Disclaimer: This is an acronym-laden zone. Please proceed with care.
Sometimes we aren’t very good about celebrating our successes. That feels especially true right now in the sad story of the DC Regional Health Information Organization, which only just recently launched and is now, suddenly, suspended. (See this reporting in the Washington Business Journal to learn more.)
The DC Primary Care Association’s ambitious plan was to use the DC RHIO to coordinate the provision of health care services across the regional network of hospitals and specialists and community health clinics like Bread for the City. The goal was to achieve — through established channels of shared information — better patient-centered medical care with fewer errors, greater cost-savings, and protection for the most vulnerable people in our community.
It is a beautiful and exciting vision. In our unfortunate current reality, there are many separate data systems across the city, even within a single organization (like a hospital for example), that all track different pieces of care, without the ability to talk to one another. That makes for seeing a whole health picture very difficult. Think of it this way: in the 21st century, we can access all the world’s information from gadgets in our palm, but when we go to a neurologist or the ER, our doctors don’t have access to our primary doctor’s most recent labs and notes. James Turner of the HealthIT Now Coalition draws a parallel, “It’s as if we live in a time when someone with a Verizon phone can’t talk to someone with AT&T service. But this is healthcare!”
Consider the following scenario that our Dr. Randi lays out: “Say a patient of ours had a heart attack or a stroke. They have just been released from the ER, and they are confused and distressed. They might have no idea what doctors they saw, what tests were performed, or even the outcome of the visit. With a Health Information Exchange, we [providers] can look that patient up in the system, see lab results, medications prescribed, pathology reports, discharge summaries, and we can begin to piece the picture together for the patient. When we can help in that way, the patient is relieved and more informed and we can give them better care with less redundancy and run-around.”
And perhaps the best reassurance that we were doing the right thing with the RHIO: patients were behind it. When we would tell Bread for the City patients that we would be sharing their information with other providers in the RHIO, the response was often “Aren’t you doing that already?!” After all, that’s what quality healthcare and meaningful use of technology is all about, right?
While small at first – six early-adopter clinics and a few hospitals – the big vision for the RHIO entailed the interconnection of every point of contact in the whole system of care in the Washington DC for all the city’s patients.
So why then, if the project was underway, did the District halt the development of its Health Information Exchange? I don’t really know for sure, but I think it’s safe to say that it involves politics and money.
If the RHIO is not saved, a considerable amount of investment will go to waste — and the potential value will be lost. The District has announced the pursuit of a bare bones Direct Project model, instead of a more robust HIE – but this feels a little like salt in the wounds. This Direct Project is essentially just a protected email service — while it serves a function that could be integrated into a bigger HIE system, it falls far short of the comprehensive data sharing necessary to improve care.
Now what? Rather than lose years of progress and millions of dollars which put DC at the cutting edge of health information technology, we think DC should reconsider this new direction. The DC RHIO is an investment worth protecting. Let’s ensure the effective implementation of the health information technology initiatives that we need to modernize our healthcare system. The State Health Information Exchange is really a valuable public utility — so the Mayor and City Council should be committed to identifying budgetary solutions for next year and beyond. We need $3,086,000 to be funded to DCPCA through the Office of the Chief Technology Officer to save DC RHIO. Please contact the Mayor and your Councilmember today and ask them to invest in our city’s health.
SAVE THE DC RHIO!