2012 Accomplishments: Regional Health Information Integration Project (RHIIP)

The Regional Health Information Integration Project (RHIIP) finished its final year of HRSA SPNS funding (completed on August 31, 2012), producing several remarkable achievements. RHIIP developed the Carolina HIV Information Cooperative (CHIC) Regional Health Information Organization (RHIO), which enabled data-sharing via CAREWare in the Ryan White Region 3 HIV Network of Care in North Carolina. The medical care for Region 3 is coordinated and provided by Wake Forest Baptist Health.  Client data is exchanged between Wake Forest and five AIDS service organizations in the Region. As of October 2012, the RHIO had grown to 43 users with 3835 clients and active data exchange was occurring within the network of care and the State AIDS Care Program.

In 2012, the core CHIPR team for RHIIP—Lynne Messer, Heather Parnell, Renee Huffaker, Darren Webber, Miriam Berger, and Casey Rubenstein—completed an evaluation of RHIIP’s activities based upon data collected through medical chart abstractions and other RHIIP data. These evaluation activities resulted in the production of one publication, as well as a total of six presentations on RHIIP’s work at a variety of venues, including the 140th Annual Meeting of the American Public Health Association, National Association of Social Workers 2012, and 5th Annual Society for Epidemiologic Research Meeting.

Publications and Presentations

• Messer LC., Parnell, H., Huffaker R., Wooldredge R, Wilkin A. The development of a health information exchange to enhance care and improve patient outcomes among HIV+ individuals in rural North Carolina, International Journal of Medical Informatics, Available online 13 August 2012, ISSN 1386-5056, 10.1016/j.ijmedinf.2012.07.009.
  • BACKGROUND: The Regional Health Information Integration Project (RHIIP) has developed the Carolina HIV Information Cooperative regional health information organization (CHIC RHIO). The CHIC RHIO was implemented to improve patient care and health outcomes by enhancing communication among geographically disconnected networks of HIV care providers in rural North Carolina. CHIC RHIO comprises one medical clinic and five AIDS Service Organizations (ASOs) serving clients in eight rural counties.
  • METHODS: Communication among the CHIC RHIO members is facilitated by CAREWare software. The RHIIP team assessed organizational readiness to change, facilitated relationship-building for CHIC RHIO, created the CHIC RHIO and used both qualitative and quantitative approaches to evaluate the process-related effects of implementing a data-sharing intervention.
  • RESULTS: We found the CHIC RHIO member organizations were ready to engage in the IT intervention prior to its implementation, which most likely contributed to its successful adoption. The qualitative findings indicate that CHIC RHIO members personally benefited – and perceived their clients benefited – from participation in the information exchange. The quantitative results echoed the qualitative findings; following the CHIC RHIO intervention, quality improvements were noted in the ASO and medical clinic relationships, information exchange, and perceived level of patient care. Furthermore, hopes for what data sharing would accomplish were overly high at the beginning of the project, thus requiring a recalibration of expectations as the project came to a close.
  • CONCLUSIONS: Innovative strategies for health information exchange can be implemented in rural communities to increase communication among providers. With this increased communication comes the potential for improved health outcomes and, in turn, healthier communities.
• Messer L.C., Parnell H., Sullivan K. “Regional Health Information Integration Project” Oral presentation at the 2012 Ryan White Grantee Meeting Washington, DC. November 27 – 29, 2012.
• Parnell H., Messer L.C., Huffaker R. “Development and utilization of a health information exchange to enhance communication between ancillary and medical HIV care providers in rural North Carolina.” Roundtable presentation at the 140th Annual Meeting of the American Public Health Association. San Francisco, CA. October 27-31 ,2012.
• Messer L.C., Parnell H., Tchwenko  S. “Trends in health outcomes for HIV patients in rural North Carolina following the implementation of a health information exchange to improve community based practice in HIV.” Poster presentation at the 140th Annual Meeting of the American Public Health Association Annual Meeting.  San Francisco, CA.  October 27-31, 2012.
• Messer, L.C. “ACASI results combined 2009 and 2010.” Presented at the final RHIIP CHIC RHIO meeting. Winston Salem, NC. August 22, 1012.
• Rubenstein C., Parnell H., Messer L.C., Wilkin A, Huffaker R. “Regional health information integration project: A new perspective on case management.” Poster presentation at the National Association of Social Workers 2012 Conference. Washington, DC. July 22-25, 2012.
• Tchwenko S., Parnell H., Messer L.C. “Health outcomes following a health information exchange intervention for HIV patients.” Poster Presentation at the 45th Annual Society for Epidemiologic Research Meeting. Minneapolis, MN. June 27-30, 2012.