achievement for the small state. By design, an HIE allows doctors, nurses, pharmacists and other health care providers to appropriately access and securely view vital medical information electronically — improving the speed, quality, safety and cost of patient care. Some of the benefits include avoiding unnecessary hospital readmissions, avoiding medication errors, improving diagnoses and decreasing duplicate testing. 

Delaware, which had been developing a plan for an HIE since 1997, launched DHIN in 2007. The organization, headed by CEO Dr. Jan Lee since 2011, has shown tremendous leadership, not only as the first to launch statewide, but the first to have 100% acute care hospital participation for clinical results delivery, to establish an information seeking query-based exchange with another state’s HIE (C.R.I.S.P. in Maryland, going live this spring) and to consult to another state (Hawaii) on the launch of its HIE program. 

According to Lee, herself a family practice doctor, “The simplest way to envision the HIE is as a combination of an electronic post office and library. A hospital, laboratory or imaging group completes medical tests ordered by doctors. DHIN delivers the results quickly and securely to the ordering doctor and other physicians involved in the care of the patient. This speeds care to patients by lessening the amount of time and number of places a practitioner has to look for results, and, it saves money by preventing redundant tests as a doctor can see all of a patient’s results in the Community Health Record. Most importantly, it saves lives – particularly in the ER, when time is of the essence and having test result data and medical history at hand can save minutes, if not hours.”

A 2011 study* showed that DHIN reduced lab tests, through efficiency and cost savings, by $6 million across the state. With nearly 90% of the DHIN enrolled practices in Delaware “signed off” (using DHIN as the exclusive provider of medical results) it is expected that the savings will continue to grow.

Terry Murphy, president and CEO of Bayhealth Medical Center, based in central Delaware, notes that health care costs are rising at the slowest rate in decades in Delaware. 

“There’s no doubt that DHIN contributes to that, by reducing duplication,” he said. “This is a unique system that works to the benefit of every patient by creating the opportunity for better outcomes.”

Consumers may not know the system is there, but they should know how well protected it is. 

“Access to information is based on a very strict ‘need to know’ protocol,” said Lee. “Only licensed physicians and their designated staff members can view the clinical results on the network. Access is restricted and strictly monitored. We audit the activity of our users regularly to help ensure the system is being used in accordance with its intended purpose: to help speed better care to patients.”

Discussing how access is enabled, Lee continued, “Logic built into the system detects whether the provider has an established treatment relationship with the patient. If not, the provider or staff member must enter their justification for requesting access before it is granted, and each such request is audited. Consent to such auditing is a requirement for participation in DHIN.”

During the coming years, patients will be more and more engaged in how their medical results and records are delivered. From his perspective in private group practice, Vaught sees the time coming very soon. 

“It is important for patients to know that DHIN exists and understand how it works. Even those patients who are unaware of what DHIN is or how a medical practice is utilizing it, DHIN is still making their medical experience better,” said Vaught. “It is imperative that the medical community recognize the benefits DHIN has to offer and get on board. It is easy to use, saves time and money, and allows us to do what is important, which is focus on patient care. It’s a ‘win’ all the way around.”


*Study by Maestro in 2011. Reports a reduction in redundant lab and imaging test results from 2009 to 2011. A copy of this study may be found at www.dhin.org/about/meetings-minutes

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