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N.H. bill would connect medical records, providers

Imagine what it was like in the old days: A Concord resident rides the stagecoach to Conway for a week’s vacation. While there, he unfortunately takes a tumble and falls unconscious. The good doctor from Conway wants to know what medical allergies this patient may have, so he sends a note to Concord requesting his file from his primary doctor, and a day or so later, the paperwork shows up.

Until just a few years ago, though, the situation wasn’t all that different.

Though New Hampshire has the country’s second-highest rate of medical providers who have switched to electronic medical records, getting those records from one provider to another has been another challenge altogether.

A bill going to the full House on Wednesday tweaks the New Hampshire Health Information Organization, a program that acts like a secure Pony Express, speeding medical records electronically from one provider to another.

Ideally, when it’s fully operational, it should save patients from having to give their full medical history to new providers, help prevent medical mistakes and eliminate redundant testing, said Jeff Loughlin, the program’s executive director.

“Providers in the state are using great electronic health records within their organizations. . . . But if your primary care physician refers you to an orthopedist, your whole electronic list of medications is sent as a paper list and someone has to scan it or manually retype all the information, which takes a lot of time and energy and leaves a lot of room for error,” Loughlin said.

“We’d rather start to take advantage of the fact that doctors have great sets of data available.”

Six provider organizations – including Concord Hospital, Dartmouth-Hitchcock Medical Center and Elliott Hospital, and their affiliated physician practices – are fully on board already. Several dozen others are in various stages of implementation.

Loughlin’s original mission was to manage the federal funding to get the network started; now he’s switching to promoting the system to hospitals and other providers, and soon to patients.

The proposed legislation, which was already approved by the Senate, also gives patients access to their data on the exchange for the first time, and expands the definition of which providers can access it for care coordination.

That will allow organizations like visiting nurse associations, long-term care communities and insurers to access relevant information. They’d be able to review this same information if they requested it from a doctor or hospital, but under the current law, can’t use the network, Loughlin said.

“You could fax this information if you want,” he said. “But at the end of the day, it’s not safe. We don’t want to see patients’ information faxed or mailed across the state.”

Though the program is still in its infancy, it’s already yielding benefits, said Chris Baker, information technology services director at Concord Hospital.

“It’s not quite mature yet, but a number of us are sending messages through it,” Baker said.

The hospital uses the secure connection to send information to the state about infectious disease diagnoses and admissions from the emergency department, he said.

Before, the hospital needed a separate secure connection with the state and every other medical provider it needed to share records with. Those costs added up, Baker said.

Each connection was a private network, so, theoretically, no one else could access the patient files being shared. The new network is even more secure, because the messages themselves are encrypted, he said.

“In reality, even they can’t read the message as it goes on to someone somewhere else. It’s like a closed envelope,” he said.

And having just one channel, he said, means “less expense, less things to monitor, and less things to break.”

(Sarah Palermo can be reached at 369-3322 or or on Twitter @SPalermoNews.)

Correction: A previous version of this story misspelled Jeff Loughlin's name.

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