History

In mid-2005, a group of Brooklyn hospitals, nursing homes, home health providers, and payers came together to think about ways to share clinical information and improve quality of care among multiple health care organizations. 

In September 2005, New York State announced the Health Efficiency and Affordability Law (HEAL-NY), a $1 Billion bond act to support healthcare restructuring and to promote health information technology and exchange. 

Led by Maimonides Medical Center, a group of initial stakeholders applied for funding under the HEAL-NY Phase 1 to create the Brooklyn Health Information Exchange. The initial group included: 

Hospitals

• Maimonides Medical Center
• Kingsbrook Jewish Medical Center

Home Care Agencies

• Visiting Nurse Service of New York, Inc.
• MJGC Home Care, Inc.
• First to Care Home Care, Inc.

Nursing Homes

• Metropolitan Jewish Geriatric Center
• Rutland Nursing Home
• Shorefront Jewish Geriatric Center
• Sephardic Skilled Nursing and Rehabilitation Center 

Payers

• 1199SEIU National Benefit Funds
• ElderPlan, Inc.

In May 2006, the Brooklyn Health Information Exchange project received a $4 Million HEAL-NY Phase 1 grant from the New York State Department of Health. While the contract governing the HEAL-NY Phase 1 grant was being finalized (final contract was received in May 2007), the Participants worked collaboratively to discuss technology issues and to develop the BHIX Committee and Governance structure.

As a result of this collaborative work, in July 2007, an independent entity called Brooklyn Health Information Exchange, or BHIX, was created to oversee the day-to-day operations of the project.  The BHIX governance structure promotes representation of all the Participants, including representatives of the Brooklyn community.

Working Toward the Future

BHIX will be implemented in phases.  The first phase will cover the period funded by the HEAL-NY Phase 1 grant and will draw on data in electronic form and paper from Health Information Sources including a subset of the initial Participants.  It is anticipated that BHIX will be “turned on” for authorized users at certain Participant sites during the Summer of 2008. 

Initially, the shared data includes:

• patient demographic information
• advance directive information
• physician/primary contact information
• allergies
• medications
• problem lists and diagnoses
• procedures

During this first phase, work is proceeding with the Participants to address the privacy, security, and confidentiality of electronic health information.  Work also focuses on ways to promote interoperability through the use of nationally defined standards. BHIX is also working to evaluate how its offerings can provide value and improve coordination of care across the healthcare delivery system.

Completion of work during the period covered by the HEAL NY Phase I Grant will allow BHIX to proceed to its expansion phases. The goals of those phases include:

• Incorporating additional participants;
• Adding patient information such as laboratory results, radiology images, discharge/transitional care summaries, and Medicaid data;
• Implementing a patient portal/personal health record;
• Providing avenues for public health and quality reporting;
• Incorporating clinical decision support;
• Facilitating e-prescribing capabilities;
• Creating a business model that promotes financial sustainability.