NEHEN Base Case

Organization: New England Healthcare EDI Network (NEHEN)

Headquarters: Waltham, Mass.

Phone: (781) 890-7446

Business: Cooperative electronic medical records network involving health care providers and payers in Boston and New England

Size: Members operate 45 hospitals, including Massachusetts General and Mount Auburn. Three largest operators record $5.8 billion in annual revenue. Two main “payers” that are members report $3.3 billion in annual revenue

Chairman and CIO: Dr. John Halamka

Challenges: To create a common network for handling patient information requests and claims transactions between health care providers and payers; cut administration costs; and comply with looming federal requirements for safely exchanging medical information electronically

Baseline Goals:

  • Create a near-“plug and play” infrastructure that can accept any New England health care provider or payer in days rather than months
  • Build a “peer to peer” network that allows member institutions to exchange data while retaining control of 100% of their patient records
  • Reduce inquiry transaction times by at least 80%
  • Reduce transaction fees and costs from dollars per transaction to cents
  • Reduce claims-processing costs by at least 40%