We're one of four Regional Extension Centers in Texas.
All four collaborate very regularly.
And all Regional Extension Centers in Texas,
what we're doing is,
we are really focused on enhancing
the primary care practitioner's practice,
with health IT being a way
to support improving their practice.
So we go out, we assess the practice,
look at their work flow,
look at what three or four technologies
might work for them,
help them to develop a plan,
work with the vendors to make sure
that there's no "gotchas" in terms of cost,
or any other impediments to their implementation.
And then we also work very closely
with all of the health information exchange groups
in the state, to the Regional Extension Center is really
the point of the spear, working with the practitioners
in transforming their practice,
and then reaching out to that practitioner's network
to help them exchange data, building on the infrastructure
around health information exchange
that is very briskly being adopted in the state.
With the start of hurricane season, we have,
particularly for medical special needs patients,
it's really important that they be able to,
if they have to leave their home,
that their information is transferred
to the next practitioner, in terms of caring for them.
If they do what's called "sheltering in place,"
we want to make sure that the information is available
so that, as we need to support them in their home
after the storm or after the thing has passed,
that we could actually help them and make sure that they had
the services and things that they need.
During Katrina, there in Houston,
we had about 1/4 million folks that came over from Louisiana,
and they came over, and they all needed health care.
And what we learned during that period of time
is that the key thing
that was most useful was the e-prescribing.
We were able to quickly work with the state agencies
and other groups to get access to that medication data,
and that was really important to be able to understand
what the patients' medications were,
because that gives the doctors taking care of the patients
some clues, in terms of at least being in the right ballpark,
in terms of what their problems and things like that are.
All of this -- implementing electronic health records --
is difficult, because you're really changing
the practitioner's work flow.
But the Regional Extension Centers,
what we've been funded to do is to help that practice
understand what their work flow is, implement the technology
that's going to support their work flow
and minimize the impact on their practice revenue
and the amount of time and the cost that is associated
with implementing electronic records.
The goal is to basically really try to use this
as an opportunity for getting physicians
back in a leadership role for their patients,
in terms of quality.
The patients really need to start asking questions,
and in fact, it's really funny -- our practice
gets calls regularly now from patients
that are seeking a doctor, and one of the first questions
they ask is, "Do you have an electronic health record?"
And I think that's great.
The second thing that I think patients need to ask is,
"Do I have access to my information?"
Through what's called a patient portal.
EHRs alone will not assure quality of care.
Use of the data from EHRs, and bringing that back
into a quality improvement program for the practitioners,
that's what will actually change how care is delivered.
Integrating EHRs into a local health information exchange
to make sure that this doctor's data
is exchanged with the other doctor's data
to keep everyone on the same page
is how we're actually going to be able to do several things
that are going to be very important
for reducing the costs and improving the care of patients.
In terms of being able to decrease
duplication of services,
not repeating the same MRI -- you go to this doctor,
and they say, "Well, I need to do this,
because I don't have access to it."
Another big thing is in terms of medication reconciliation.
This doctor often doesn't know what's been prescribed,
and you can't just rely on the patient memory
or the bag of medications that they show up with
in the office.
We really need to be able to use the existing data
that's out there in exchanges
to be able to focus on those two key things.
The thing to start thinking about is,
just like you discharge a patient,
we need to think of discharging the patient's information
to the patient's medical record
back to their primary care doctor.
So it's a big believer in people, processes,
and then using technology to support effective processes.