Western North Carolina Health Network Steps to the RHIO Forefront

Officials from the U.S. Department of Health and Human Services, including Secretary Mike Leavitt and National Health I.T. Coordinator Dr. David Brailer, view Regional Health Information Organizations (RHIOs) as the essential building blocks for the national health information network (NHIN). Currently, there are more than 200 RHIO initiatives underway in the United States, and MEDITECH customers are involved from coast-to-coast, usually at the forefront of the more advanced efforts.

One of the best RHIO examples is in rural North Carolina, where a group of 16 independent hospitals has formed the Western North Carolina Health Network (WNCHN). Six of the 16 sites, including the first four sites to go LIVE with this Data Link project this past January (Rutherford Hospital, Angel Medical Center, Transylvania Community Hospital, and Haywood Regional Medical Center), are MEDITECH facilities. Soon after the go-LIVE, MEDITECH sat down with Gary Bowers, executive director of WNCHN, and Tommy Finley, CIO of Rutherford Hospital, to get some insights into RHIOs:

Q: What is the history behind WNCHN? How and why are all these competing entities working together?

Tommy Finley (TF): The idea for this specific RHIO project was born five years ago. The hospital network had been together for 11 years, setting the foundation for trust and positive relationships. Even though we are competing with one another, we had previously identified areas where there was room for collaboration, such as group purchasing and the development of patient quality care initiatives. The Data Link project was a naturally collaborative effort which put quality of care and the overall health of the community over the business competition.

Q: So, you worked toward developing your own RHIO before the term existed?

Gary Bowers (GB): Most definitely. We proactively viewed data sharing as a vital part of the future of health care information technology, and we wanted to be at the forefront.

Q: RHIOs are very popular in certain legislative circles. Did you have any allies at the federal or local level?

GB: Fortunately for us, North Carolina Congressman Charles Taylor shared the same high technology vision as the health care organizations. Rep. Taylor was intent on making western North Carolina a technology hub to attract business and industry. In addition to ensuring the entire area was wired for Internet broadband access, Rep. Taylor also helped to secure the funds to develop this unique and important project. He was very excited about the project, as he was confident that the Data Link would result in reduced wait times, improved accuracy and effectiveness of treatment, and more affordable patient care. Additionally, he shared our opinion that this project would bring patient safety and care to a higher level.

Q: One of the key elements to a successful RHIO is collaboration, and you've certainly got that. Another is governance -- tell me how you tackled responsibility issues, data ownership issues, etc.

TF: At first, there was a lot of disagreement on how this should be done, but we persevered and arrived at a solution that was satisfactory for all involved parties. It was imperative that we determine a way to share data, yet still allow all of the facilities to maintain their independence and control over their own data.

GB: We are proof that this can be done, despite any obstacles. We have 16 hospitals and all of them were concerned about their own data, but we all got together and hammered out a solution based on our common desire to share the important patient data. We concurred that our development partners, IBM and AccessPt, were well positioned to help us improve our data access and patient care.

Q: What was the significance of the first four sites all being MEDITECH facilities?

GB: The MEDITECH MAGIC sites were aggressive about wanting to go LIVE with the Data Link, which certainly made things easier for the first wave. Additionally, AccessPt, the company that is involved in our Web portal, had successful experiences working with MEDITECH in the past and suggested that those hospitals would be the prime candidates to go LIVE first.

TF: We absolutely wanted to be among the first to go LIVE with this project. We were excited about the project and felt, by using MEDITECH MAGIC, we were in great shape technologically to achieve success with the Data Link.

Q: Once you solved all the issues, and got everything in place, it seems as if things moved very quickly, correct?

GB: Very much so. The task force that we assembled was very happy with how quickly we were able to get the project up and running. The first few sites have been LIVE for a few months now, and we are excited about the results we have seen.

Q: What types of data are you sharing, and how are you sharing it?

TF: We are currently sharing patient demographics, Laboratory and Radiology results, transcribed reports, and Pharmacy data via a Web portal data link within the network. This list will soon be growing to include PACS imaging and other data.

Q: Have you seen any unexpected benefits?

GB: Actually, we have. In matching patient records across the region for Data Link, we've found patients who were frequenting different emergency rooms in the region in order to improperly obtain prescription drugs. We can actually see this Data Link being used as a tool to control illegal drug procurement in the area, which is definitely an unexpected, but welcomed, benefit to the project.

Q: What's the ultimate goal of the project?

TF: We envision a long-term goal of implementing the ability to have any provider, anywhere in the country, with the proper user name and password, view important patient data via the portal.

GB: We're looking forward to the continued evolution of this project as it expands to other health care providers. Ultimately, the goal is to provide authorized users the ability to access electronic records from regional physician offices, health departments, clinics, and other health care providers to create a longitudinal view of the patient's medical history.

Q: Lastly, it seems that most of the folks out there touting their success tend to be fronted by large, academic medical centers. Do you feel a special sense of pride in being a group of moderately-sized facilities from a rural area?

GB: Sure, there is a big sense of pride associated with our success in this project, especially from getting a plan together, overcoming obstacles, and executing it with successful results. However, we are also proud to show that smaller, more rural hospitals can create a RHIO as well as larger academic medical centers.

TF: That's true. Ultimately, we are most proud that we developed this plan to share data with the goal of providing more quality care and increasing patient safety. I think we have illustrated that RHIOs are achievable, whether your organization is a large academic facility, or a small rural hospital. And I think we are proof that vision, determination, and perseverance are rewarded with success.

 

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