Rhode Island a leader in health care IT advances

PBN Staff

03/06/2010

While Washington debates health care reform, Rhode Island is proceeding with its own set of changes to improve the quality of health care. Just as information technology has changed our daily lives – in activities ranging from banking to social networking, among others – now Health Information Technology has the potential to transform health care delivery as well.
Imagine a health care system that has only electronic health data, a secure ability to exchange data at the point of care between clinicians, more accurately measure how clinicians take care of patients and how well patients take care of themselves, and the ability to measure the health of our population. These are some of the potentials of HIT, which can be divided into three important initiatives in Rhode Island:
• The Electronic Health Record.
• The Health Information Exchange.
• The Patient-Centered Medical Home.
The EHR allows clinicians to enter data that are easily retrievable, more complete, measure performance and are shared between providers. In addition, the EHR allows for “decision support,” which means clinicians will be able to access information on various conditions, diseases and practice guidelines in the care of their patients.
The American Recovery and Reinvestment Act has allocated funds to physicians for the adoption of this information technology. In addition, Rhode Island is at the center of this initiative with a $6 million grant to the Rhode Island Quality Institute to help implement the adoption of EHRs by clinicians and hospitals in a secure and private manner.
The HIE is a network that links patient’s health information and clinicians. For example, this exchange allows an emergency room physician to retrieve a patient’s electrocardiogram from the patient’s primary care physician or cardiologist’s office at the time of evaluation.
This connectivity helps clinicians make more informed diagnoses and treatment plans, and avoid duplication of tests. Physician offices are currently enrolling patients through the Rhode Island HIE termed “currentcare” that is administered through the Rhode Island Quality Institute. The Institute recently received a $5.28 million grant to help build the HIE. In addition, the Rhode Island legislature last year passed a bill to protect the privacy and confidentiality of health information on the health-information exchange. The PCMH is a new model of care utilizing a team approach to care coordination, treatment of acute, chronic and complex medical conditions with the primary care physician and the patient at the center of care. Health plans in Rhode Island are participating in a pilot of this concept around the state. Elements of the PCMH will allow physicians to coordinate care, objectively measure performance and identify needed areas of improvement in patient care.
Additionally, the Centers for Medicare and Medicaid Services recently introduced “meaningful use” criteria for EHRs and the HIE. The criteria help to coordinate information sharing, create standards for data entry and provide help to clinicians in their clinical decisions, using evidence-based guidelines and cost-effectiveness studies, leading to improved care for the community.
These initiatives in care redesign are some of the most important innovations in the practice of medicine in many years. They will unfold further over the next five to seven years and have the potential to improve the quality and decrease the cost of health care for all Americans. •

Dr. N.S. Damle is a general internist at South County Internal Medicine Inc., in South Kingstown, the governor of the Rhode Island chapter of the American College of Physicians and a member of the board of directors of the Quality Institute of Rhode Island.

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