Modernizing Healthcare Communication

Medical Information When and Where You Need It
by Julie Gray
Quality Quest for Health of Illinois

Efforts are currently underway in Illinois to develop a health information exchange (HIE) to modernize healthcare communications. HIE allows healthcare providers with an electronic medical records system and patient permission to share health records across different computer systems. In February 2009, Governor Pat Quinn signed Senate Bill 1132 into law, appropriating $3 million to the Department of Healthcare and Family Services to establish a program for health information exchange planning.

The state was divided into 16 regions, with each area being awarded a one-year planning grant. In central Illinois, three grants were awarded to Quality Quest for Health of Illinois to coordinate planning for the Peoria, Bloomington and Decatur areas. A fourth grant, to the Champaign/Urbana Public Health District, is being used, in part, to pay Quest for managing their planning process as well. The three grants to Quality Quest totaled $529,688. The planning territory covers 20 counties and spans from Fulton County in the west, to the Indiana border in the east, and south beyond Decatur to Shelby County.

Experts have long recognized that sharing data among providers has a positive impact on safety and quality and lowers cost, but progress toward HIE has been a struggle for many communities across the U.S. Challenges have been technological (How many providers actually have electronic records?), financial (Who is going to pay for the exchange?) and political (Will healthcare competitors rally around a common cause for community good?).

The Benefits of HIE
Why is HIE important to the medical community in Peoria and central Illinois?

“The ultimate goal of an HIE system is to make patient health information completely portable so that no matter where a person goes for medical services, their physician will be able to immediately access the information that is needed to provide quality care,” says Joy Duling, HIE project manager.

QUALITY QUEST UPDATES

Adult Preventive Care Calculator
Keeping up-to-date on preventive care screenings and immunizations is one way individuals can impact their own health. Studies show more than half of all Americans do not receive all of the important preventive services they need. Why? Many people are unaware of the preventive services they should be getting based on their age and gender. The Adult Preventive Care Calculator is Quest’s first interactive web-based tool that helps consumers create a customized list of recommended preventive care services.

The calculator is for adults 18 years of age and older. The recommended services are based on adult preventive care guidelines from the Institute for Clinical Systems Improvement (ICSI). Additional preventive care services may be necessary depending upon a person’s personal or family history or if they have a chronic condition such as diabetes, heart, kidney or lung disease. All that is required is to type in an individual’s age and gender and click the submit button. A list of recommended services is provided, which can be printed and taken to the next doctor's appointment for discussion.

Interactive Consumer Search Function
Consumers will now find an interactive search interface when they visit the Quality Quest website “Reports” page. Instead of choosing from a static list of reports, visitors will be able to search by different criteria. For example, the Generic Prescribing Report is searchable by clinic name, county, physician name, specialty and zip code. Visitors may compare information from different time periods and also compare clinics.

Peoria County Safe Drug Disposal Group
Quality Quest convened a group of companies and organizations to work together to expand the efforts of Pontiac Prescription Drug Disposal program into Peoria County by implementing and funding six drug disposal sites. The group hopes their work will help protect water resources and keep unwanted drugs out of children's hands. By offering six different secure pharmaceutical collection centers throughout Peoria County, residents in Peoria, Peoria Heights, Bartonville and Chillicothe will have easy access to properly dispose of their unwanted medications. The participating organizations are Quality Quest, Illinois American Water, Office of State Senator Dave Koehler, Peoria County Sheriff’s Department, Peoria County Recycling, Alwan Pharmacy, Peoria County Health Department, and OSF HealthCare.

The long-term benefits of health information exchange, where successful implementation has been achieved in states such as Rhode Island, Maine, Minnesota, and Nebraska, are:

  • Improving healthcare quality and outcomes
  • Reducing health disparities
  • Reducing medical errors and duplicative services
  • Enhancing coordination of patient care among providers
  • Reducing or eliminating paper
  • Controlling the cost of healthcare.

When Opportunity Knocks
Even before taking office in early 2009, President Barack Obama repeatedly emphasized his plan to have all U.S. residents covered by electronic medical records within five years. He followed through on that commitment with $59 billion in stimulus dollars for healthcare initiatives through the American Recovery and Reinvestment Act of 2009 (ARRA), including $19 billion specifically earmarked for healthcare information technology.

Under the new Act, physicians and medical practices can qualify for $44,000 or more in incentives if they can demonstrate “meaningful use” of an electronic health record by 2011. The formula for hospital incentives is more complex, but starts at a base of $2 million. On the back side, providers that do not implement an electronic health record (EHR) by 2015 will receive lower Medicare reimbursement.

There are three base requirements for meaningful use in the
new law:

  • Use of certified or qualified EHR technology
  • Electronic exchange of health information 
  • Use of EHR in reporting on clinical or other quality measures.

The promise of federal funds for providers in central Illinois is very real and quite imminent. The HIE planning currently happening under the auspices of Quality Quest is a critical component for positioning providers in our community to access the stimulus dollars. In short, central Illinois must have an HIE in place in order for providers to meet meaningful use requirements.

The Process
The planning team has worked diligently to establish governance structures, solicit provider collaboration and build the operational framework and social capital that will be necessary to sustain an HIE long-term. In the Peoria area, a Regional HIE Advisory Council meets monthly to provide local perspective to the planning. The Council includes representatives from local hospitals, health departments, health clinics, independent physicians, physical therapy services, behavioral healthcare, pharmacies, employers, insurance companies and consumers. Similar councils are providing input from Bloomington, Champaign and Decatur.

“We have six work groups made up of diverse stakeholders throughout the region who are examining issues from privacy and security to financial sustainability and technical infrastructure,” explains Duling.

A successful plan, then followed by implementation, would create a central Illinois HIE that would connect all healthcare providers across the 20-county area, creating a system of exchanging data for more than 1.3 million patients across 29 hospitals, 20 health departments and more than 2,100 physicians, pharmacies, laboratories and other healthcare settings. Long-term planning for interoperability with other regional HIEs will be essential, and Illinois is looking to local planning groups to make statewide health information exchange possible.

The central Illinois project is slated to submit its full HIE implementation plan to the Illinois Department of Healthcare and Family Services in July 2010.

Quality Quest is gathering information about the readiness of local providers for EHR and HIE. Focus groups involving physicians and practice managers, as well as healthcare practitioner surveys have taken place. Medical education programs are planned in mid-April for the Peoria, Bloomington and Champaign areas. Learn more at qualityquest.org. iBi