Preparations continue in an effort that could see Rhode Island serve as a test
site for information technology capable of linking hospitals, doctors’ offices
and patient medical records on a scale never before possible.
Signed into law in July, an advisory committee will be formed this fall to assess the state’s current use of computer technology by physicians and health insurers and offer recommendations for developing a statewide health care IT infrastructure. The committee will be responsible for outlining the specifications of a system, setting standards for administrative data exchange, clinical support programs, quality performance measures and the maintenance of the security and confidentiality of individual patient data.
“The health care system has been slower than other sectors of the economy to utilize advancements in computer technology,” said Cranston’s Sen. Elizabeth H. Roberts, who worked to submit the legislation in coordination with Lt. Gov. Charles Fogarty. “Promising research shows that using computers for tasks, like saving electronic medical records and prescription forms, can significantly improve efficiencies and quality,” she said.
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As an example, Roberts said linked systems would allow a patient who goes into Kent Hospital with chest pains and is treated and released, only to seek treatment at Miriam Hospital three days later, to have their doctor immediately see a record of that previous visit. Without such a system, the Miriam doctor has no access to Kent’s records.
Roberts said the work of the Rhode Island Quality Institute, as well as representatives from the group, would likely take a prominent role on the advisory committee. The institute, a collection of leaders from the state’s government, academic and business industries, has already begun talking to potential software vendors and considering how to market the state as a test site.
Roberts said legislators were quite receptive to the bill. “There’s a real belief this is the direction we should be headed in,” she said.
While the idea wouldn’t have been realistic 20 years ago, Roberts said software and hardware are becoming more affordable as the years go by. No state money is included in this year’s budget for the project.
“It’s not just about finding funding,” Roberts said. “We’ve got to find a program and a model that’s a good fit and get everyone on-board with making the adjustments necessary in the medical system.”
Laura Adams, the Quality Institute’s president and CEO, said her group is already waiting to hear about at least one significant grant and is hopeful the e-prescription project the state recently collaborated on will serve as an example of Rhode Island’s capabilities.
“There’s a lot of substantial one-time demonstration project funding that’s coming down right now,” Adams said. “Because Rhode Island’s been at work on this for three years, getting the collaborative structure in place, we think we are very well positioned. … As a state, we could take that money and build out an infrastructure others could only dream of. Five million dollars goes a lot further for Rhode Island than it does for California.”
Adams said a big key will be ongoing talks with insurers about possibly offering incentives for physicians to invest in a system. She noted that while hospitals’ profit margins certainly aren’t substantial (though the Lifespan network has already begun making investments in IT), it’s the physicians who currently look to bear the biggest burden in making the changes.
Adams said estimates are that about 4 percent of the gains of implementing a networked system would come to the physician, while 96 percent of the return on investment would come to the payer, the purchaser, or someone else.
“Right now, not only are we harming patients, but paper is crippling the system,” Adams said. She said a number of research studies have found that along with quality and safety gains, an improved IT structure could have a number of longer-term savings benefits.
The members of the health care information technology and infrastructure advisory committee, under the leadership of the director of state Department of Health and Human Services, will include representatives from Rhode Island-licensed hospitals, medical and nursing professionals, health insurers, consumer advisory organizations and other parties with an interest and expertise in health care information technology. The committee will also establish criteria for eligible health care information technology and infrastructure projects.
