Harris County Public Health Care System Council Information Technology Update November 2005
The goal of developing a full-scale shared electronic medical record among all Harris County safety net providers, while laudable, is still far into the distance. After its presentation to the Council in April, the IT Committee felt that there were some shortterm projects on which progress could be made, which would be successes in and of their own right, as well as play into a more comprehensive shared IT system if and when the providers are ready to tackle that task. In June 2005, David Bradshaw (Memorial Hermann Healthcare System) and Tim Tindle (Harris County Hospital District) met and outlined four such projects and have been working within their respective organizations and collaboratively to move them along. A brief summary of each project and its status follows. Project #1 – Develop a Management Information System (MIS) for the FQHCs Gateway to Care has a grant that provides for the assessment, selection and implementation of a MIS for five years for the community clinics. Many of these smaller clinics do not have a viable computer system for scheduling appointments, creating bills, producing financial statements and tracking clinic performance. The purchase/lease of a shared system, in which all FQHCs would be allowed to participate at no cost for the five years, will enable the clinics to address this basic need and serve as information support for the required annual performance and cost reporting to HHS. A needs assessment of the clinics has been conducted by HCHD’s IT Division, vendors narrowed to two, and site visits scheduled for this month. We estimate that the system can be operational in the first clinic within 60 days of vendor contracting. As Gateway to Care becomes a part of the Alliance instead of HCHD, a decision must be made as to whether this grant and the corresponding work will be transferred to the Alliance. Tim Tindle expressed his interest in transferring the grant and work. The project fits squarely within the scope of work of the Alliance because it is a community provider support function. Ideally, the MIS system would be expanded to other community providers and eventually be part of a larger clinical MIS including EMRs and, ultimately, a community-wide Master Patient Index. Project #2 – Develop a Community-based Case Management System Memorial Hermann Healthcare System has been working on a case management system for some time. There was a grant for which they unsuccessfully competed that would have allowed the development of a community-based system. MHHS has authorized and funded a pilot internal project using its McKesson software to develop a module for congestive heart failure patients. If proven successful, this system can be expanded to include other diagnoses and other provider groups under the Alliance concept if desired.
Project #3 – Recommend a Common Eligibility System Such a system would allow all safety net providers to utilize a common software program that would identify those patients eligible for funding by various sources (Medicaid, HCHD Gold Card, Title XX, etc.). By sharing data on patient eligibility, providers can reduce the amount of duplicated eligibility determination work and expense communitywide, as well as improve the numbers of patients being seen for whom reimbursement is available. Tim Tindle estimates that HCHD will be able to put out an RFP to determine what types of shared eligibility systems are available after the first of December. This system would complement, and close the loop on, the funding source identification tool described as a project for the Alliance. Together, these projects will enable providers to identify funding sources AND share patient demographic data. Project #4 – Develop a Portal Through Which Safety Net Providers Access Shared Programs This is envisioned as a website vehicle, with appropriate security levels, through which safety net providers could access IT solutions designed to be shared across providers, such as the common eligibility system and the community-based case management system. MHHS already has a similar type portal through which its network physicians access a variety of programs. That technology could be applied on behalf of the Alliance for the programs that it would operate. Additional Notes • Neither of the two potential RHIO grants that included Houston were awarded to local organizations • A return on investment RFP, as originally projected by the Committee, has been postponed in favor of the above four short-term projects through which the benefits of coordination and collaboration can be shown Submitted by David Bradshaw, Karen Love, Elena Marks, Kathleen Randall, and Tim Tindle