UnitedHealthcare Partners with CalRHIO to Expand Electronic Health Information Statewide

UnitedHealthcare, a UnitedHealth Group (NYSE:UNH) company, is collaborating with the California Regional Health Information Organization (CalRHIO) to support California’s statewide electronic health information exchange (HIE) initiative. UnitedHealthcare is the first national market participant to support and pay for HIE services statewide.

As part of the initiative, CalRHIO’s HIE will deliver secure patient information – including medication history, laboratory results, and clinical data from claims – to hospital emergency departments for UnitedHealthcare/PacifiCare of California commercial HMO health plan customers. The CalRHIO HIE will begin rolling out in Orange County emergency departments this summer in collaboration with the Orange County Partnership Regional Information Organization (OCPRHIO).

Use of the health information provided by UnitedHealthcare to CalRHIO is restricted to patient care and is protected and exchanged under strict medical privacy and confidentiality regulations.

“UnitedHealthcare is excited to join CalRHIO in this groundbreaking effort to build a market-based solution that modernizes health care and improves safety, coordination and quality of care while reducing costs,” said Sam Ho, MD, UnitedHealthcare’s executive vice president and chief medical officer. “Immediate access to critical medical information when and where physicians need it will better enable them to make the right health care decisions at the point of care. We believe CalRHIO has the right technology and business model to be successful in the long term.”

“We sincerely appreciate how UnitedHealthcare has stepped forward to lead and serve as an example through its commitment to HIE – a cornerstone of the Obama Administration's health reform efforts,” said C. Duane Dauner, California Hospital Association president and CalRHIO board vice-chair.

“CalRHIO has worked long and hard to develop a way to finance HIE that is sustainable and provides a return on investment. Federal stimulus funds, state budget monies and private foundations will not be adequate to sustain HIE services indefinitely,” said Molly Coye, CalRHIO board chair. “UnitedHealthcare’s leadership in supporting CalRHIO’s business model is a major step toward ensuring that we can finance and sustain HIE for communities across California. Our intention in future stages is to extend HIE to physicians offices throughout the state.”

“Having access to electronic health information in an emergency room setting is critical to expediting patient care, providing more cost-effective services, and in some cases saving lives,” said Douglas Evans, M.D., MPH, CFO of the San Francisco Emergency Medical Associates, who practices at the California Pacific Medical Center in San Francisco. “I commend UnitedHealthcare for recognizing the importance of this initiative and partnering with CalRHIO to improve patient safety and care.”

CalRHIO is borrowing the capital to build the early stages of the HIE system. Like a toll-road project, those benefiting from this service will contribute only when the highway is open and used. Revenue realized from payments health plans make for services will enable CalRHIO to repay the loans, finance the ongoing deployment of HIE services throughout California, and assist in making information technology accessible for safety net care providers.

Savings for health plans and other payers are expected to result from better information being available where and when a physician needs it to make health care decisions. For example, it may be possible to avoid a hospital admission or certain tests, as well as prescribe medications more efficiently, because the emergency department physician has more complete information about a patient’s history.

In April 2008, CalRHIO was endorsed by the California Public Employees’ Retirement System (CalPERS), based in part on the finding of a third-party review that concluded the initial provision of HIE services in emergency departments would present a substantial opportunity for quality improvement and savings. CalRHIO also has been endorsed by California’s leading hospital, medical group and emergency physician organizations, as well as Medi-Cal managed care plans and OCPRHIO.

About CalRHIO

CalRHIO is a 501(c)(3) organization that provides statewide health information exchange services to local communities throughout California. For more information about CalRHIO see www.calrhio.org.

About UnitedHealthcare

UnitedHealthcare (www.unitedhealthcare.com) provides a full spectrum of consumer-oriented health benefit plans and services to individuals, public sector employers and businesses of all sizes, including more than half of the Fortune 100 companies. The company organizes access to quality, affordable health care services on behalf of more than 25 million individual consumers, contracting directly with approximately 590,000 physicians and care professionals and more than 4,900 hospitals to offer them broad, convenient access to services nationwide. UnitedHealthcare is one of the businesses of UnitedHealth Group (NYSE:UNH), a diversified Fortune 50 health and well-being company.