With some of the most gorgeous landscape in America, a temperate climate and a relatively low cost of living, western North Carolina is fast becoming a retirement mecca. For the 16 community hospitals nestled in the shadows of the Great Smoky and Blue Ridge Mountains in this part of the state, that influx of seniors translates into an increasing population of Medicare recipients, a factor that has helped drive development of the Western North Carolina Data Link project.
Launched at the end of January 2006, WNC Data Link is a regional health information organization that will ultimately connect those hospitals serving the 15 counties of western North Carolina to allow quick and easy sharing over the Internet of patient data among participating physicians and their office staffs. The long-term goal is to provide every western North Carolina resident with a longitudinal electronic medical record that can be accessed and updated in real time by any authorized provider. The short-term goal is to allow the secure exchange of electronic patient information among western North Carolina hospitals.
Rural Patients Linked to Urban Care
The data exchange is already up and running in four hospitals. Angel Medical Center, Haywood Regional Medical Center, Rutherford Hospital and Transylvania Community Hospital--all of which use the Meditech Magic clinical information system platform--are connected and sharing laboratory and radiology reports, medication histories and admissions data. WNC Data Link plans to expand the information exchange to PACS images and eventually physician EMR suites.
The hospitals leading the effort have agreed that for security purposes, there would be no central data repository or data warehouse used to store patient data. Instead, software from AccessPt hosted at an IBM data center will make it possible to retrieve information from participating provider databases.
Governance of the RHIO, whose initial $2.5 million in federal Health Resources and Services Administration funding was secured with the help of U.S. Rep. Charles Taylor, is provided by the Western North Carolina Health Network, an Asheville-based not-for-profit collaborative of hospitals, county health departments and other providers to support the delivery of cost-effective, quality health services to the region.
“We’ve been working at this RHIO since 1999,” says Bob Bednarek, CEO of Transylvania Hospital, a 54-bed hospital in Brevard, a town of 7,000 about 40 miles south of Asheville. “I see this as simply a start. We’ll be building this for 10 years and probably improving it forever,” he says.
Bednarek, who chairs the data link’s steering committee, says not only is western North Carolina drawing more Medicare patients, but it also already has a high proportion of Medicaid and uninsured. “That’s because of the predominance of small business,” he says, which represents mostly service industries catering to tourists and retirees. “We don’t have major corporations driving any single initiative in this region. Also, we have widely dispersed communities with mountain boundaries between and a population spread out over 15 counties.”
The electronic communication among providers, quick and easy access to patient information and elimination of duplicate tests made possible by the data link should result in more accurate and efficient care for this diverse and dispersed population. “Doctors really get enthused as a result of the improved quality and safety. That to me is really exciting,” Bednarek says. “We’ll be able to send key patient data to an Asheville hospital, and that data will be accessible by clinicians before the patient even gets there via a 35-minute ground transport.”
Perhaps a prime example of the RHIO’s benefits would be in the case of a patient from an outlying community who must travel to Asheville, the region’s urban hub with 70,000 people, for a complicated invasive procedure like heart surgery at one of the large Mission Hospitals. A week after returning to his community, he might end up in the emergency department of a local community hospital, and WNC Data Link would allow the ED physician to access all of his lab results and medications from the big hospital’s EMR.
Versatile, User Friendly System
So far the implementation of WNC Data Link has been glitch-free, says John Olivier, director of IT at 195-bed Haywood Regional Medical Center in Clyde, a town of 1,300 about 20 miles west of Asheville. That’s likely due to IBM and AccessPt’s experience with implementing Meditech systems, which is one of the reasons hospitals with that system were phased in first. Olivier, who is active on the RHIO’s IT task force, says the AccessPt software queries a hospital’s database and retrieves the patient clinical information over a VPN tunnel, or secure virtual private network.
John Woods, a clinical information systems specialist at 60-bed Angel Medical Center in Franklin, a town of 3,500, manages 85 WNC Data Link users, all community physicians and associate staff who refer the bulk of their patients to the hospital. A single logon for those users brings them to the WNC Data Link Web site, which automatically pulls up clinical information on patients currently admitted to any of the participating hospitals. Doctors also can search for information on a particular patient who is not currently an inpatient, and the system will query each hospital’s databases for any relevant lab, radiology, administrative and pharmacy data.
Users can look at clinical information from any period they choose--the last 2 days or the last 30 days depending on need--and can click on individual tests for more detailed information. “It’s extremely easy to use. That’s one of the reasons it’s gone over so well with staff,” says Woods. Should a physician need to print a hard copy of a face sheet or lab report, for example, the data can be converted to a PDF document with a special WNC Data Link watermark for validity. “It’s a beautiful document to print,” he says. Also built into the system: audit tools that allow Woods to track who is accessing patient information to better ensure patient privacy and confidentiality.
Transylvania CEO Bednarek supports the big picture. “My role is to help the technical people stay focused on the long-term vision. We need to keep developing a sustainable business model for this RHIO. The idea of simply linking the hospitals together as mini-hubs has a certain amount of value. But the real value is in linking physician offices and physician office data so family practitioners can access information about what happened to a patient in Asheville at the cardiologist’s office,” he says.
While the hospitals have agreed to provide a base of funding in the early stages, as the RHIO matures “it can’t be funded on the backs of hospitals,” Bednarek says. The question is one of utility. People who access the information should pay for it on a usage basis. The next step is for WNC Data Link to bring in other players like insurers, employers, pharmacies, nursing homes--people who want to access patient information. “That’s one of the roles of administration. We’re creating value. Who will pay for it? I don’t have the answer to that yet.”
Chuck Appleby is a freelance writer specializing in health care and technology.
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This article first appeared on September 27, 2006 in HHN's Magazine online site.
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