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Determined to build a RHIO

September 2, 2008
by Brian Albright
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A behavioral healthcare organization aims to do what it takes to create a regional health information organization

Verde Valley Guidance Clinic, a behavioral healthcare provider agency based in Cottonwood, Arizona, is planning to build a regional health information organization (RHIO) to collaborate and exchange data with other local providers. Once established, the RHIO will be one of the few in the country led by a behavioral healthcare agency.

The RHIO project is an outgrowth of an integrated care initiative already under way at Verde Valley. In 2009, the clinic will complete construction of a two-story building that will house its own psychiatric practitioners along with primary care providers to whom patients can be referred for general medical services.

"With that integration under way, the next question was, how do we share information?" says Robert Cartia, Verde Valley's CEO.

Verde Valley was an early adopter of an electronic medical record (EMR) system, and Cartia says historically the agency has been an innovative technology user. Cartia wanted to be able to electronically share information with the physicians at the new building as well as other area providers. So earlier this year the clinic applied for and received a grant to begin developing the RHIO from Arizona’s Government Information Technology Agency (GITA) Rural Health Information Technology Adoption (RHITA) Grant Program, which is part of Arizona's Health-e Connection Roadmap initiative.

Cartia says the clinic will use the nine-month grant to plan the RHIO’s governance and structure, as well as outline a sustainable business foundation.

"We're already pretty clear on what will happen on the technology side," Cartia explains. "What's going to sustain the RHIO, though, is getting partners onboard and organizing it sensibly so that it will support our ongoing activities."

The RHIO initially will encompass the primary care practice at the new building, the local hospital’s emergency department, the nearby Mingus Center behavioral healthcare facility, and NAZCARE, a consumer-operated community mental health services agency.

"From there, we want other stakeholders like pharmacies and labs to come onboard through the natural linkages that will occur," Cartia says.

"If there is a cost to develop this that goes beyond what we originally projected, we're just going to pay for it and move forward. I am that committed to this." —Robert Cartia

Although the technical details are not finalized, Cartia says the RHIO likely will take the form of a Web portal that the participating providers can access.

"RHIOs tend to fail for a variety of reasons," Cartia notes. "One is that the project is too ambitious, or that there is too much information being exchanged. We want to be specific, and pass along just the information the provider needs to help them do their job."

Verde Valley already has had some discussions with its existing EMR vendor (Netsmart Technologies) and its outside consulting firm (Zumasys) about the project, although there has not yet been any decision on how the infrastructure will be built.

Once the nine-month grant period is over in March, Cartia says the clinic will move forward with the RHIO as quickly as possible.

"In our little world, a RHIO is not likely to make a lot of money," Cartia explains. "What I'm telling the stakeholders is that we will save through efficiencies, better care, and less frustration. If there is a cost to develop this that goes beyond what we originally projected, we're just going to pay for it and move forward. I am that committed to this."

Brian Albright is a freelance writer.