Information technology is the lever that can help transform today’s medical practice, improve quality of care, and streamline the use of data. Successful adoption of information technology, however, demands we address economic, fragmentation, and standardization issues unique to health care. For that to work we need to bring together diverse interests and create a collective vision; the very essence of what the Rhode Island Quality Institute is working to achieve.
Making Electronic Health Records Affordable
Electronic health records will help physicians deal with the rising-tide of reporting information, enhance patient communications, reduce errors, and automate repetitive processes such as prescription refills. Smaller medical practices, however, need financial and other support to move to electronic health records. This is especially relevant in Rhode Island where 87% of physicians are in private practice, with 90% in groups of five or less. Our objective is to lower barriers so physicians in any size practice are able to select and use electronic health records with greater speed and confidence. Bottom-line—electronic health records must make good business sense.
While many physicians classify themselves as independent and prudently cautious by nature, the physicians participating in our forum have proven they not only know how to collaborate, they also know how to innovate.
Independence and caution are not always conducive to collaboration, yet participants in our forum find they can be strong team players and still generate solutions that are in their best interest.
Rhode Island Doctors Create EHR Companies
As a non-profit organization, the Rhode Island Quality Institute provides a framework to guide discussion, investigation, and experimentation that advances efforts for widespread adoption of technology—technology that we believe will help transform health care. We foster a collaborative environment that allows participants to meet, share ideas, and form unique ventures. Our role is to nurture innovation and we also strive to keep the playing field level and not recommend any specific technology solution. We encourage everyone in the health care community to consider the broad spectrum of technological alternatives and EHR options that are available in the marketplace.
We salute the entrepreneurial efforts of two local, physician-led companies that offer electronic health records at group discounts. In addition to collective buying power, cooperative ventures like this allow smaller practices to share system installation and maintenance services. One joint venture was started by participants in our organization; the other was created independent of our efforts. Demonstrating the power of collaboration, these two, competitive companies are working together with the Department of Health to pilot initial laboratory standards for a Statewide Health Information Exchange.
Connecting the Docs—RI’s Health Information Exchange
The electronic health record is one solution piece in the health care communication puzzle; sharing information is another. A Statewide Electronic Health Information Exchange will provide physicians with access to patient information outside their practice setting. Data from laboratories, radiology, and other health care professionals will automatically populate electronic patient records and provide information that will be highlighted rather than buried in a paper chart.
For the Statewide Information Exchange to work we need to adopt a common set of standards so systems will communicate with each other. That means for now, Rhode Island’s hospitals and physicians will need to select from electronic health care record systems that are compatible with statewide standards. It is expected that eventually medical information software will be available with network connectivity tools built in.
Funding Sources
Governor Carcieri has asked the state Legislature for $20 million to complete development of technological infrastructure that will help connect the Statewide Health Information Exchange. Funds from the revenue bond will leverage federal and private resources to acquire hardware and software and the network capabilities necessary to share, secure, and compile medical data.
Funded by a $5 million grant from the federal Agency for Healthcare Research, the Rhode Island Health Department has formed a unique public/private partnership with the Rhode Island Quality Institute to develop the foundation for a health information network. As a Regional Health Information Organization, RIQI provides governance for establishing and managing the support structure necessary to build the Statewide Health Information Exchange, which involves many diverse stakeholders. Phase one involves defining standards for sharing data and building the initial infrastructure. Testing of data sharing is expected to be underway in early 2007.
Smoothing the Way to New Technology
Some medical practices do not have the dedicated IT staff and administrative planning functions necessary to install and maintain an electronic health record and they may need technological training and other support. One solution is being provided by Quality Partners of Rhode Island, an organization charged with the quality assurance component of Medicare. Quality Partners of Rhode Island helps small to medium sized practices with Medicare patients select and maximize use of electronic health records, manage organizational change, and make improvements in care delivery systems within their individual or group practices. Learn more by subscribing to the Quality Partners newsletter.
Blue Cross & Blue Shield of Rhode Island is piloting an innovative “Pay for Performance” program that includes some early-stage funding assistance for the adoption of electronic health records. Learn more by contacting: Gus Mannochia, Medical Director at BCBSRI.
(401) 459-5621). Email manocchia.a@bcbsri.org.
Partnering with Physicians to Solve Issues
In July, 2004, we formed a physician-led Clinical IT Committee to advise the Institute’s board on issues relating to physician adoption of health information technology, financial incentives, and pay-for-performance programs. This committee also provides feedback and guidance to other statewide initiatives related to the development and use of health information technology.
Physicians are engaged in many aspects of the Rhode Island Quality Institute, including the Policy and Legal, E-Prescribing, Executive, and Nominating committees as well as our board of directors. All our committee and board meetings are open to the public. Learn more about participating.
