Earlier this month the Quality Health Network (QHN), the Western Colorado health information exchange was awarded $11.8 million by the Beacon Community Cooperative Agreement Program, an initiative of the Office of the National Coordinator for Health Information Technology. QHN, which went live in October 2005, was one of 15 health IT pilot communities that received grants totaling $220 million, funded by the American Recovery and Reinvestment Act (ARRA). Healthcare Informatics ’ Associate Editor Jennifer Prestigiacomo spoke with QHN CEO Dick Thompson about what projects would be funded by the award and how he’s going to continue to grow his network to include more than 20 hospitals and attendant physicians in the 40,000 square miles of Western Colorado.
Healthcare Informatics: How many organizations and healthcare providers are signed up with QHN now?
Thompson: We have 125 disparate organizations and 561 providers. We’ve connected almost every kind of organizational entity in the healthcare delivery system, from hospice to extended care to occupational health to physical therapy to surgical centers—you name it, they’re connected.
HCI: What were the overarching goals for setting up QHN?
Thompson: Our organization was chartered to optimize the health of the residents of this area. And one of the first initiatives was to try to improve care transitions and care coordination. Both of those endeavors require robust exchange of information to be optimal. So it was decided an HIE would serve the purposes of both improving quality and efficiency among independent providers.
HCI: What specifically are you going to be doing with the award you received from the Beacon Program?
Thompson: That grant application was congruent with the direction we were headed. The first objective was to expand connection with the Quality Health Network to all of Western Colorado, not just the nearby counties. So, our intermediate term objective is to connect 20 some counties and approximately that many hospitals and attended providers into the network within 36 months.
Additionally, we intend to provide better disease state management and population management tools and improve the ability of the health information exchange to gather data from electronic medical records systems. We are also focusing on improving the physician portal so that participants who may have hospital privileges at two or three hospitals can get a single sign-on accomplished via connection to QHN and from there, provide easy access to other care organizations. That is an increasing problem for physicians—we’ve got increasing amounts of data as an industry, but we’re making it more and more difficult to gain access to it.
The other area of focus is to deploy a wide patient portal so we can improve patient to physician communication. A tethered patient portal for an EMR is in our view, not the answer.
[We also want to] connect with other HIEs in the area. We are a Western Colorado trade area, but that also includes Eastern Utah. Although the geo-political lines say that Colorado and Utah are different, from a patient perspective, they readily traverse the area. We also want to connect with the CORHIO Initiative, which is focused on the eastern side of the state because we have a small percentage of our patient population who are referred there for some specialized situations.
HCI: How are you encouraging adoption among providers?
Thompson: That’s probably a three-hour dissertation. [Chuckles] There’s no simple answer to that. I think from an altruistic perspective all physicians simply want to do a better job at treating patients and have quick and easy access to relevant data that can be provided in a timely fashion—that’s really the attraction. We also do practice and workflow redesign, particularly with those offices that are largely paper-based organizations. There are some efficiencies that accrue from the act of connecting to QHN. At some point you get to a critical mass or a tipping point, in terms of those who are connected and those then who are not feel that they need to and are more compelled to participate. The IPA (Mesa County Independent Physicians Association) here also provides some nominal financial incentive for participation with the network.
HCI: What kind of education are you doing to help participating doctors implement EHRs?
Thompson: Oh my! It is initial and ongoing and persistent. We have analyzed it and we spend about 48 hours per doctor over the course of months and years in helping them move from paper-based processes and clear up to population management tools and disease registries. [We do everything] from very low levels of what I’m going to call a process improvement pyramid, clear to the top, which would include automated processes that include disease state and population management and preventative care management—that’s about 48 hours per doctor. That includes training their staff. There’s just no short cut to it. I think that one of the things that has made us successful is that commitment to initial and ongoing teaching, training, consulting, and support.