Sept 2006
HIMSS RHIO Connection
"Santa Cruz RHIO Reaping Tremendous ROI"
 More than 10 years ago, as Medical Director of an independent practice association (IPA), Physicians’ Medical Group of Santa Cruz County, Robert Keet, MD, FACP sought to improve overall clinical efficiency and quality and led the charge to build a RHIO. “In 1993, our IPA had about 120 to 130 physicians that contracted with hospitals and major outpatient laboratories and radiology services. The IPA spearheaded the entire process, bringing all of those groups together in a common electronic network, started with taking all of the clinical data and turning it into electronic messages sort of like email but electronic. We evolved from there building tools to manage that data, manage the flow, the receipt of data and how doctors deal with the data.”
Today, it’s grown to more than 700 users in the community and about a third of those are doctors and the other two-thirds are staff, explained Bill Beighe, CIO, Physicians Medical Group, IPA, Santa Cruz. “We’ve been looking at numbers pretty closely since 2002. We’ve grown from about 200,000 page views a month to more than one million in a month over the last four years. It’s pretty dramatic.”
The Santa Cruz RHIO extends outward from the city itself, a northern California coastal community of 40,000, to several agricultural towns which dot the area and bring the total regional population to 280,000. An advantage at the outset was that the IPA had good relationships with the two hospitals in the community: Dominican Santa Cruz (part of Catholic Healthcare West) and Watsonville, a for-profit 100-bed hospital. Today, its members include more than 70 independent physician groups, laboratories, community health clinics, Planned Parenthood, the county healthcare department.
Once the RHIO is in place there is a tremendous return on investment (ROI) for data providers, Keet added. “The people feeding the data have a much more efficient way of accessing information. The physician has the advantage of being more efficient. We also have the ability to graph information over a couple of years. For many doctors, we are using it as the primary data source for the patient. We have a dual electronic paper record but the electronic is the primary source. I’m a practicing physician and I receive 100 percent of my information electronically.”
Interoperability was part of the network from the beginning. Beighe noted that whenever possible data is obtained in an HL7 format using standards and link coding so that things can be standardized. However, some things don’t fit into discrete data coding. For example, the Sleep Study Center issues reports that are word documents and cannot be graphed but it’s securely delivered to the physician, avoiding paper, faxing, and things being lost. Once it is delivered it’s always linked to the patient. A receiving physician can look back next year and see what was recommended. |
