Chuck Christian, VP of Technology and Engagement, IHIE, Chapter 1

If there’s one word that could best describe Chuck Christian, it’s curious. Throughout his career — from the early days as an X-ray technician to more than 20 years as a health system CIO to now — he is constantly asking questions and trying to find ways to get the industry to a better place. It’s that drive that led him to his current role, where he is helping to lead one of the largest HIEs in the nation in its mission to leverage technology to improve patient care. In this interview, he talks about his passion for understanding policy and translating it to CIOs, his candid take on FHIR and how he believes it can work, how the Indiana HIE has been able to thrive (and what other HIEs can learn from its success), why clinical interoperability is so difficult, and why he believes the industry is just hitting its stride.

Chapter 1



* History of IHIE

* 20 years of sharing data — “We were doing HITECH before it was even thought of.”

* Writing their own code — “We don’t depend on anyone else’s software.”

* Partnership with Regenstrief Institute

* Dealing with customized service requests

* Data stored in Indiana Network for Patient Care — “We don’t own it; we’re stewards of the data.”

* Docs4Docs & electronic mailbox

* “I’m a policy wonk.”



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Bold Statements

In this metropolitan area, we’ve got a high concentration of large medical centers and people have a tendency to go to different ERs. And so those physicians were treating people based upon what information they had immediately available, but they needed more so they could do it well.

We can get together and make a decision and move very quickly, but we are a nonprofit supporting organization — we’re not in the business to make a lot of money. We’re in the business of making enough money to pay the bills, to add some services that our members would like to help improve their business.

When we joined the Exchange and sent our data, labs, and discharge summary, we could always see our data. But it wasn’t until that patient was registered in the ER or one of our outpatient clinics or in the hospital that all the data on that patient was made available, regardless of where that patient had care.

Most healthcare organizations want to do their own analytics. They don’t want somebody to do it for them and just give them the answer. With the depth and breadth of the data that we have in the Exchange, we can look across a variety of settings of care rather than just one setting of care.

It’s that kind of stuff that fuels the success of the organization, because we can see how the tools are getting used in the clinical setting and address some the needs of the data for clinical integrated networks, ACOs, bundled payments and quite a few other things.

Gamble:  Hi Chuck, It’s always a pleasure to speak with you. Thank you for taking some time for us today.

Christian:  Thanks for the opportunity.

Gamble:  Great. Let’s get a little background information about Indiana Health Information Exchange. You’re VP of Technology and Engagement, correct?

Christian:  That is correct. The IHIE is about 12 years old if you want to look at the incorporated entity. The exchange itself and the actual fact of sharing data has been going on in the Indianapolis area for over 20 years. The exchange actually grew out of some clinical needs from a variety of different sources in working with the folks at IU Medical School, the Regenstrief Institute, BioCrossroads and quite a few other folks. It was designed to share clinical data, particularly for those patients that may be seen in multiple emergency rooms, because in this metropolitan area, we’ve got a high concentration of large medical centers and people have a tendency to ...