Last week Quality Health Network (QHN) CEO Dick Thompson spoke with HCI Associate Editor Jennifer Prestigiacomo about how the health information exchange was using its Beacon Community Cooperative Agreement Program award, issued by the Office of the National Coordinator for Health Information Technology, to broaden its reach to more than 20 hospitals and attendant physicians in the 40,000 square miles of Western Colorado. In part two of that interview, Thompson discusses some of QHN’s strategies for success.
QHN keep things light with the dodo award.
HCI: What has been the biggest challenge that QHN has faced with setting up this HIE?
Thompson: Initially, when we began in 2005 there weren’t a lot of organizations of our ilk running, so the first obstacle was gaining adoption, which we accomplished in the first couple of years. The second obstacle was sustainment, which we’ve been cash flow positive since 2007; so we’ve not been federal or state-grant funded. The current obstacle is interoperability with medical records systems. There are many vendors that espouse interoperability, but there are not that many who can get the job done today, and that is going to be an ongoing challenge in the industry.
HCI: Why do you think QHN has been so successful with implementing its network?
Thompson: Being a single source for physicians is attractive, and because we’ve been able to gain a large and widespread adoption of physicians it attracts sources. So it’s a Catch-22; you need to attract both a large number of sources and a large number of receivers at the same time to achieve critical mass so that a sustainable reaction occurs. And we’ve been able to do that because the physician groups and acute care groups agreed that it was something they wanted to do at the same time.
The other key to our success is that we’re a very high-touch teaching, training, and consulting organization. We do an awful lot of handholding that not a lot of other organizations do. A lot of folks attempt to try to shortcut that, and we found that shortcutting it just makes the trip longer. The University of Colorado did a study here a couple years ago because they wanted to understand why our level of adoption was so high, and one of the things they found—and this is going to sound simple—is that we answer the phone. We have real people, not voicemail. Around here if the phone rings twice, then someone is diving for it. We have a staff of 12, and we’ll be 18 with the added resources made available by the Beacon grant. Our team is made up of healthcare knowledgeable people. They’re not oriented to technical things. Most of them have been recruited within the healthcare delivery system, so they already understood what goes on within hospitals, so they understand workflow and understand urgency.
HCI: What advice would you give other leaders who want to set up an HIE?
Thompson: Governance is a key element to success. We have a very engaged small board of directors, and that has been one of the keys to our success. We’ve been very successful, but we’ve done it one step at a time. And we’ve not tried to boil the ocean and do too many projects at once. There are so many [projects] that are compelling and laudatory to do, but we’ve learned to say ‘not yet.’
We also hire people who have a passion for what we do. They’re fully engaged because this is a community endeavor that improves care and improves outcomes for patients, and if you have that passion it helps you over the rough spots. We also laugh a lot. Various things have been used to keep things light. The current one is that we have a dodo bird. The dodo bird is either self-awarded or there’s a kangaroo court that decides to award it. I can tell you I am the owner of the dodo bird at this point, but I can’t tell you why. I think it’s a good mix of passion and also understanding that we can laugh at ourselves and our own foibles. Although we take our projects seriously, we don’t take ourselves too seriously.