The Colorado Regional Health Information Organization (CORHIO) recently signed on seven hospitals, nine medical practices and four community mental health centers to share patient data through its health information exchange platform.
The public-private partnership, which is focused on improving healthcare quality for Coloradoans and is the designated entity to facilitate statewide HIE, is also the regional extension center. I spoke with Phyllis Albritton, executive director, last week and she shared some of CORHIO's best practices in helping physicians adopt health IT.
All of the best practices have community at the center. While the federal incentives for the meaningful use of EHRs reach specific provider groups, CORHIO's Colorado Health Foundation grant is enabling the REC to reach out to other healthcare providers, such as the community mental health centers, which expands the value proposition for the whole community, she said.
In reaching out to communities, CORHIO found that many healthcare providers in the state were ahead of the national curve of understanding healthcare IT. Albritton said a number of factors have led to this "perfect storm." Colorado's communities have historically struggled with a healthcare workforce shortage and saw a value proposition in technology assisting the workforce at a lower cost. Many practitioners in the state are also involved in quality initiatives and through training have understood the value of interconnection with providers in neighborhood communities to manage population health, she said.
The Colorado Foundation for Medical Care, the official Quality Improvement Organization for the state, oversaw a care transitions project for Medicare. The project enabled stakeholders to work through workflow issues to improve community care in theory and then look to technology to reach its goal of better, faster, less-expensive care, Albritton said.
Albritton referenced her colleague, Dick Thompson, executive director and CEO of Quality Health Network, the health information exchange based in Grand Junction. Thompson said there is no wrong door to improving healthcare, she said. Practitioners need to be met where they currently are in order for organizations such as the regional extension centers to help them find the right tools for their practices instead of forcing them to adopt technology that is the most ubiquitous in that area.
Surprisingly, an analysis of a physician practice may lead to the recommendation that an EHR may not be what the office needs at this point in time. Once the office is comfortable with secure health information exchange, the office can move to implementing an EHR system, at which time they can see value proposition, Albritton said. This has been a helpful mechanism and a helpful way to work with practitioners that helps them move forward without overwhelming them to the point of not being able to do anything, she said.
The Colorado Medical Society and county-based medical societies were concerned that the RECs were only helping primary care physicians, rural hospitals and safety-net providers. They created a program, which CORHIO supports through its REC partners, to help non-eligible practitioners understand meaningful use, value proposition and the requirements needed to enter the electronic world. It is the collaborative spirit - ensuring that nobody gets left behind and meeting people where they are - that is key to the state's success, Albritton said.
The HITECH Act approach is to get the physician office electronic and then get connected. The experience in Colorado, however, is to connect people and then find value of creating an electronic office, Albritton said. "Don't make presumptions about what's most beneficial," she said. It's the physician office's decision to make, and the REC's goal to provide tools and support to help get them to where they need to go.
"Helping practitioners get to a place where they can see and understand a value proposition for moving in these directions is really important," she said. "We can only do that is by working with providers individually."
In the world of meaningful use incentives, it's somewhat shocking to hear Albritton say, "If they don’t see a value proposition, they should not do this." This is not to say the physician practice ought not to implement an EHR system. Rather, CORHIO helps practices think through different possibilities for the value proposition. Sometimes, the practices don't know what the challenges are, so the analysis is a good eye-opening experience, she said.
Ultimately, Albritton said, "It’s really important to understand that it's all about the value proposition for the providers on how they can provide better care to the communities they serve, individually or population. Often it's the community discussion and collaborations that show the different participants the value proposition."
Photo by ellenm1 courtesy of Creative Commons license.
