Safety-Net Providers Moving Forward with Health Information Exchange

MERRIAM – With initial assistance from the REACH Healthcare Foundation, more than a dozen safety-net medical providers in Johnson and Wyandotte counties have started working to improve care coordination by sharing patient records electronically.

The organizations’ officials gathered at the REACH offices Tuesday to kick off the Metro KC Safety Net Information Exchange Initiative, a two-year, $300,000 pilot project. Planners said they hope to expand to the Missouri side of the metropolitan area after further fundraising.

A key aim of the initiative is helping safety net providers connect with the statewide health information exchanges taking shape around the country.

Representatives from the exchanges serving Missouri and Kansas briefed Kansas City-area safety-net providers earlier this year.

“We know this is not an easy thing for you all,” said Scott Lakin, executive director of the Regional Health Care Initiative, which is coordinating the information-exchange pilot. “It is not easy to stop and implement new programs.”

Organizers have hired BluePrint Healthcare IT, of Cranbury, N.J., as a consultant on the pilot project.

On Tuesday, BluePrint executives began helping the providers hone in on the one or two patient populations they’d like to focus on in the pilot. That process should take no more than two months, said Eric Smith, director of HIE implementation & Strategic Development for BluePrint.

For example, the group might decide to focus on behavioral health patients who also have other chronic medical problems.

Narrowing the scope is essential, said Rebecca Goldberg, the company’s project manager for the Kansas City-area project.

“There are a lot of challenges in beginning this work,” she said. “You try to boil the ocean, right? We have this opportunity, but the opportunity is so large and so immense and there are so many places that we need to see improvements happen.”

The providers brainstormed about the types of information that would be most helpful to share electronically, including psychiatric diagnoses, lab results and care summaries from hospitals following a patient discharge.

Sandra Selzer, BluePrint’s director of healthcare transformation, came to the company after working with Dr. Jeff Brenner on a project to improve care for low-income patients in Camden, N.J. Brenner also is working with Kansas City-area organizations.

She said in the Camden project most patients came to their hospital discharge follow-up appointments “with nothing, absolutely nothing,” for the safety-net providers regarding the details of their hospitalizations.

“What we did find,” she said, “and what you will find through this process, is that the (health information exchange) is only as good as the data coming in. There’s work at the hospital end to get these chart summaries in faster.”

Safety-net officials noted that more efficient care is becoming increasingly important as states move toward managed care in their Medicaid programs, such as KanCare in Kansas.

Handling glitches and breakdowns in the computer system will be a challenge for the Health Partnership Clinic, a Johnson County participant, said its chief executive, Jason Wesco.

His organization doesn’t have an information-technology manager, he said. When something breaks or stops working, Wesco said, staff just quits using it.

Karen Suddath, senior vice president with Wyandot Inc., which operates a community mental health center in Wyandotte County, worried about overloading care staff with more information-technology requirements.

The staff is already digesting new billing codes and a new electronic medical record system, she said. “It is just a lot going on,” Suddath said.

She was enthusiastic about the pilot, though. Suddath was confident that any patient population the group decided to focus on would be relevant for her organization.

Dr. Tim Johnson, an emergency room physician, attended as a representative for the Children’s Mercy Pediatric Care Network, which coordinates care for pediatric Medicaid patients.

He noted the need for better sharing of lab results.

For instance, he said, it’d be nice to know that doctors have already tested the newborn he’s seeing for jaundice.

That way, Johnson said, “I wouldn’t have to stick this little baby in the heel, which hurts — and costs money.”

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