A Tale of RHIO Success

BRISBANE, Australia — Nearly as fast as regional health information organizations (RHIOs) cropped up a couple of years ago, they have started to disappear or at least scale back their plans due to financial difficulty. But there are some success stories to be found for those who look hard enough.

Try, for example, Winona, Minnesota, where a small network is thriving. At MedInfo 2007, the triennial congress of the International Medical Informatics Association, at a first-ever international symposium on nursing informatics leadership on Monday, the world got a tale of success from Winona Health.

When the United State’s first health-IT czar, David Brailer, called for interconnecting clinicians with what he called RHIOs in 2004, Janice Turek, clinical director of information systems at Winona Health, knew exactly what he was talking about. “We had already connected a region,” said Turek, a registered nurse. “We have been able to sustain and develop informatics in a small community.”

Indeed, the nonprofit health system in southeastern Minnesota has brought together six competitive, independent organizations onto a single health-IT system. It wasn’t easy, but leadership, from clinicians all the way up to the executive suite, saw it as a means of survival.

“It was a competitive issue,” Turek explained, because a lot of small, community-based healthcare organizations had been going bankrupt or simply shutting their doors. “We didn’t want to be one of them.” And Winona had the added disadvantage of being just 40 miles from the Mayo Clinic’s main Rochester campus.

The strategy for Winona Health was quite different from most other provider organizations. Winona started in 2000 with a Cerner patient Web portal and personal health record (PHR) to build the foundation for an electronic health record (EHR).

“This is when we actually married the Cerner Corp., and it’s been a wonderful marriage,” said Turek. Winona Health also helped other organizations in and around the town of 30,000 become Cerner customers because a common system would facilitate data sharing.

Since that time, Winona has integrated 28 separate IT systems to create an EHR at its facilities and non-affiliated physician practices, imaging centers, and laboratories. The EHR is complete with computerized physician order entry (CPOE), a home-health component, and secure online patient-clinician communication — for which physicians have begun receiving reimbursements.

With the help of interconnected clinicians, it now takes just 15 minutes to move a patient upstairs once the decision is made to admit someone from the emergency department. Electronic medication administration has reduced errors in drug delivery by 80 percent. Unit secretaries still enter 80 percent of inpatient orders, but Winona Health already has a plan to redeploy the secretaries as physicians gradually take over that responsibility.

And soon, Winona will reach out to Mayo to widen data sharing, since many tertiary referrals from the smaller town go to Rochester.

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