Creating sustainable system-level community change through health information technology

Background Through the Office of the National Coordinator, Beacon Community Program funding, the Greater New Orleans area region endeavored to address the community's care coordination gaps, after much research and validation the community procured an open source HIT solution which was then piloted and implemented.

Objective/Purpose The Greater New Orleans Health Information Exchange (GNOHIE) is a community-shared open source HIE solution and infrastructure that facilitates innovative care coordination and chronic disease management by enhancing information and process linkages across multiple health systems to improve the quality of care.

o Emergency Department/Inpatient Notification: Alerts and clinical information are sent in real time to primary care providers about patient visits to emergency departments and hospital admissions. Caregivers are then able to contact the patient and ensure the necessary follow up care occurs to help prevent unnecessary readmissions.

o Electronic Specialty Care Referral: Referral requests and supporting documentation of the referring primary care provider are sent electronically to the specialist. Specialist consult summaries are, in turn, provided electronically to the primary care provider.

Methods The retrospective and ongoing evaluation of these interventions is made possible using a mixed methods approach. Sources of information include the GNOHIE, electronic health records (EHR) systems, site visits and individual interviews with key clinic and hospital staff.

Results Research is still ongoing, but preliminary findings will be presented to include: 1) The strategy of working with an operational, open-source HIE, 2) Sustainability model 3) Frequency of patient visits to facilities beyond the medical home.

Discussions/Conclusions The HIE solution implemented by the CCBC was done so at a fraction of the cost of traditional proprietary HIE systems, the coordination of care in the Greater New Orleans area for connected entities can now be improved and planned for improvement at a system level.