Georgia safety-net group ready to link providers to HIE system

Suggested Content

SAVANNAH, GA – The Chatham County Safety Net Planning Council (CCSNPC) has successfully linked one of its hospital emergency departments (ED) with one of its federally qualified health centers (FQHC) through its health information exchange (HIE) system.

The council, whose goal is to improve healthcare for the underinsured and uninsured, will begin linking its remaining provider partners by summer once system and database testing and staff training have been completed, according to executive director Paula Reynolds, MD. All providers will be connected by September 2012.

CCSNPC's participating providers include two hospitals, two FQHCs and three volunteer clinics. Layoffs, a result of the economic recession, have been creating a bigger pool of uninsured in the county of 250,000 people. More people are seeking primary care at the hospital ED, which is straining the healthcare system. "The need for our services has certainly grown," Reynolds said.

Thus far, 120,000 patient records are in the database. "We are beginning to be able to see patterns and trends," she said. "We have finally - through this pilot - been able to successfully capture those individuals who go to the emergency department." One feature of its HIE system, which is provided by Orion Health, alerts the clinics to reach out to individuals looking for primary care at the ED and offer them appointments. The goal is to move them to a medical home. "Even in the very beginning of our pilot project we are already seeing results," Reynolds said.

One trend CCSNPC tracked was a 30 percent increase in the number of children coming into the healthcare system in 2010, possibly a result of parents getting laid off from their jobs, she said. CCSNPC received a new grant from a private Atlanta funder to extract data from the HIE system to identify the children who come in for primary care without insurance. Social workers will then call the parents to determine their children’s eligibility for PeachCare for Kids, a program to cover uninsured children in Georgia.

When CCSNPC was formed in 2004, one of its first tasks was to develop a shared measurement system. The council has produced an annual evaluation of access to care ever since, which has allowed it to track efforts, spot trends and plan accordingly. For example, one year it tracked an increase in its Latino population and responded by opening an evening clinic with Spanish-speaking staff.

CCSNPC's data collection methods, however, were rudimentary. CCSNPC couldn't track how many tests or visits were being duplicated because of lack of provider communication or understand a population’s pattern of ED use for primary care in real time. It couldn't track health outcomes, which contributes to reaching its ultimate goal of a healthy community, Reynolds said. "We needed a fully developed health IT system," she said. The council's strategic planning session in 2005 included a priority to adopt health IT to allow it to take it to the next level.

In 2007, the Georgia Department of Community Health awarded CCSNPC a two-year planning grant for a demonstration project of health IT. The council launched its pilot in April 2009 as the only HIE with multi-organization participation among the three awardees.

At some point, the prison health system will be linked to the database, and CCSNPC will be involved in a state demonstration project for an electronic medical records system at a mental health hospital. There's a connection between released prisoners and ED and mental hospital visits, Reynolds said. The lack of communication among those entities contributes to the ex-convict population falling through the cracks, which results in money being wasted on redundant tests and visits and lack of quality care, she said.

A champion of CCSNPC, the Chatham County government continues to fund the HIE infrastructure for the county safety-net providers via its indigent care budget. "Even if we get not a penny more than the county gives us, we have accomplished our goal of creating an HIE exchange for our safety-net system in Chatham County," Reynolds said.

There is a lot of potential for growing and expanding its HIE infrastructure, which is why CCSNPC is pursuing public and private grants. The council is partnering with the Savannah Business Group, which comprises self-funded employers that cover a third of the lives in the county, for a patient-centered medical home project involving private providers in the area. CCSNPC is also looking to partner with regional communities to address their health needs through a utility model.

"Our HIE focuses on our community's issues," Reynolds said. "It's not IT for IT's sake. If you have an organization that uses health IT as a wonderful tool to address a pressing health problem, don't you automatically have a meaningful use for your community? We think so. That's what we rallied around and made us successful and focused."