Rhode Island has been a leader in health care information technology for several years, primarily through the efforts of the Rhode Island Quality Institute, a nonprofit collaboration between providers, insurers, policymakers and others.
Earlier this year, the institute won more than $11 million in federal stimulus grants to support two major projects: currentcare, a statewide health information exchange, and a regional “extension center” to assist providers in the adoption of electronic health records.
Last week, U.S. Sen. Sheldon Whitehouse, D-R.I., a founder of the institute, announced it had won another $15.92 million, under the stimulus-funded Beacon Communities program. Laura Adams, president and CEO of the institute, answered questions about the new grant.
PBN: What is the Beacon Communities program, and what does it mean for Rhode Island to be chosen for it?
ADAMS: The Beacon Communities grants were awarded to 15 communities across the U.S. [among more than 135 applicants] that have achieved advanced capabilities in health information technology to demonstrate how electronically enabled care delivery systems improve health and health care.
Each “Beacon Community” must deliver tangible improvement in quality, cost and population health metrics through the use of health information technology.
The Rhode Island Beacon Community will drive positive change in quality, cost efficiency and population health outcomes through HIT by focusing on two primary objectives: supporting the state’s transition to the Patient-Centered Medical Home model by developing needed foundational capabilities through HIT; and improving Rhode Island’s ability to see and act on the quality and efficacy of the health care system by providing new capabilities in quality reporting and public reporting.
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PBN: You’ve said the grant will fund 12 projects. What do they entail?
ADAMS: The projects fall into three main categories: HIT and exchange activities, care coordination, and reporting. The grant will leverage federally supported HIT/exchange projects in Rhode Island already under way, such as currentcare, the Regional Extension Center – designed to assist providers with EHR adoption – and Blackstone Valley Community Health Care’s EHR hub, linking it to currentcare.
The care coordination projects will make critical information available at the right time to patients and their physicians so they can avoid preventable emergency-room visits and re-admissions to the hospital. The reporting projects will provide critical information on the performance of the delivery system and whether our [efforts] are actually working.
These projects were chosen in part because of their specific relevance to health issues faced by Rhode Islanders, and because the sum of these projects is greater than the parts.
PBN: How does the Beacon grant fit with what you’ve done to date?
ADAMS: Beacon Community grants are awarded only to national leaders in the advancement of health IT. Over the last five years, Rhode Island has made significant progress – in terms of infrastructure, processes and implementations – toward health information exchange and the meaningful use of HIT.
We expect the Beacon Community to help increase provider and patient participation in currentcare; build upon ongoing work to interconnect EHRs in community health centers; and partner with PCMH initiatives such as the Chronic Care Sustainability Initiative and the Blue Cross & Blue Shield of Rhode Island PCMH project; expand the CMS Safe Transitions in Care contract to decrease Medicare re-hospitalization rates.
It will also build on KIDSNET, Rhode Island’s nationally known HIT infrastructure that has dramatically improved childhood immunizations, to improve adult immunization rates. And it will build on Rhode Island’s mandatory public reporting efforts.
PBN: What is the time frame for making these projects happen? Is the pace of HIT advances in Rhode Island accelerating?
ADAMS: Because this is stimulus funding, the time frame is very aggressive. The Beacon Community projects have to be complete and producing measurable outcomes in 36 months. The pace of HIT advances in Rhode Island has been steadily increasing, but with the influx of stimulus funding received by the RIQI, in addition to the substantial incentives to hospitals and physicians under the stimulus bill – $44,000 per physician under the Medicare incentive program and $63,000 per physician under Medicaid – we can anticipate an even more rapid acceleration.
PBN: Are Rhode Island providers being able to jump on this wave of innovation, or are we seeing a split between innovators and the mainstream?
ADAMS: According to the most recent (2009) annual survey from the R.I. Department of Health, 39.5 percent of the office-based and hospital-based physicians who responded said they use EHR components with basic or advanced functions at least 60 percent of the time. This is much higher than the national average of 13 percent.
Seventy percent of Rhode Island community health centers use EHRs, and the rest are in the process of implementing them – again, much higher than the national average. The Rhode Island Free Clinic delivers patient care with a state-of-the art EHR.
In short, the Rhode Island health care community is distinguishing itself collectively as innovators. If there’s a split, it’s between Rhode Island and most other states in the nation.
To learn more about the Quality Institute and its projects, go to www.riqi.org. In addition, the institute is holding a series of workshops to update the state’s health information exchange strategic plan and is seeking public input.
