What is CRISP?
CRISP (Chesapeake Regional Information System for our Patients) is Maryland’s statewide health information exchange. Health information exchange, or HIE, allows clinical information to move electronically among disparate health information systems. The goal of HIE is to deliver the right health information to the right place at the right time—anywhere in Maryland—providing safer, more timely, efficient, effective, equitable, patient-centered care. As one example of the application of HIE, a patient’s discharge summary from a hospital visit could be securely and electronically delivered to his or her primary care physician, providing for more seamless continuity of care.

Combined with the widespread adoption of electronic medical records by hospitals and physicians, HIE is one of the two critical components to building a truly integrated, 21st-century healthcare delivery system.

Who Is Involved In This Initiative?
CRISP is a not-for-profit membership corporation advised by a wide range of stakeholders responsible for the healthcare of Maryland’s citizens. We receive input and advice from patients; hospital systems; physicians; insurance providers; technology providers; privacy advocates; public health officials; and advocates for seniors, the uninsured, and the medically underserved. CRISP is formally designated Maryland’s statewide HIE by the Maryland Health Care Commission, as directed by the state’s legislature and Gov. Martin O’Malley.

Why Invest in Health Information Exchange?
Research shows that better care coordination saves lives and reduces medical costs. Why shouldn’t a “360-degree view” of a patient’s medical history be available to doctors and nurses at the point of care—regardless of where in Maryland that care is delivered? CRISP believes it should be.

The technology is available. Privacy and security concerns are serious, but manageable. In Maryland, a strong spirit of cooperation exists. We have a comprehensive plan. CRISP’s objective is to turn the vision of an interconnected healthcare delivery system into a reality.

How is CRISP Going to Fulfill Its Mission?
CRISP’s guiding principles:

• Begin with a manageable scope and remain incremental.
• Create opportunities to cooperate even while participating healthcare organizations still compete in other ways.
• Affirm that competition and market-mechanisms spur innovation and improvement.
• Promote and enable consumers’ control over their own health information.
• Be flexible to support both distributed and data bank models.
• Use best practices and standards, particularly as they relate to privacy and security.
• Serve the entire Maryland healthcare community.

CRISP has been funded with $10 million over three years through a state-approved adjustment to the rates that insurance companies pay participating hospitals. It also intends to seek federal grants for health information exchange through the American Recovery and Reinvestment Act. CRISP has laid out a plan to be self-sustaining in the long term.

When Will Patients Benefit from Health Information Exchange?
Many already are. During the planning phase for health information exchange in Maryland, CRISP implemented a service to provide real-time, electronic medication histories to many patients being treated in the emergency room at the Memorial Hospital at Easton. CRISP has plans to expand the medication history service to other care settings in Maryland.

CRISP intends to employ an incremental approach to providing new services for Maryland patients. Services such as exchanging lab results and hospital discharge summaries will be launched based on an assessment of clinic value, geographic impact, technical feasibility, cost, and other factors.