Despite gains, CurrentCare improvements eyed

EXCHANGE OF IDEAS: Providence Center psychiatrist Ujala Fawad, above in red, sees promise in CurrentCare. Also pictured above is registered nurse Susan Hardy. / PBN PHOTO/RUPERT WHITELEY
EXCHANGE OF IDEAS: Providence Center psychiatrist Ujala Fawad, above in red, sees promise in CurrentCare. Also pictured above is registered nurse Susan Hardy. / PBN PHOTO/RUPERT WHITELEY

When someone suffers an accident, they can’t always inform the responding EMTs about medications they’re taking, or tell them about a serious condition they might have.
When that happens in Rhode Island, there’s a good chance the EMTs and the emergency room staff will get that important information all the same. More than 400,000 Rhode Islanders – roughly 40 percent of the state’s population – have enrolled in a Rhode Island Quality Institute-developed program called CurrentCare that keeps all their medical records stored digitally, where they’re always accessible to doctors, nurses and EMTs.
The program has been under development since 2010, the year the federal government provided grant money to every state to develop a health-information exchange. Rhode Island is ahead of most of the country. Only a dozen such exchanges are up and running at this point.
“It’s been an effort by the entire Rhode Island health care community,” said Laura Adams, president and CEO of Rhode Island Quality Institute, a nonprofit set up by hospitals and health insurers to improve health care in the state. As part of that mission the institute – which recently announced the enrollment milestone – handled the development of the CurrentCare system.
“We have partners all over the state,” Adams said. “They’re physicians, hospitals and other health care providers. Employers are encouraging employees to sign up. Insurance companies are building in incentives for health care providers. Last year, Blue Cross offered a financial incentive for physicians to get their patients signed up.”
The benefits are obvious, as Adams points out. “There is an increasing amount of valuable patient information available to providers,” she said. “Access to this information through CurrentCare services is leading to improvements in the quality, safety and value of health care.” Medical professionals have largely endorsed the system.
“It’s a great tool,” said Ujala Fawad, a psychiatrist working at the Providence Center. “My life has become much easier.”
Fawad said all her patients hear her recommend that they sign up.
“I explain that if they sign up, their doctors and hospitals will be able to look up their info, and that could mean they’re getting better care, or that they’ll need fewer blood tests,” she said. “I tell them it could save patients money, because I can see what other physicians have done and not repeat the same work. I’ll know if a patient recently had blood work done, for example. That could mean fewer copayments.”
The institute hired Intersystem Corporation of Boston to build the CurrentCare system. The information is stored on two servers in different parts of the country – Massachusetts and North Carolina – to help ensure service is never interrupted by natural disasters. Information on patient care flows into the CurrentCare system from 65 sources throughout the state, including all Rhode Island hospitals and Lawrence & Memorial Hospital in Connecticut.
The institute has also taken steps to ensure information remains private. “We’ve put security first and foremost,” Adams said. “We have an active penetration-testing system going on at all times. We use the same standards a financial institution would use, but we store nothing that could be linked to financial records and no social security numbers.”
Funding comes from several sources. A federal grant provides some money. And the institute is paid $1 a month per insured person by insurance companies, self-insured companies and Medicaid. Some health care clients have provided funding as well. For example, the institute has signed a contract with the Chronic Care Sustainability Initiative Rhode Island.
The institute is forever looking for new ways to get people signed up for CurrentCare. One idea now being discussed calls for setting up self-serve sign-up kiosks in public places, such as senior centers and medical buildings. There’s also a website that allows people to sign up from home. There is a drawback to the system: At this time CurrentCare data is only available if a person is injured in Rhode Island. Because doctors and health care providers in other states aren’t’ members of the system, they can’t access information. That will likely change, however. There are plans to eventually link health-information exchanges in every state, but no one is saying when that might happen.
Another solution might be the consumer portal the institute plans to add to CurrentCare sometime next year. It will allow an individual to log on and view their own records. A person could then show their data to an out-of-state doctor.
Health care professionals know how important it is to know as much about what they are dealing with as possible.
“We had an emergency care situation where a patient was unable to tell EMTs what medications she was taking,” said Bethany Gingerella, a registered nurse and paramedic chief for Westerly Ambulance. “The EMTs were able to quickly look up the patient’s medication list in CurrentCare and were then able to make better-informed care decisions on the spot.”
CurrentCare also issues immediate notification to primary care physicians when one of their patients is admitted or released from a hospital.
As a result, hospital follow-up “is a lot easier,” added Dr. Gregory Steinmetz, of the Rhode Island Academy of Family Physicians. “We now get rapid notification from the hospitals when a patient is discharged. My staff is able to quickly contact patients regarding hospital follow-up.”
CurrentCare expects to add alerts to patients as well, reminding them of needed work. •

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