About RIHCA - Clinical Quality
Chronic Care Sustainability Initiative of Rhode Island (CSI-RI)
The Chronic Care Sustainability Initiative of Rhode Island (CSI-RI) is funded by
the Center for Health Care Strategies (CHCS) with the goal of improving the delivery
of primary care services to those with chronic illness through the implementation of the patient-centered
medical home practice model. This initiative, which began in October 2008, now encompasses 13 practices, including two health center sites.
In support of this exciting effort to transform health care delivery, RIHCA is an
active participant on the joint steering committee for CSI-RI Steering Committee and the RI Beacon Community Program (see below), and works to assist health center leaders and staff in successfully implementing the medical home delivery model of care.
Beacon Communities
All Rhode Island community health centers with fully implemented electronic health records (EHR) participate in the Rhode Island Beacon Community Program which was created as part of the American Recovery and Reinvestment Act. The program provides communities with funding to build and strengthen their health information technology (HIT) infrastructure. The Rhode Island Quality Institute (RIQI) won designation as one of 17 Beacon Communities by the Department of Health and Human Services Office of the National Coordinator for Health Information Technology (ONC). The objectives of the RI Beacon Community Program include: enhancing the quality of care provided to patients with diabetes, by encouraging adherence to nationally recognized evidenced based guidelines; reducing preventable hospital and emergency department use; reducing the impact of tobacco use; and reducing the impact of undiagnosed and untreated depression.
RI Chronic Care Collaborative (RICCC)
All of Rhode Island’s community health centers participate in the Rhode Island Chronic
Care Collaborative (RICCC), an in-state collaborative effort to examine innovative
ways to manage patients with chronic illnesses. The continuing health disparities
that lead to differences in death and complications from chronic diseases such as
diabetes, asthma and cardiovascular disease, as well as other illnesses, illustrate
the need to address these issues aggressively. To achieve meaningful improvements
in the lives of all of their patients, including the underserved populations who
suffer disproportionately from the burden of these health disparities, centers participating
in the RICCC adopt shared clinical measures that are aligned with and based on the
proven guidelines of experts, external reporting requirements and/or other community
standards of care.
The principles of the RICCC include several models that, when used as designed, bring about rapid improvements in health care. In partnership with the RI Department of Health and through participation on the RICCC Planning Team, RIHCA provides guidance, training and technical support to the RI health centers in these models of care and improvement, assisting them in transforming the way that care is delivered.
Colorectal Screening Project
Colorectal cancer is a preventable disease and is almost always curable when detected
early. However, because of low screening rates, this cancer is not always diagnosed
at its earliest, most treatable stage. Several of Rhode Island’s community health centers
are pilot sites in a project sponsored by the RI Department of Health (HEALTH) aimed
at improving screening rates for colorectal cancer among target populations. The
multi-year project began in 2008 by targeting a population of health centers’ patients
ages 50 through 65, as well as the centers’ African-American patients ages 40 through
65. The pilot sites have worked to develop methods designed to reduce resistance
to screening and thus improve screening rates. RIHCA has provided training and technical
assistance to the four health centers participating in the pilot, particularly around
self-management goal setting, a cornerstone of patient-centered medical care, and
continues to work with HEALTH to provide ongoing support to the pilot sites.
Electronic Health Records
Rhode Island’s health centers were early adopters of health information technology. Seventy per cent of Rhode Island’s health centers have adopted an electronic health record (EHR) and an electronic practice management (EPM) system. The remaining centers are working toward implementation of an EPM as a first step in the EHR adoption process; it is anticipated that all of Rhode Island’s community health centers will have fully implemented EHRs by the end of 2011. Electronic medical records improve efficiency and clinical outcomes, aid in quality improvement, and streamline resource management.
Training and Technical Assistance
RIHCA conducts needs assessments and offers training and technical assistance for all facets of community health center operations, both clinical and administrative. We provide emergency preparedness technical assistance, development training for consumer members of health centers boards and educational sessions on clinical and operational topics for health center leaders and staff.
For more information about any of the above mentioned initiatives or projects, contact Mary Evans, RIHCA’s Senior Director of Operations
and Clinical Support, at (401) 274-1771, extension 211, or
mevans@rihca.org.