Thinking Big

Among the 700-plus unique queries the PCIP program has run to date have been queries around such questions as total patient load, encounters per year, BMI profile, diabetes and hypertension prevalence, adherence to recommended medication guidelines, distance patients travel to providers’ offices, and age, gender, race, and ethnicity distributions.

Meanwhile, in the trenches, practicing physicians say they are delighted with the PCIP program. “It’s totally changed the way I practice,” exults Michael Richter, M.D., a primary care physician who serves about 2,000 patients in the middle-class neighborhood of Rego Park in Queens. The program “is of value to me and to public health,” he attests. “Doctors don’t have time to report every case of gastroenteritis, so collecting syndromic data is automatically fantastic,” says Richter, who went live with his EHR (and whose go-live was facilitated by the NYDH) in 2009.

POTENTIAL FOR REPLICABILITY
Ultimately, Singer’s vision for the PCIP is as an initiative that can proactively improve care for New Yorkers of all backgrounds and neighborhoods, through a strong and continuous interaction between the health department and the primary care physicians taking care of patients city-wide; and that includes next moving into a still-broader phase involving creating a city-wide health information exchange (HIE). Still, Singer says, not every city or county health department will be able to achieve what New York has. “I think the stars have to align a bit,” he cautions. “We’ve had buy-in and support from the very top; we have a mayor who cares about public health and about technology; and commissioner of health who believes in what we’re doing, as well as tens of millions of dollars in grants,” not all of which have gone directly to the program, but which have created the technological infrastructure to support it.

Nevertheless, Singer reports that numerous representatives from health departments around the country have expressed interest in attempting similar initiatives, which he says indicates the potential for this kind of work to spread to communities across the U.S. In the end, he says, such work will necessarily be first and foremost about the health of communities. “As we say, health IT is just a vehicle we’ve chosen for public health, it’s not a be-all and end-all. And though we’re all geeks here and love information technology, in the end, it’s all about the public health for us,” Singer concludes. “It’s just lucky that we get to combine that commitment with our love for information technology.”