R.I. readies for online health data exchange pilot

TOM O'BRIEN, right, manager of the EDS facility in Warwick, discusses electronic health records visuals with a project manager, Beth Perry. /
TOM O'BRIEN, right, manager of the EDS facility in Warwick, discusses electronic health records visuals with a project manager, Beth Perry. /

The initial plan is modest: Create an online system that pools test results from Rhode Island’s largest lab networks and prescription drug data from pharmacies and allow doctors in a handful of large practices to use it to look up information about their patients.
They could log in during a checkup to find out when the patient last had a cholesterol test, and what it showed. Or when writing a new prescription, they could quickly review what drugs their patients are already taking – and thus avoid potentially dangerous conflicts.
This is how Rhode Island plans to test the concept of a statewide health information exchange, in the next year or two. The idea is to see how it works, what issues come up, and use the lessons to build a full-fledged exchange in the future.
The state has been preparing for this pilot for more than two years, using a $5 million grant from the federal Agency for Healthcare Research and Quality that will also pay for the pilot – and for an evaluation of the system’s effectiveness.
That work has been spearheaded by the Rhode Island Quality Institute, a collaboration of health insurers, hospitals, doctors, state officials and others committed to improving quality in health care in several ways, most notably through information technology.
Now, with most of the groundwork laid, the state has chosen a vendor to actually build the pilot system, Electronic Data Systems Corp., a Texas-based company that already has a presence in Rhode Island handling the claims adjudication system for Medicaid.
The contract with EDS for the health information exchange is still under negotiation. But on its own, the company has made a big commitment to Rhode Island: Late last month, it announced the creation of a “national center of excellence” for electronic health records here.
Jim Duffey, general manager for EDS’ U.S. public sector unit, said the company chose Rhode Island for the center “for several reasons,”
including Gov. Donald L. Carcieri’s “outspoken support for electronic health care” as well as “access to high-quality educational institutions, Rhode Island’s national reputation for Medicaid innovation and our successful long-term relationship with the state.”
Laura Adams, president and CEO of the Quality Institute, said she was “very pleased” with the news. EDS’ decision, as Adams saw it, acknowledged the state’s leadership in health care information technology and recognized “Rhode Island’s potential for innovation to scale.”
Dr. David R. Gifford, the state health director, had a similar response.
“I think it’s great to have a national company like that put a center of excellence here, in an area where I think we’re leading the nation,” he said. On other projects, including claims management for the state’s HIV drug assistance program, EDS has helped create efficiencies that led to “significant savings,” he added, there is potential to do more.
EDS already employs about 200 people at a facility in Warwick, and for the new center, it’s hiring 25 more – programmers, business analysts, project managers and health care IT experts, said Tom O’Brien, the local managing director.
O’Brien wouldn’t comment on the pending negotiations for the pilot project contract, but he said EDS has a few electronic contracts in the works in different states, and the Warwick team would be involved in all of those projects.
It’s going to be somewhat of a new field for EDS. The company has been involved in claims management for years, and to some extent, that involves clinical data as well. But EDS has never built a system specifically to exchange clinical data – not in the United States.
“We have worked in Canada and the U.K., so it’s not brand-new,”
O’Brien said. “But it’s really just taking off here in the U.S. … Electronic health records are a major emerging market, so EDS is gearing up to be a significant player in that market.”
EDS does not build EHR software per se, O’Brien explained, and it doesn’t intend to get into that market. What the company does is build systems that connect different platforms to one another so they can exchange information.
“One of the core competencies of EDS is that we are an integrator,” he said, “and because we have a major presence in the health care market, we also have relationships with many vendors who have the kind of software that can support electronic health records.”
To prepare for Rhode Island’s pilot project, the Quality Institute has had committees working on everything from technological challenges to legal and ethical issues to patients’ concerns, while subcontractor Quality Partners of Rhode Island has been working directly with doctors to assess their needs and preferences.
Adams said the goal is to have several large doctors’ groups participate in the pilot, so there’s a critical mass. And time is a factor as well; Adams said the pilot needs to run for at least one year before the AHRQ grant expires in late 2009.
Meanwhile, Rhode Island is already preparing for the next step. Last year, the General Assembly approved a $20 million bond to cover the state’s share of the cost of a full-fledged health information exchange, and it requested that the entity that will run that exchange be identified relatively soon.
The state has issued a “request for information” seeking input on what the exchange should look; responses are due by Feb. 12. With that input, the state will then issue a request for proposals to choose the manager of the exchange.
In practice, the Quality Institute already serves that function, and Adams noted that the nonprofit represents Rhode Island in that capacity at the national level. Asked whether the institute, which now has a staff of two, wants to build the exchange, she replied:
“I do think that there is an interest.” The institute could subcontract much of the work, she noted, but it would be a major commitment of resources.
“There’s a deep commitment on the board to make sure that everything we’re doing serves the quality improvement agenda,” she said. “We certainly believe that health information technology serves that agenda, but there are many other things that we also want to do.”

- Advertisement -