To create a clinical data exchange capability to improve patient care in the New York City region

Annual Report

The 2007 NYCLIX Annual Report is now available for download.

Our Vision

Our History

Origins of NYCLIX

In 2004, responding to problems of rising cost and quality gaps in healthcare, President Bush called for modernization of the nation’s Health Information Technology (HIT) infrastructure and capabilities. He created the Office of the National Coordinator (ONC) to help advance the widespread use of technologies such as Electronic Health Records.

In late 2004, ONC Director David Brailer announced a federal HIT strategy that advanced interoperability of health information through creation of a secure, standards-based infrastructure to support a variety of transactions between the many stakeholders in the healthcare marketplace. An interoperable infrastructure would interconnect the disparate organizations whose repositories contained fragments of a patient’s health record, thus providing authorized clinicians with a far more complete and accurate view of the patient’s medical history than previously possible. Interoperability would speed adoption of IT in the clinical setting by greatly improving access to information and facilitating online transactions. Interoperability would improve efficiency and quality while reducing cost and errors by improving the ability of clinicians to collaborate and ensure continuity of care.

Pioneering communities in Indianapolis and Massachusetts had already demonstrated the feasibility of interoperability amongst healthcare organizations. With a well-defined value proposition in place, numerous public and private agencies at the federal, state and community levels began creating funding opportunities to advance the concept of interoperability.

In June 2004, the Information Technology Committee of the Greater New York Hospital Association (GNYHA) convened a discussion of how to improve healthcare within the region using information technology. The Committee decided to pursue the concept of interoperability through a regional information exchange capability. Although this would require collaboration between otherwise competing healthcare organizations, all agreed that the goal of improving care of the patients they jointly served within their market outweighed potential competitive concerns.

The Committee also decided to focus initial efforts on the needs of providers in the Emergency Department setting in order to deliver the highest clinical value using the interoperability infrastructure. The GNYHA brokered subsequent discussions that brought numerous stakeholders into the consortium, including New York City and State Departments of Health, non-acute healthcare organizations, local philanthropies, and State medical societies.

The early collaborators decided to apply for a planning grant from the National Library of Medicine (NLM) at the National Institutes of Health (NIH) under the Integrated Advanced Information Management Systems (IAIMS) program. This would allow the group to work out the myriad legal, technical, financial, privacy and governance details associated with implementing a regional interoperability infrastructure.

The grant application was submitted in June 2005, with New York University Medical Center serving as the Principal Investigator. In 2006, a $300,000 grant was funded for NYCLIX’s planning activities [press release].

In September 2005, New York State announced the Health Efficiency and Affordability Law (HEAL), a four-year, $1 Billion bond act to support healthcare restructuring and IT modernization. HEAL Phase I made $50 million available for health IT projects in the areas of Electronic Health Record implementation, electronic prescribing or interoperability. Projects could last up to two years and all were required to support some degree of interoperability across multiple organizations in alignment with the Federal health policy as outlined by the Office of the National Coordinator. The program required 1:1 matching of funding by participants.

With the formal incorporation of NYCLIX, fourteen organizations participated in the NYCLIX HEAL Phase I grant application. The five primary aims outlined in the proposal were:

• Build a technical infrastructure that would enable the exchange of data among the participating organizations
• Implement a data exchange capability in the emergency department setting
• Use interoperability to support public health activities, including disease surveillance and health reporting
• Carry out an evaluation to measure the impact of the data exchange on healthcare cost, quality and safety
• Create an extensibility plan to sustain the effort beyond the two years of the HEAL Phase I period

In May 2006, NYCLIX received a HEAL Phase I award for $2.3 Million. Participants matched this award through in-kind work such as implementation of system interfaces and staff time to the NYCLIX leadership, resulting in a $4.7 Million budget for Phase I. NYCLIX received a final contract from New York State in May 2007.

In August 2007, NYCLIX contracted with First Consulting Group to use their FirstGateways ™ technology to implement the exchange [press release]. NYCLIX began implementation work shortly thereafter.

NYCLIX has a vision of growth. The consortium intends to grow in Manhattan, Brooklyn and Queens by adding provider organizations such as hospitals, non-acute care providers and ambulatory physician groups. It will increase the diversity of participants, adding a broader variety of providers such as regional laboratories, pharmacies and diagnostic and imaging centers. NYCLIX also intends to support a variety of value-added services such as disease management programs. NYCLIX is actively pursuing integration with other emerging RHIOs in the New York City area, and will ultimately interconnect with the National Health Information Network.

NYCLIX’s two highest priority goals are (1) implementing the technical infrastructure outlined in HEAL Phase I, and (2) developing and implementing a business plan to ensure long-term viability.  The latter goal remains challenging, and will involve identifying and unlocking the full value of interoperability, and actively engaging the various parties to whom such value accrues.

The HIT landscape continues to evolve at the national, state and community levels. New York State has recently appointed Lori Evans as the first Deputy Health Commissioner for Health Information Technology. The New York eHealth Collaborative (NYeC) has also recently been founded, with leadership and support from the New York State Department of Health. As a public-private partnership, NYeC will serve as a focal point for healthcare stakeholders to build consensus on Statewide HIT policy priorities, and to collaborate on state and regional HIT implementation efforts. NYCLIX is committed to being a leader healthcare interoperability within New York State, and is putting significant effort into involvement with these community-wide efforts.