NAME OF NETWORK  
FLEX CAH HIT Network Implementation (Improving Texas Rural Community Healthcare Through HIT Implementation)

Name of Grantee       
Texas Office of Rural Community Affairs 

Principal Investigator - Theresa Cruz      (ORCA)
Address  1700 N. Congress Avenue –Ste 220 Austin, Texas  78701    
Phone 512. 926.6719
Fax 512.936.6776
Organizational Website www.orca.state.tx.us        
E-mail tcruz@orca.state.tx.us

Project Manager –
Kathy Mechler  (Texas A&M Health Science Center-Rural and Community Health Institute)
Address  3833 Texas Avenue –Ste 150 Bryan, Texas  77802            
Phone 979.862.5004
Fax 979.862.5015
Organizational Website www.rchitexas.org   
E-mail mechler@tamhsc.edu

Project Purpose The goal of this project is to improve health care delivery and quality of life through HIT implementation in two rural communities as a demonstration model for all rural Texas communities. The objectives are to improve the safety, quality, efficiency and effectiveness of health care delivery through implementation of health information technology.  The project is intended to connect health information within each individual community and to their tertiary care facility in Amarillo, Texas.  Additionally, the project intends to improve access to healthcare services through the use of telemedicine.

Outcome Measures/Expectations

1. Disease Management Indicators

The ability to collect and measure the disease specific measures for diabetes and heart disease as indicated below (a & b) will only be possible once the clinical information system is installed in each community.  Baseline findings from these measures will be obtained at the time of clinical information system implementation ( Phase 2, Month 5) and monitored throughout the grant period.

a. Diabetes: Average patient HbA1c at or below the American Diabetes Association and Physician Consortium for Performance Improvement Measurement Set goal of 7.0%.  Per Patient – Trend of HbA1C values over 12 months.  Per Patient Population - Numerator: Number of Patients with one or more HbA1C tests.  Denominator: All patients diagnosed with diabetes.  The study will also provide the opportunity to evaluate the distribution of HbA1c values by range: <6.0, 6.0-6.9%, 7.0-7.9%, 8.0-8.9%, 9.0-9.9% >10%

b. Cardiovascular: Average patient LDL at or below 100.  Measurement standards established by the American College of Cardiology, American Heart Association and the Physician consortium for Performance Improvement will be utilized.  Per Patient – Trend of LDL values over 12 months.  Per Patient Population – Numerator: Number of patients who received at least one lipid profile to include LDL. Denominator: All patients with cardiovascular disease.  The study will also provide the opportunity to evaluate the distribution of LDL values by range: >160, 130-159, 100-129,<100.

1. Patient Safety Indicator

         The ability to collect and measure the decubitus ulcer patient safety indicator will continue to be monitored and evaluated through the use of administrative data utilizing the AHRQ algorithms currently available through the rural data warehouse. 

a. Decubitus Ulcer: Cases of decubitus ulcer per 1,000 discharges with a length of stay of 4 or more days.  Numerator: Discharges with ICD-9-CM code of decubitus ulcer in any secondary diagnosis field among cases meeting the inclusion and exclusion rules for the denominator. Denominator: All medical and surgical discharges 18 years and older defined by specific DRGs. Exclusions: Length of stay of less than 5 days, ICD-9-CM code of decubitus ulcer in the principle diagnosis field or in a secondary diagnosis field if present on admission, MDC 9, 14, ICD-9-CM diagnosis of hemiplegia, paraplegia, or quadriplegis, spina bifida, debridement or pedicle grants before or on the same day as the major operating room procedure, admission from a long-term care facility or transferred from an acute care facility.

3. Inpatient Quality Indicator  
Pneumonia: The ability to collect and measure the pneumonia inpatient quality indicator will continue to be monitored and evaluated through the use of administrative data utilizing the AHRQ Pneumonia mortality rate algorithms as currently available through the rural data warehouse. Baseline data for this measure is provided. Pneumonia mortality will be measured utilizing mortality in discharges with a principle diagnosis code of pneumonia.  Numerator: Number of deaths among cases meeting the inclusion and exclusion rules for the denominator.  Denominator: All discharges, age 18 years and older, with a principal diagnosis of  pneumonia.  Exclusions: Missing discharge disposition, transferring to another short-term hospital, MDC 14, 15.

4. Effectiveness and Efficiency Indicator
Medication Errors:  Currently data collected regarding medication errors that ultimately impact the effectiveness and efficiency of medical care in both Collingsworth and Friona is a paper-based system.  Through the implementation of a community-wide patient information system, medication error is expected to be reduced and the efficiency of treatment enhanced through information sharing throughout the continuum. Medication errors will be measured by evaluating the number of medication errors monthly.  Numerator: Number of medication or dispensing errors per month. Denominator: Number of medications dispensed per month.

Service Area This project intends to impact the two frontier communities of Wellington and Friona, Texas located in the Texas panhandle.  Both of these community hospitals and local providers offer limited specialty care, forcing local residents to drive more than 70 miles from one community and more than 100 miles from the other to access specialty care in Amarillo.  

Network Members

Equipment/Vendors or Collaborative Partners:

OPUS is the selected vendor for this project.
Contact: Chris Mountzouris
VP, Marketing & Business Development
Opus Healthcare Solutions, Inc.
12301 Research Blvd., Bldg. IV, Suite 200
Austin, TX 78759

Toll Free: 800.676.3371
Phone: 512.336.4410
Fax: 512.336.4799
Email: cmountzouris@opushealthcare.com
Web: www.opushealthcare.com

Go to: Top | HRSA | HHS | Disclaimer | Accessibility | Privacy