Regional Approach for Transforming Healthcare Quality through Information Technology (THQIT) in Rural Settings
Project Final Report (PDF, 201.35 KB) Disclaimer
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Project Details -
Completed
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Grant NumberUC1 HS016162
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AHRQ Funded Amount$1,499,999
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Principal Investigator(s)
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Organization
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LocationDanvillePennsylvania
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Project Dates09/30/2005 - 09/29/2009
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Technology
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Care Setting
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Population
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Type of Care
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Health Care Theme
Rural populations face many barriers to access high quality care. Health information technology (IT) is a solution to many of them but cannot be adopted unless implementation is affordable. The goal of the planning and implementation projects funded by the Agency for Healthcare Research and Quality was to create a standards-based, sustainable, secure, and confidential health information exchange called Keystone Health Information Exchange (KeyHIE) that would provide rapid, organized access to clinically valuable patient information from regional health care organizations (HCO) needed to support optimal care processes and patient outcomes. Geisinger Health System (GHS), an integrated delivery system with over 600 physicians and 40 clinics, in collaboration with regional HCOs, developed an approach to leverage health IT investments already made to provide incremental but important functionality that supports wider access to information, communication, and demonstration of the value of health IT.
There were five major components to this project:
- First, the development of a governing body to oversee the development and management of KeyHIE.
- The second was creating the standard technical architecture used to identify and match patients as well as store their demographic information. It also included a list of visits for each patient and a portal to display this information to authorized clinicians according to each patient's consent.
- The third component was a single sign-on feature that allowed clinicians to link from the KeyHIE portal to an HCO's electronic health record (EHR) without requiring the clinician to login a second time.
- The fourth component was the implementation of a clinical document store that permitted authorized clinicians to access clinical documents published by each HCO with information about their patients, so they could quickly access care information without requiring access to another EHR .
- The final component was a community lab interface to take lab results from a hospital lab system and file them into a different HCO's EHR using nationally recognized standards to translate the lab test names.
This project led to more effective triage in rural emergency departments in Pennsylvania, better informed clinicians, and better coordination and higher quality of care. This was achieved by keeping costs relatively low by using an incremental approach and translating a community hospital's lab results to LOINC (the standard terminology), and incorporating unstructured, high-value clinical documents (e.g., discharge summaries). An important lesson learned was that managing patient identity is one of the largest ongoing operating costs.
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