'Health Information Technology for dummies: what I wish I had known before implementing HIT in a rural region'

Health information technology (HIT) provides the umbrella framework to describe the comprehensive management of health information across computerized systems and its secure exchange between consumers, providers, government and quality entities, and insurers. Health information technology (HIT) is in general increasingly viewed as the most promising tool for improving the overall quality, safety and efficiency of the health delivery system (Chaudhry et al., 2006). Broad and consistent utilization of HIT will:...
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“Health Information Technology for dummies: what I wish I had known before implementing HIT in a rural region” “HealthInformationTechnology fordummies:whatIwishIhad knownbeforeimplementingHIT inaruralregion”KikiC.Nocella,PhD,MHAUniversityofSouthernCaliforniaJune5,2006RuralCalifornia Rural Medical Service Study Areas Frontier – less than 7 persons per square mile Rural – less than 250 persons per square mile Non-Rural80% of land mass14% (and growing) ofpopulationlive in rural California4.9 million residentsSource: 2000 census dataMarketArea(Tehachapi,Mojave,CaliforniaCity)CrossingtheQualityChasminSoutheastKernCountyPopulationCentersinSoutheastKernCountyare: Tehachapi(population34,383)¹• CaliforniaCity(population8,385)²• Mojave(population3,836)²• Boron(population2,025)²• NorthEdwards(population1,227)²• 1.TehachapiChamberofCommerce(2006projected) 2.2000U.S.CensusTheBasics….vitalstatisticsofSEKern• SecondworstcountyinStateforratesof Chlamydia(57thoutof58)• 3rdlargestandthe7thpoorestof California’s58counties.• Deathsduetodiabetes,47thoutof58• Deathsduetocoronaryarterydisease, 56thoutof58 98.7%outwardmigrationforinpatientcare Hospital Discharges of Patients living in southeast Kern 1.9% 0.8% 2.3% 1.2% 1.8% 1.3% 0.7% 3.9% 0.7% TVHD 0.5% 0.5% 7.2% 9.7%9.5%10.0% 47.0%OurProject Infrastructure• Telemedicine• EHRsandCHIE• PHRs• DiabetesEducation• Healthprofessionstraining• EHealthAlerts•Whatweknewgoingin…. Therewouldbeugliesunderthecarpet• Therewasnotrust• Unknowncapacity• It’s“perfect”•Successes Collaboration• Communication• Networkexpansion• Processvs.Task•Lessonslearned….andstilllearningLet’sstartwiththebasicsDoesanyonehavea3prongedoutlet?Whydoesithavetobesodifficult?Teleopthalmology….4reimbursement modelsEHRsandHIE–fromalayperson’s perspectiveOr…..amIanidiot?You’regoingtoneedmorethanoneitemonthemenu….Andachefwhocancookitall!Cananyonespell“CPTCode”?….letalonegetone?• K.I.S.S. I AAFP Price Quote Price Quote Willingness Server Ranking t’s 1st Provider Additional Maintenance Fee Training Fee to Partner / Placement Score (Software) Providers Notes (n) A Yes lo Additional $4,500/mid-level cost to 18%/year ofEncounter Pro $6,500/provider $1000/medical ~$100/hr/day In-house/ASP ...