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Verizon debuts nationwide health information exchange

Verizon has introduced a nationwide network of services that it says can transform healthcare informatics by putting it all in the cloud.

Telecom giant Verizon has launched an ambitious new service that it hopes will become the backbone of a new wave of health information exchanges (HIEs). The Verizon Health Information Exchange can be used by doctors and healthcare providers to store, manage and transfer patient information, including medical records, test results, medical images and more, all hosted on Verizon's infrastructure.

The project is nothing if not ambitious. Verizon says it is ready to roll nationwide and can absorb as many electronic medical records (EMR) as are currently out there; there may eventually be one for every person in the United States. It may even offer personal health records (PHR) to its 120 million telco customers. Early adopters of Verizon's HIE say it is a good way to address the most severe handicap of the medical industry.

"Healthcare has had the most advanced technologies available, but it's all in diagnosis and treatment," said MedVirginia CEO Michael Matthews, who added that communications and data management technologies remain primitive in the healthcare industry. "To get the data to the physician, you might as well be using [the] Pony Express," he said.

Matthews said that while attitudes are starting to change, IT staples of the business world, like process and intelligence tools and data management, are severely underfunded in hospitals. He said 2% of a providers' technology budget typically goes toward improving data usage, whereas in the banking industry it was more than 10% and viewed as a high priority.

MedVirginia is a healthcare provider-owned health information exchange. It currently hosts more than one million patient records in the state of Virginia and provides a gateway to the National Health Information Network, a federally-funded project attempting to connect healthcare networks across the country.

Matthews said it had been operational for five years but is currently switching off its own homegrown systems in favor of Verizon's service by the first quarter of 2011. Matthews added that MedVirginia would still operate its gateway to the NHIN, but its entire base of patient records will be stored with Verizon and delivered via the cloud.

Matthews said the chief benefit to using the Verizon HIE is its practically limitless scale, something he could never hope to match, as well as access to Verizon's managed security and identity services, something he also said Verizon was far better positioned to deliver than he was.

"There were two driving factors for us," he said. "One was scalability -- MedVirginia has grown pretty dramatically over the last few years. The other was security."

Verizon said that it is in talks with several existing statewide HIEs but has not announced any other customers yet. The company wants to take advantage of $548 million in federal grants being made available through the America Recovery and Reinvestment Act (ARRA), specifically for healthcare providers to buy EHR/EMR technologies.

How Verizon's HIE operates in the cloud

Verizon's HIE is typical of cloud services, in that it is built on already available technologies. Virtualized instances of Oracle Healthcare Transaction Base provide the back-end database. Verizon says it can spin up new instances wherever and whenever necessary to handle data location and compliance issues for healthcare providers. Verizon's Managed Security Service and Identity Management Service handle user access and network security; doctors (eventually patients, too) will interact with the service using a customized EHR portal based on MedFX Lifescape. The service is delivered and hosted over Verizon's IP networks and in Verizon data centers in the U.S.

Verizon makes it clear that it can provide all relevant compliance needs, from HIPAA and HITECH to PCI DSS, and meet any security standards necessary. It says data is mirrored on each coast and connected via Verizon's IP backbone. HIE deployments for customers are called 'partitions' and Verizon claims it can deploy a unique partition in as little as one hour, along with connecting or isolating that partition to any other HIE instance on command.

The company says that it has deliberately made the service as flexible as possible. Verizon states that it can serve doctors' offices with two physicians and a few thousand patients as well as it serves the largest provider networks in the country, which can have thousands of doctors and many millions of patients a piece. Providers can use 'lite' versions of the EMR portal and other parts of the service if they want to start small.

Although the service is a combination of online storage and Software as a Service (SaaS), customers like MedVirginia will get some back-end access to the database technology. Doctors, meanwhile, get a Web portal, a "Google Apps for your doctor" that gives the physician point-and-click access to a patient's medical history, medications, and access to knowledge bases on drug interactions, current research and scheduling and communication tools.

Verizon to set the standard for U.S. HIEs

Gerard Grundler, managing principal for Healthcare IT at Verizon, said that the telco was putting a significant amount of resources into this venture and that its ambition was no less than to become the country's standard for HIE. Some states, including Maine's HealthInfoNet, run a public HIE; Grundler said Verizon will not compete with those services but try to sell them Verizon's platform instead.

Some large corporations run some form of health record service for employees, and all the major insurers have billing and service records (but not clinical data) that patients can access online. Grundler said Verizon HIE will interoperate with all of them. Grundler called improving the quality of healthcare information usage critically important.

MedVirginia's Matthews agreed, and said that nothing less than the future of the U.S. healthcare system rests on reforming and improving the flow of information and how healthcare providers actually work. He said the average senior citizen in Virginia sees 13 doctors and is prescribed 50 medications a year, and it is certain that only a few, or possibly none, of those doctors are aware of the others. Making patient care information centralized, available and comprehensive is vitally important, he added, both for improving the absurd amount of waste in healthcare and for improving patient outcome.

After all, Matthews said, "how would you like to be that thirteenth doctor, prescribing that fiftieth medication?"

Carl Brooks is the Technology Writer for Contact him at

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