Fresh out of college in 1982, computer science major Daniel Porreca landed a degree in technology operations at Marine Midland Bank. He was working at Computer Task Group in 1997 when his 5-year-old daughter Elise ended up with a rare, stubborn infection that doctors in Western New York struggled to treat.
“What I found out pretty quickly is that doctors knew what they knew, and what their close network of associates knew, but beyond that there was not a lot of ability for them to use technology to figure out what was going on with my little girl,” Porreca said.
Elise recovered from her infection, and Porreca turned curiosity over her care into his current job as executive director of HEALTHeLINK, which seven years ago began to gather electronic medical information from hospitals, doctors and other health care providers across the region. The goal: share that information across a wider swath to improve treatment, improve personal and community health and lower costs.
“In some ways, it’s kind of obvious that if doctors have better information, they can make better decisions,” said Porreca, 55, a West Seneca native who lives in Lancaster with his wife, Lee. They have three daughters, Katie, 27; Elise, now 24; and Jacquie, 21.
Q. How has the idea of sharing electronic medical records taken shape in the region?
Think about it, you walk into an emergency room and those doctors don’t know you. They’re trying to piece together information to make an assessment and put together a treatment plan. Data is a key thing. When you think about the presence of HEALTHeLINK in that scenario, they can get information about any labs that have been done, any radiology studies. If you’ve been in any other hospitals, they can get the discharge summaries that might be helpful in addition to the exam and the interview. That’s the power of HEALTHeLINK.
Q. Where do the funding sources come from for the nonprofit?
Initially, the charter members were responsible: Kaleida, Catholic Health, ECMC, Roswell and the payers: BlueCross BlueShield of WNY, Independent Health and Univera. Think about it, they’re competitors and in a lot of cases adversaries when they start negotiating, but they really came together for the benefit of the community. … We’ve also gotten a number of state and federal grants that have helped build out additional functionality.
Q. The greatest challenges overcome and those that still lay ahead?
We see the momentum building on more and more adoption and use. That’s a function of people using it and recognizing the value of it, and spreading the word. We know anecdotally and based on the research that we’re reducing the number of unnecessary tests and giving doctors the ability to have better information so they can make better treatment decisions.
Q. What are some of the most immediate challenges you’re looking to overcome the next few years?
That’s a tough question because there’s so much opportunity. That’s what makes it so much fun. We have a list of projects that are so numerous, we have to cut it off. We’re always thinking, what can we do next? Continuing on the core things we’re doing – increasing the number of doctors using it and making it easier for them to use, increasing the number of patients that have signed their consent forms and helping them understand what the value is to them – and as time goes on, making sure the quality of the data that comes in is at the highest level possible. In order for population health activities to happen, in order for researchers to use the data, the quality has to be good.
Q. Can you give some examples about how HEALTHeLINK and the larger exchange has helped patients and saved money?
In an emergency department study, we put one of our people for six weeks in three different emergency departments. For a certain number of patients that walked through, we pulled data on every one of them. There was a control group that the data was not getting pulled on, and then we compared. We asked doctors, “What did you do differently because you had access to HEALTHeLINK information?” We got some very positive results along the lines of, “I didn’t order this test.” “I ordered a different med.” “I did this instead of that.”
Separate from that, we had a Brookings Institute fellow who did analysis just on the raw data and looked at the ordering patterns of the doctor who had the data versus not. In one of the emergency departments, there were 52 percent less labs ordered and 36 percent less radiology ordered. In another, it was 25 percent less labs and 26 percent radiology, and in the third there was 47 percent less radiology tests ordered. This is less costly for hospitals because they get a bundled payment for the ED visits. The patient may not even realize HEALTHeLINK saved them from going through another CAT scan and getting exposed to unnecessary radiation or having to get stuck with another needle to get more blood drawn, but the doc knows it because they would have ordered this otherwise.