Well we're with Laura Adams the CEO of Rhode Island Quality Institute,
which operates the state of Rhode Island's Health Information Exchange,
called Current Care.
Laura, I really appreciate your taking the time to be with us today.
The Current Care has a very interesting history,
dating all the way back to 2001.
If you could just explain that to us and
maybe the role that you played in getting SureScripts launched briefly and
walk us through today, that would be great.
>> Certainly. We started in 2001 as a public private
partnership.
We're a 501, not for profit free standing entity, not a state agency,
but deeply engaged with our state as a partner in all of this.
Our goal was to dramatically improve quality, safety and value.
We started out as a consortium of leaders basically,
people with our hands on the levers of Rhode Island's healthcare system.
And our first question was we'll great, we're all in a room,
we're all agreeing to collaborate, what do we do?
We settled on information technology.
My background is quality improvement and I knew that I was stymied at every turn
because of the paper based system, that if we were really going to improve
quality we had to go for health information technology.
So we became the place where SureScripts decided that they would do their first
beta test of end to end true electronic prescribing.
That pilot ended up being an incredible success and
obviously SureScripts is nationwide now and robust and
we're very proud of that opportunity to participate in that.
>From that point on, we received the state on our behalf,
the state government received a grant from the agency for
health care research and quality called the State and
Regional Demonstrations In Health Information Exchange.
That came in 2004, and kicked off the funding for our privacy framework,
our governance framework, and our stakeholder engagement piece of this.
Along came HITECH in 2009.
Our organization was the only one to hit the trifecta,
to win all three major HITECH grants.
That was the Beacon, the HIE, and the Regional Extension Center.
We were able to land about $27 million in 90 days to build
out everything we've done so far.
So, that's sort of the history of how it all came about.
>> Now, one of the reasons I'm here is because you're such an innovative and
extensive user of Direct.
So, how did that come about?
>> We are a big believer of a centralized model in that what model you
choose depends on what you're looking to do in the future, what your goals are.
For ours we wanted a very robust, persistent database where
we could do research, we could do quality improvement,
population health, comparative public reporting, lots of things with that.
But in 2004 we did a little survey and
there were 60 plus different, EHR platforms in our state and
we said, what are we going to integrate with all 60 of these?
There's going to be 70 and there's going to be 80 and
then we have to keep every interface up and running.
The cost of that was beyond our reach and the time frame for
doing that was beyond our comprehension, we want to move fast here.
So suddenly we were at a national meeting when Direct was announced and
then our Chief Operating Officer, Gary Christianson, turned to me and said,
point to point.
He said what if one of those points is in EHR and the other point is our HIE,
Current Care?
Couldn't we use that to lift a continuity of care document
out of those EHR's?
No interface required, no upkeep required,
no millions of dollars to get our community connected.
We were astonished at the simplicity of that solution and it has worked for us.
So we have platforms in beta line of code.
When a physician closes a record or
some other trigger that they've put into their platform, we close the record,
it sends out an automatic API call up to Direct messages formed.
It attaches the current continuity of care document,
ships it up to current care.
So it's all automated, behind the scenes,
no physician ever has to push a button, to remember to do something.
It's automated, so for us, we were incredibly excited about it.
>> So, I want the students to focus on what Laura just said.
I've talked repeatedly about the need to integrate direct into workflow, and
you just heard an example of that.
>> That's right, that's right.