Wednesday, October 6, 2010

HIT for All Communities

The “Steering Committee on Telehealth and Healthcare Informatics” and the “National Health IT Collaborative for the Underserved” collaboratively held a briefing September 30th, on Capitol Hill to discuss the status of HIT efforts for underserved and minority communities.

Neal Neuberger, Executive Director, Institute for e-Health Policy, assembled the experts to discuss the impact of federal and state health investments, the increasing need and importance to use health IT in these communities, successes achieved, challenges ahead, and the next steps to take.

Last week, NIH announced that the National Center on Minority Health and Health Disparities will now transition into the National Institute on Minority Health and Health Disparities (NIMHD. This re-designation elevates the Center’s program to the NIH Institute level.

Garth Graham, M.D., M.P.H., Deputy Assistant Secretary for Minority Health at HHS, moderator for the panel, said “When there are disparities in the population, it is very important to work together to decrease the gaps in care in minority communities and to find workable solutions.”

Ruth Perot, Managing Director for the NHIT Collaborative for the Underserved & in addition, the Executive Director/CEO for the Summit Health Institute for Research and Education (SHIRE), explained that the National Health IT Collaborative for the Underserved (NHIT) was formed with SHIRE operating as the Program Management Office for NHIT.

NHIT was established as a public private community partnership to use HIT to expand healthcare access, improve quality, promote consumer self-management, provide education, training and outreach, and find ways to finance and sustain projects.

NHIT is actively supporting pilot projects to demonstrate how innovative and existing information technology can be used effectively in underserved communities. Presently, NHIT is working with pilot programs in South Carolina, Georgia, and Florida.

“Wellpoint believes that health IT benefits should be available across health delivery systems nationally, particularly in rural or underserved communities where health inequalities are greatest and adoption of health IT is often the lowest,” said Charles D. Kennedy, M.D., Vice President Health Information Technology, at WellPoint Inc.

As Kennedy told the group, “WellPoint is implementing an investment program to support HIT in rural critical access hospitals in medically underserved communities. Many of these hospitals cannot access capital or access capital at suboptimal interest rates which can limit their ability to take advantage of federal incentives. The program is starting to roll out and will begin in California and Georgia in 2011 to allow qualifying hospitals to borrow short term funding to pursue HIT.”

Andrea Anderson M.D. a bilingual Family Physician with Unity Health Care, a non-profit organization provides healthcare services to the poor and underserved in Washington D.C. She is also Assistant Medical Director, at the Upper Cardozo Health Center in Washington D.C. that treats an ethnically and economically diverse community and now takes care of about 80,000 patient visits annually

Dr. Anderson emphasized how invaluable health IT has proven to be when treating vulnerable populations. She described how a Spanish speaking male collapsed, was diagnosed with a heart condition, and given a pacemaker. He has a family and children to support but because he couldn’t work for awhile, he was depressed and did not feel on top of his healthcare.

Today, he is benefiting from all that health technology offers. The EHR system in use at the health center enables him to use technology to communicate with his doctors, plus he receives reminders by telephone but also by texts. Using health technology at the Center has enabled patients to feel empowered and feel that they are an important part of the program.

The North Carolina AHEC has nine regional centers and has the structure to create highly successful REC centers reports Ann Lefebvre, Associate Director of the program at the University of North Carolina at Chapel Hill.

With the support of collaborating partners, NC AHEC is going to use their existing regional infrastructure to hire and train over 40 positions in the nine regions to provide on-site technical assistance to primary care providers. The goal is to help providers adopt EHRs, help providers optimize their use of EHRs, and provide the on-going educational resources needed.

In some cases, Lefebvre reports that REC technicians are able go into the community especially when there is just one primary care physician in a town. For example, a doctor in Southeast North Carolina was unable to leave town easily because if he left, then the emergency room in the town would not have a doctor. The REC technicians went to his office to help him manage better and help him upgrade his EHR to meet the new requirements of “meaningful use”.

The state of Pennsylvania has cities like Philadelphia and Pittsburgh with vast populations but the rest of the state has huge underserved and large rural areas, according to Philip Magistro, Deputy Director & State HIT Coordinator for Pennsylvania. In meeting the needs of the rural parts of the state, Magistro see the immediate need for doctors to make the best use of technology to maintain quality, reduce hospital readmission rates, and to implement a workable chronic care model.

Presently, the state’s working with the University of Pittsburgh Medical Center and the Geisinger Health System with the goal to help expand basic exchange capabilities. In addition, the state is working on connectivity issues with smaller community providers.

Scharmaine Lawson-Baker, DNP, FNP-BC, President and CEO for Advanced Clinical Consultants, LLC located in New Orleans, recounts how she was able to provide medical records during Katrina. All of the information on the patients was accessible electronically even when Lawson-Baker was in San Antonio for awhile.

Back in New Orleans, she sees the tremendous value of supplying information electronically. Most of the patients she sees are elderly can be homebound or bed bound, but they are much more involved in their care since the EHR has been put in place. Lawson-Baker is now able to show information to patients, pull up lab reports, x-rays, and use e-prescribing.

She’s lobbying for Congress to pass (S 2814) the “Home Health Care Planning Improvement Act” introduced by Senator Susan Collins and a companion bill on the House side (H.R. 4993) introduced by Representative Allyson Schwartz. As she explained, both bills would provide more timely access to home health service for Medicare beneficiaries.

For more information on future briefings, go to or contact Neal Neuberger at (703) 562-8870.