Health information exchange leads to improvements in rural disease control initiatives
July 27, 2011
This report originally appeared in the July 2011 issue of DOTmed Business News
By Jamie Welch
The Louisiana Rural Health Information Exchange was formed by the Rural Hospital Coalition with $13 million in funding provided through the Louisiana Department of Health and Hospitals in the 2007 session of the state legislature.
Working with Fusionfx technology from Carefx, a subsidiary of Harris Corporation, LaRHIX has fulfilled its mission to support state HIT initiatives in rural areas, facilitate professionals’ access to medical records from any provider database, provide health information exchange for 24 rural hospitals and deliver connectivity between rural physicians and specialists at the Louisiana State University Health-Shreveport.
More recently, however, LaRHIX has faced added challenges in the form of new and emerging chronic conditions and population movement and growth. LaRHIX has responded with innovations in data source integration, telemedicine, mobile mammography and planned linkages with other hospitals in the LSU system.
While LaRHIX covered 1.3 million people at its inception in 2007, it now covers more than 2.5 million. A combination of factors, including Hurricane Katrina, the Gulf oil spill and the 2011 flooding of low-lying areas, have forced people to move away from New Orleans. As a result, cities such as Shreveport have grown from 10 to 15 percent. LaRHIX has responded to population shifts by increasing its number of computer servers as well as expanding its master patient index.
The diseases and conditions of patients treated have also changed. The Crescent City Beacon Community, now serviced by LaRHIX, is part of the Beacon Community Program of the Office of the National Coordinator for Health Information Technology. The Crescent City Beacon Community received funds from the ONC to tackle smoking and diabetes among rural minority residents.
Now, however, the Crescent City Beacon Community must revamp its program and substitute smoking with asthma. This is a service that is required in the area due to the increase of Louisiana adults – close to 12 percent – who have been diagnosed with asthma. In 2008, the percentage of Louisiana residents between the ages of 18-24 with asthma doubled from 6.3 percent to 13.3 percent, according to Louisiana’s Department of Health and Hospitals in a 2008 report.
Another disease management and detection program provided by LaRHIX is its mobile mammography program. Under this program, patients over 40 with no insurance are provided the opportunity to receive mammograms at a severely reduced cost. Of the 200 women served, almost 80 percent have never had a screening, primarily due to lack of funds and access to local services. The mobile van program serves some 200 patients per month, one every 12 minutes. Radiologists discover a lesion in two out of 10 women scanned. Since the start of the program, LaRHIX has seen a 20 percent increase in the detection rate of breast cancer.
LaRHIX provides instant feedback to women who might not otherwise return to receive their results. Working with Population Health, LaRHIX is already tracking the long-term outcomes of women with abnormal mammography readings.
Along with breast cancer and asthma, diabetes is a serious and costly disease for the state. Close to 330,000 adults age 18 and older received diabetes diagnoses, according to the 2007 Louisiana Behavioral Risk Factor Surveillance System. Moreover, diabetes prevalence within the state increased from 5.2 percent in 1997 to 10.1 percent in 2007 among adults age 18 and older, an increase of close to 5 percent.
LaRHIX addressed the statewide diabetes epidemic by augmenting its telemedicine offerings with a retinal scanner to detect glaucoma and other eye conditions among diabetics. It also added a foot and plastics consult so diabetics could receive immediate feedback on foot and wound care, increasing patient awareness of their own treatment needs.
A look into the future
LaRHIX now links to Louisiana State University Health in Shreveport. When LSU’s other nine hospitals go live with a unified record from EPIC at the end of 2012, LaRHIX will cover 3.9 million people out of the state’s total population of 4.5 million.
Lessons learned at LaRHIX that carry on to state HIEs
Start small, think big, move fast: LaRHIX started with seven small hospitals in 2008. Six years later, the organization covers 90 percent of the state.
Engage physicians and other clinicians: Communicate the vision and value of health information exchange, while allowing health care professionals to experience significant, immediate benefit in routine practice.
Think local: Sell providers on the vision of health information exchange, but also offer practical operations support.
Stay lean, but not mean: LaRHIX started with a staff of four. Although the project is now three times its original size, LaRHIX still functions with a staff of five.
Invest only when you must: LaRHIX has consistently resisted the temptation to replace systems with new and trendy vendor product lines.
Tune into patients: Stay aware of demographic and psychographic shifts, as well as changing disease and condition profiles. Consult resources from the Centers for Disease Control and Prevention, Kaiser State Health Facts and state agencies.
Jamie Welch is the chief information officer for the Louisiana Rural Hospital Coalition, Louisiana Rural Health Information Network.
By Jamie Welch
The Louisiana Rural Health Information Exchange was formed by the Rural Hospital Coalition with $13 million in funding provided through the Louisiana Department of Health and Hospitals in the 2007 session of the state legislature.
Working with Fusionfx technology from Carefx, a subsidiary of Harris Corporation, LaRHIX has fulfilled its mission to support state HIT initiatives in rural areas, facilitate professionals’ access to medical records from any provider database, provide health information exchange for 24 rural hospitals and deliver connectivity between rural physicians and specialists at the Louisiana State University Health-Shreveport.
More recently, however, LaRHIX has faced added challenges in the form of new and emerging chronic conditions and population movement and growth. LaRHIX has responded with innovations in data source integration, telemedicine, mobile mammography and planned linkages with other hospitals in the LSU system.
While LaRHIX covered 1.3 million people at its inception in 2007, it now covers more than 2.5 million. A combination of factors, including Hurricane Katrina, the Gulf oil spill and the 2011 flooding of low-lying areas, have forced people to move away from New Orleans. As a result, cities such as Shreveport have grown from 10 to 15 percent. LaRHIX has responded to population shifts by increasing its number of computer servers as well as expanding its master patient index.
The diseases and conditions of patients treated have also changed. The Crescent City Beacon Community, now serviced by LaRHIX, is part of the Beacon Community Program of the Office of the National Coordinator for Health Information Technology. The Crescent City Beacon Community received funds from the ONC to tackle smoking and diabetes among rural minority residents.
Now, however, the Crescent City Beacon Community must revamp its program and substitute smoking with asthma. This is a service that is required in the area due to the increase of Louisiana adults – close to 12 percent – who have been diagnosed with asthma. In 2008, the percentage of Louisiana residents between the ages of 18-24 with asthma doubled from 6.3 percent to 13.3 percent, according to Louisiana’s Department of Health and Hospitals in a 2008 report.
Another disease management and detection program provided by LaRHIX is its mobile mammography program. Under this program, patients over 40 with no insurance are provided the opportunity to receive mammograms at a severely reduced cost. Of the 200 women served, almost 80 percent have never had a screening, primarily due to lack of funds and access to local services. The mobile van program serves some 200 patients per month, one every 12 minutes. Radiologists discover a lesion in two out of 10 women scanned. Since the start of the program, LaRHIX has seen a 20 percent increase in the detection rate of breast cancer.
LaRHIX provides instant feedback to women who might not otherwise return to receive their results. Working with Population Health, LaRHIX is already tracking the long-term outcomes of women with abnormal mammography readings.
Along with breast cancer and asthma, diabetes is a serious and costly disease for the state. Close to 330,000 adults age 18 and older received diabetes diagnoses, according to the 2007 Louisiana Behavioral Risk Factor Surveillance System. Moreover, diabetes prevalence within the state increased from 5.2 percent in 1997 to 10.1 percent in 2007 among adults age 18 and older, an increase of close to 5 percent.
LaRHIX addressed the statewide diabetes epidemic by augmenting its telemedicine offerings with a retinal scanner to detect glaucoma and other eye conditions among diabetics. It also added a foot and plastics consult so diabetics could receive immediate feedback on foot and wound care, increasing patient awareness of their own treatment needs.
A look into the future
LaRHIX now links to Louisiana State University Health in Shreveport. When LSU’s other nine hospitals go live with a unified record from EPIC at the end of 2012, LaRHIX will cover 3.9 million people out of the state’s total population of 4.5 million.
Lessons learned at LaRHIX that carry on to state HIEs
Start small, think big, move fast: LaRHIX started with seven small hospitals in 2008. Six years later, the organization covers 90 percent of the state.
Engage physicians and other clinicians: Communicate the vision and value of health information exchange, while allowing health care professionals to experience significant, immediate benefit in routine practice.
Think local: Sell providers on the vision of health information exchange, but also offer practical operations support.
Stay lean, but not mean: LaRHIX started with a staff of four. Although the project is now three times its original size, LaRHIX still functions with a staff of five.
Invest only when you must: LaRHIX has consistently resisted the temptation to replace systems with new and trendy vendor product lines.
Tune into patients: Stay aware of demographic and psychographic shifts, as well as changing disease and condition profiles. Consult resources from the Centers for Disease Control and Prevention, Kaiser State Health Facts and state agencies.
Jamie Welch is the chief information officer for the Louisiana Rural Hospital Coalition, Louisiana Rural Health Information Network.