The California Health eQuality (CHeQ) program, managed by the UC Davis Institute for Population Health Improvement (IPHI), has launched a new $1 million Rural Health Information Exchange Incentive Program to help physicians, clinics and hospitals in rural California implement technologies that enable the secure and reliable exchange of health information to improve health-care quality, lower costs and achieve federal meaningful use criteria.
In describing the new rural HIE incentive program in his keynote address to the recent 2013 California HIE Summit, IPHI’s director and UC Davis distinguished professor Kenneth W. Kizer explained that the effective use of electronic health records (EHRs) and health information exchange (HIE) are prominent features of current efforts to overhaul the U.S. health-care system. As part of these efforts, doctors and hospitals must implement electronic information management systems that meet so-called meaningful use standards, which include various core clinical measures such as being able to check for harmful drug interactions.
Kizer, who is also CHeQ’s director, explained that the new Rural HIE Incentive Program aims to address the many challenges that rural health-care providers face when trying to establish HIE systems. Because of the scarcity of providers in rural communities, especially specialist physicians, patients typically have to travel long distances to receive care, often from many different sources, increasing the likelihood that providers don’t have access to all of a patient’s health information. As a result, patients may undergo duplicative laboratory tests or imaging studies, receive prescriptions for incompatible medications and experience others problems resulting from such fragmented care.
"The Rural HIE Incentive Program leverages a new, more cost-effective model for enabling exchange in rural communities," Kizer said. "The program offers rural providers a choice of five designated HIE service providers who have been pre-screened and qualified for their ability to provide a menu of key health information exchange services, thereby allowing rural providers to procure the services that best meet their needs at a substantially subsidized rate."
He noted that CHeQ has allocated $1 million for the Rural HIE Incentive Program for the remainder of 2013. Continuation of the program after that time will depend on the availability of funds and the results of the current effort.
The new Rural HIE Incentive program was promoted during the 2013 California HIE Summit held May 8-9 in Sacramento. The event was jointly sponsored by CHeQ, the California Health and Human Services Agency and the Healthcare Information and Management Systems Society.
"While a number of rural communities have begun to unite around the need for health information exchange and have established local HIE initiatives, many others are in need, and few have means to implement it," said Rayna Caplan, manager of CHeQ HIE funding programs. "The CHeQ Rural HIE Incentive Program addresses these challenges by providing an overall structure of support for rural HIE implementation, which includes offering a list of designated health information exchange service providers and subsidizing 65 percent of the cost of initial implementation."
"Partnering with an HIE service provider also allows rural communities to manage their local governance while outsourcing implementation," Caplan explained. "We are optimistic that the new incentive program will help accelerate health information exchange in rural communities."
The service providers offer many types of high-priority, standards-based services. These include exchange with Direct as an option, the Nationwide Health Information Network’s secure, scalable and standards-based way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the Internet, as well as query-based exchange, with both longitudinal patient record services and repository services
HIE service providers range from established technology vendors who provide software-as-a-service solutions to systems integrators or consultants integrating multiple vendor applications to existing health information organizations offering exchange services
outside their governance domain. They were selected using a competitive process to meet meaningful use Stage 1 and 2 objectives, emerging care delivery and payment models, as well as local needs.
CHeQ-designated rural HIE service providers include:
- Axesson, Santa Cruz, Calif., www.axesson.com
- Informatics Corporation of America (ICA), Nashville, Tenn. www.icainformatics.com
- Inland Empire Health Information Exchange (IEHIE), Riverside, Calif.,www.iehie.org
- Orange County Partnership RHIO (OCPRHIO), Orange, Calif., www.ocprhio.org
- Redwood MedNet (RWMN), Ukiah, Calif., www.redwoodmednet.org
California Health eQuality (CHeQ), a program of the UC Davis Institute for Population Health Improvement, administers statewide health information exchange (HIE) projects for California. Funded by the California Health and Human Services Agency and under the auspices of the Office of the National Coordinator for Health IT (ONC) State HIE Cooperative Agreement, CHeQ is promoting coordinated and integrated care through health information exchange. Programs including a trusted exchange environment, improved public health capacity for electronic reporting, HIE acceleration funding opportunities, and the monitoring of HIE adoption lay a foundation for improvedquality of care for all Californians.