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PA partnership publishes IT recommendations
Public-private coalition unveils four-phase plan
The Pennsylvania e-Health Initiative (PAeHI), a public-private coalition, has unveiled a set of health information technology recommendations designed to improve the quality of Pennsylvania's health care and reduce costs, while giving patients improved access to their own health care information.
In a statement that accompanied the release of the report — "Connecting Pennsylvanians for Better Health: Recommendations from the Pennsylvania eHealth Initiative" — the coalition outlined two major goals: "evolving electronic patient health records to a uniform format for all health care providers, and outlining in detail how the Commonwealth can assist in the development of local approaches to create an integrated statewide health information network." The entire report can be found on-line at www.paehi.org.
"Essentially, [electronic transmission] is a way health care information can be accessible to providers so that they can be better enabled to provide care than they are through a paper chart," says Martin Ciccocioppo, MHA, MBA, PAeHI board chairman and vice president, research with The Hospital & Healthsystem Association of Pennsylvania. "In the inpatient setting, you do not have the problem of different departments wanting to hold the paper chart, since everyone will have access to a common electronic record."
In addition, he notes, there are now a wide variety of reporting requirements providers need for reviewing quality, and having electronic data available makes it easier for hospitals to report on outcomes and for providers to follow up on situations that need immediate attention, such as the recall of individual medications. "You can easily go into the system, put in a query, and identify in seconds what was taken by whom in the last few hours or days," he says.
Some of the immediate actions planned by PAeHI include:
The ultimate goal, Ciccocioppo says, "is to make a complete personal health record available to individual patients so they can take better care of themselves."
The coalition got its start three years ago when several different organizations realized they had common goals when it came to promoting a health information exchange within the state, recalls Donald F. Wilson, MD, chairman of the PAeHI communication and education committee and medical director of Quality Insights of Pennsylvania, the state's QIO. "We had some discussions with the Pennsylvania Medical Society," he says. "We were starting our new contract with CMS and part of that contract was to promote health information exchange within our state. In my discussions with them, I found it was part of their strategic plan, too."
Very shortly thereafter, he says, they decided to bring in The Hospital & Healthsystem Association of Pennsylvania "And together we became the founding members.
"Basically, after [our discussions and after] the president announced his executive order (in 2004) to have all U.S. citizens have a personal health record in 10 years, we had an invitational meeting for healthcare stakeholders — 40 organizations in all — in the winter of 2005," adds Ciccocioppo. "We considered whether there was a need to have a statewide coordinated effort to educate providers and policy makers; as a group we determined very quickly that there was, and by September 2005 we had our bylaws and were incorporated."
One step at a time
The long-term goal of the coalition is to create a statewide regional health information exchange, or RHIO. "We want to have connectivity across the state," says Wilson. "And everybody wants to jump to that, but we've seen what happened in other areas, and we're going to start with smaller steps."
Just what are those steps? "We see ourselves, for one thing, as being educators — for both providers and consumers — on the importance of having an exchange implemented across the system, then, to work with and foster efforts that are sprouting up locally within health care systems," Wilson says.
There are several systems, such as Geisinger Health System, that already have impressive electronic health information exchanges under way, he notes. "What we see ourselves as is a neutral convener for these folks to come together, so they are not doing anything as an isolated entity," he explains. "Then, as they start developing their plans, eventually they will be able to 'talk' with each other." In addition, he says, he is looking at the development of statewide standards "to hopefully meld with what will probably happen nationally."
Why is it so important to achieve what PAeHI has laid out? "For one thing, just to have the ability to get physicians to implement EHRs is critically important for patient safety as well as efficiency — like avoiding duplicate tests," says Wilson. "Basically, most of the Medicare folks we deal with see as many as 10 doctors a year and none of them know what the rest are doing. That's why it's important to have that connectivity."
Ciccocioppo says that the progress to date is impressive. "To this point, participation has been completely voluntary," he notes. "What we've been able to accomplish over two years is pretty remarkable; we not only have the three lead organizations, but there are now over 160 organizations participating."
[For more information, contact:
Martin Ciccocioppo, MHA, MBA, Vice President, Research, The Hospital & Healthsystem Association of Pennsylvania. Phone: (717) 564-9200.
Donald F. Wilson, MD, Medical Director, Quality Insights of Pennsylvania. Phone: (877) 346-6180, ext. 7802.]