Future vision of state health IT under discussion

PROVIDENCE – As part of the ongoing effort to design a State Innovation Model proposal to apply for up to $60 million in federal funds, one of the work groups meeting on a regular basis is focused on “Health Information, Technology and Measurement Work Stream.”
The diverse group of about 20 health IT experts drawn from hospitals, health insurers, community health centers and health care initiatives – such as the R.I. Chronic Care Sustainability Initiative – met on July 10 to try and reach consensus on identifying barriers that exist to adopting and accelerating the spread of priority IT initiatives.
The goal of the health IT workgroup is to finalize its plan by Aug. 21.
The overall State Innovation Model process is being managed by The Advisory Board Co., a consultant hired by the state, and coordinated by Lt. Gov. Elizabeth H. Roberts.
At the heart of the ongoing discussion is how to create a platform of interoperable technology that enables links between claims and clinical data.
Amy Zimmerman, the state’s health IT coordinator at the R.I. Executive Office of Health and Human Services, served as facilitator of the discussion.
But the dream of creating a common language of interoperability may prove more difficult to achieve, given the different agendas at play.
Among the gaps identified by the group was the insufficient adoption rate and data exchange between the electronic health records from providers and the state’s health information exchange, known as CurrentCare, managed by the Rhode Island Quality Institute. Currently, there are only about 300,000 Rhode Islanders enrolled in CurrentCare, and only about 19,000 data reports on patients have been requested by providers through CurrentCare.
Other gaps identified were the planned use of the All Payors Claim Database, which does not include data for the uninsured population, estimated to be about 140,000.
Another gap identified was the lack of a statewide provider directory.
Some members of the group challenged the accuracy of the language being used around “engagement” and “tools,” drawing the distinction that engagement is not a one-way conversation, particularly when talking about empowering patients and changing behaviors. And, it was not whether a tool existed, such as datasets, but whether a tool was actually being used, and that was often determined by cost – and time.
David Keller, the outgoing director of CSI-RI, pinpointed what he saw as the greatest the need: analytics capability at the provider level.
Ray Lavoie, executive director of the Blackstone Valley Community Health Center, reminded the group not to leave providers out of the equation in their plans, particularly those that are already capable of doing what is being proposed at the state level – upload data, report quality measures back to a practice, and report quality measures to any agency or body capable of receiving the data, such as the Centers for Medicare and Medicaid Services.
The next meeting of the work group is scheduled for July 24.

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