Dr. Jason Waterman, a pediatrician at the Heritage HealthCare Center, recently championed the transition for Heritage HealthCare Center to join a Regional Health Information Organization (RHIO). Heritage is a community health center in Harlem that provides a wide range of services across a number of specialties such as internal medicine, women’s health, dental services, podiatry services, and HIV/AIDs services across all age groups. Dr. Waterman became interested in joining a RHIO after learning that integrating with a RHIO could help Heritage to be successful in payment reform initiatives.
During the RHIO integration process, Heritage HealthCare Center received assistance from NYC REACH. Activities to start the integration included:
- Selecting a RHIO – Dr. Waterman decided to join the Healthix RHIO because the coverage and other contributors to the RHIO overlapped best with Heritage’s patients’ neighborhoods;
- Identifying changes to Heritage’s day-to-day workflow – After reviewing a sample workflow, Heritage updated their practice workflow in order to participate in existing and new payment models; and
- Offering trainings to the entire practice staff including front desk staff, nurses, medical assistants, case managers, and providers.
Dr. Waterman and his Administrative Nurse Manager, Yelitza Castanos, championed this new process, leading the practices’ efforts to successfully integrate the RHIO into their workflow. Motivating all practice staff and integrating them within a new workflow can be challenging. Ms. Castanos noted, “Something that was very beneficial was when we had the whole staff present when we were rolling out the program. Everyone understood the purpose of the program and there wasn’t any resistance from the staff.” Ms. Castanos advises practices to be flexible while implementing the workflow, as staff roles may need to change.
One way the practice customized the sample workflow was deciding how to implement the patient consent process. Because the practice is in Harlem and many of the patients speak Spanish, Heritage decided to provide patients with information about the RHIO and consent forms in both English and Spanish. Front desk staff are responsible for enrolling consenting patients, but can receive support from trained clinicians. Heritage HealthCare Center has found that patients generally have a positive reaction to enrolling with the RHIO, and some assume the practice was already involved with such a system.
After Heritage HealthCare Center implemented the new workflow, staff found it easier to view patient health information, such as a patient’s admission to an emergency room. Before Heritage integrated with a RHIO, their providers could not receive real time information on a patient’s visits to the emergency room or to other doctors – requiring them to contact the emergency room or the other practice directly or rely on the patient to share that specific information during their next visit.
Participation in the Healthix RHIO also helped Heritage HealthCare Center to be successful in the practice transformation program Patient-Centered Medical Home (PCMH). Ms. Castanos noted that “…one of the goals the practice was to meet the PCMH standard of Health Information Exchange, and with the help of the RHIO, the practice was able to do so. We are now looking into other incentive programs to see if we can receive additional incentives for using the RHIO.”
If you have questions about joining a RHIO or would like to enroll, NYC REACH is here to help. Please visit http://nycreach.org/practice-transformation/#rhio-connectivity.
A Regional Health Information Organization (RHIO) is a group of organizations, which can include public health organizations, laboratories, pharmacies, payers and providers that share healthcare-related information electronically through accepted healthcare information technology (HIT) standards. This system allows all providers involved in a patient’s care to share and receive patient information in real time for managing patient care with co-providers, track laboratory reports, diagnoses, and referrals process. New York State currently has eight RHIOs available. Three of the eight serve the New York City area: Bronx RHIO, New York Care Information Gateway (NYCIG), and Healthix. RHIOs and other networks called Qualified Entities comprise the Statewide Health Information Exchange Network for New York (SHIN-NY), which enables the secure exchange of this health information. Research has shown the use of RHIOs can improve patient care as health information about the patient is more readily available across multiple care providers.
Heritage HealthCare Center http://www.heritagenyc.org/services.php
Qualified Entities (QE) https://www.nyehealth.org/shin-ny/qualified-entities/
What is the SHIN-NY | Join SHIN-NY | NYeC https://www.nyehealth.org/shin-ny/what-is-the-shin-ny/
Health IT Improved Diagnostics & Patient Outcomes www.healthit.gov/providers-professionals/improved-diagnostics-patient-outcomes