August 5, 2014 / 11:36 PM / 3 years ago

Health insurance rivals team up to build California information exchange

Aug 5 (Reuters) - Blue Shield of California and Anthem Blue Cross, two rival health insurance providers, announced on Tuesday a collaborative plan to build a non-profit health-information exchange for California residents.

The California Integrated Data Exchange, or Cal Index, would become one of the largest exchanges of its kind, amassing electronic health records of some nine million California patients, a quarter of the state’s population.

The firms estimate they’ll spend $80 million in the initial 3-year phase. Afterward, Cal Index will charge a subscription fee to care providers and insurers who use the service. The index is expected to be operational by the end of 2014.

“We have a very diverse medical system in California with many complexities,” said Diana Dooley, Secretary of California Health and Human Services Agency, during Tuesday’s announcement. “This is easy to talk about but very hard to do.”

Anthem Blue Cross President Mark Morgan said the two companies “spent years working through the privacy concerns and challenges.”

As a health-information exchange, or HIE, Cal Index would provide a network of patient records that could be securely shared between care providers. In the past, some HIEs have struggled in the face of a complex web of security and technical challenges, as well as budget constraints.

But officials predicted that Cal Index would succeed where others have stumbled, thanks to its access to massive amounts of claims and clinical data.

One of the greatest hurdles is sharing information between different data systems that do not communicate effectively with each other, making it difficult for doctors to gain access to patients’ medical records in emergency situations. As a result, doctors routinely order duplicate tests or prescriptions, with insurers often covering extra costs.

Blue Shield and Anthem plan to work out partnerships with hospitals, insurance providers and doctors across California in the coming months. The service will be open to any patient records contributor.

But the largest electronic health record providers, such as Epic Systems, have not yet been directly approached to discuss the initiative, company officials said. It was not clear whether those vendors would cooperate.

Dave Minch, HealthShare Bay Area president and California Association of Health Information Exchanges board chair, remains cautiously optimistic about Cal Index’s prospects, believing shared patient information will prove beneficial to both patients and providers.

Minch, who expects to hear from Blue Shield representatives, said data from community and larger-scale HIOs could be used in concert with Cal Index claims data to alert physicians when a patient “falls outside of expected treatment parameters.”

“This can be a powerful tool for patients, their doctors and all their healthcare providers to make the best possible decisions about their health,” said Dooley.

Patients can prevent information from being shared, said Blue Shield President Paul Markovich, but he said he did not expect that many would do so. (Reporting By Christina Farr and Robin Respaut; Editing by Ken Wills)

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