Rocky Mountain RHIO
A low-key management style and an emphasis on improving care have boosted physician support for a RHIO in Colorado.
The Quality Health Network (QHN) in Grand Junction, Colo., was launched less than two years ago, but the regional health information organization has already reached a milestone: three-quarters of the digital health care data available to its subscribers is circulating electronically. That means physicians are actually using its services.
“We are now at the point where 75 percent of the data in our community that can be transmitted electronically is actually being transmitted electronically,” said Dick Thompson, QHN’s executive director. “The doctors really like the system, and so we feel like a transformation is truly occurring.”
QHN executives say the network’s success reflects the region’s culture of collaboration. Tucked between the Rocky Mountains and the Great Salt Lake Desert, about midway between Denver and Salt Lake City, Mesa County is defined by its geographic isolation, which leads residents to depend on one another to get things done.
In 2004, that mentality led some of the region’s major health care organizations — including two acute-care hospitals, a health care plan, a community-based specialty health care provider and an independent physicians’ association — to found and fund QHN. The network went live in October 2005.
“The idea was to create QHN as an apolitical, trusted third party,” Thompson said. Adhering to that ideal has been critical to the RHIO’s effectiveness, he added. “In other words, we are seen by everyone as a level playing field where all the participants play evenly and fairly rather than fulfilling one organization’s agenda,” he said.
The business model
QHN aggregates data from diverse sources and then delivers results and information to authenticated users.
The network collects data from two hospitals, various commercial laboratories, two surgery centers, more than 120 pharmacies, the local public health organization, physician practices and the Rocky Mountain Health Plans.
It sends aggregated data to physician practice databases, a patient population database and a repository of patient histories available only to physicians in emergencies. The data is used to reconcile medication orders, manage shared risk populations, develop disease-prevention strategies and aid in managing disease.
QHN offers 22 services, including clinical messaging, electronic medical record interfaces, electronic prescribing and ordering of medications, a common patient index, data privacy and security standards, workflow training and support, and help-desk and network management. Axolotl supplied the network infrastructure and software for QHN.
“We’ve tried to create a compelling volume of data so physicians can connect in one place and get all of this data from different sources,” Thompson said.
A benefit of participating in QHN is that physicians can now easily fill information gaps in a patient’s record, said Dr. John Beeson, vice president of medical affairs at St. Mary’s Hospital and Regional Medical Center, and one of the system’s participants.
Patients “may show up in the emergency department after visiting the office of a specialist the day before, and the results of that consultation would not have been available prior to the implementation of QHN,” he said. “Now, if the provider and the facility are both using QHN, the information is available in real time.”
Follow the data
However, the best testament to the system’s popularity comes from physicians’ increasing use of QHN, with the following results.
- The network collected more than 107,952 clinical results in March, and 75 percent of them were delivered electronically.
- User requests increased from 169,406 in November 2005 to 914,841 in January, meaning that “not only are physicians getting the data, but they’re acting on it multiple times,” Thompson said.
- The average daily number of physician requests was 26,384 in March, a 32 percent increase since December 2006.
QHN’s governance