Successful Health Care Pilot in Central Massachusetts Shows Potential for a National Model

Friday, June 1, 2012

WORCESTER – The Massachusetts eHealth Institute (MeHI) announced today that 16 Worcester County health care organizations demonstrated significant improvements resulting from the transfer of more comprehensive clinical information for patients transitioning between hospitals, nursing homes and home care. As part of the Improving Massachusetts Post-Acute Care Transfers (IMPACT) project, the healthcare organizations are participating in a pilot program to develop an advanced electronic transfer form which provides key health data to coordinate care for patients making the transition from one clinical setting to another.

“The Patrick-Murray Administration has made it a priority to advance health information exchanges and other innovative technologies to provide more efficient and higher quality care for patients, “said Secretary of Health and Human Services Dr. JudyAnn Bigby. “As a national leader in healthcare reform, we’re making great progress toward reducing health care costs and improving care for patients across the Commonwealth.”

“Improvements in transitions of care will have a dramatically positive effect on both the quality of patient care, and on the overall cost of healthcare in Massachusetts and across the nation, said Laurance Stuntz, Director of the Massachusetts eHealth Institute. “We are very encouraged by the early results of the project, and with the spirit of cooperation among the organizations participating in IMPACT.  We are looking forward to supporting the next phases of the IMPACT project as part of our effort to promote electronic Health Information Exchange in the Commonwealth.”

Massachusetts received $1.7 million from President Obama's American Recovery and Reinvestment Act to develop the IMPACT project. The Massachusetts eHealth Institute (MeHI), a division of the Massachusetts Technology Collaborative, is leading the state’s health information technology efforts.

“For decades patients in Massachusetts have been transferred from one healthcare facility to another with the same paper transfer form with little appreciation for the fact that medicine has changed, technology has changed, and the needs of patients and the receiving facilities has changed,” said Larry Garber, MD, Medical Director for Informatics at Reliant Medical Group (formerly known as Fallon Clinic) and Principal Investigator for the IMPACT project.  “IMPACT is taking an evidence-based approach to defining what information is truly necessary to make safe, high-quality, efficient and effective hand-offs from one healthcare provider to another.”

At  Tuesday's meeting, 70 healthcare providers, nurses, administrators and executives from over 40 healthcare organizations met to discuss significant improvements as a result of the pilot program. Over a four week period, the 16 pilot healthcare organizations transferred several hundred patients along with forms containing over 300 key health data elements, including medication lists, advance directives, treatment plans and other data that support the seamless transition for patients transferring from one clinical setting to another. This is in contrast to the current three-page transfer form used throughout Massachusetts which has fewer than 100 data elements.  The healthcare facilities receiving the patients found the data to be more comprehensive and valuable, which led to improvements in the quality and efficiency of care provided for the patient.  96% of the pilot sites surveyed responded that they will continue to send this expanded data set for transfers of care because it is best for the patients.

 “It was truly a remarkable collaborative effort by a group of highly talented and dedicated people,” said Amy Boutwell, MD, MPP, President of Collaborative Healthcare Strategies and lead for the IMPACT projects pilot site learning collaborative. “The face-to-face conversations between clinicians from sites that send patients and sites that receive patients led to insights and improvement in our understanding of what information must be sent to ensure safe and efficient patient transfers.”

The data elements used during these transfers were initially selected after a review of over 1000 surveys of the needs of healthcare providers and staff that receive patients during transfers, led by Terrence O’Malley, MD, Medical Director for Non-Acute Care Services at Partners HealthCare, Massachusetts General Hospital and is a co-investigator on the IMPACT project.  The 16 healthcare organizations piloted the transfer of these data elements on paper, and will pilot the electronic version this fall when the state deploys a secure statewide electronic health information exchange network.   The results of testing these data elements in the real world are being used to help define a national standard for information transfer.  Dr. Garber and O’Malley, co-chair the Long Term and Post-Acute Care Transition Workgroup of the Standards and Interoperability (S&I) Framework sponsored by the Office of the National Coordinator for Health Information Technology (ONC).

 Tuesday's “Worcester Galaxy” meeting included healthcare organizations participating in Worcester’s State Action on Avoidable Rehospitalizations (STAAR) Initiatives and the Central Mass/MetroWest Transitions in Care Collaborative which was recently selected to participate in the federal Community-Based Care Transitions Program (CCTP).  These efforts will work collaboratively to improve and implement tools to improve care transitions throughout Worcester County following the pilot sites, and subsequently throughout Massachusetts.

“The adoption of health information technology enhances our health care delivery system and improves the quality of patient care,” said Pamela Goldberg, CEO of the Massachusetts Technology Collaborative. “Mass Tech Collaborative/MeHI is advancing e-health technologies to enhance provider information and therefore provide safer and more effective care for Massachusetts residents.”

IMPACT includes the following healthcare organizations:

Beaumont Rehabilitation and Skilled Nursing Center, Westborough,
Christopher House of Worcester
Fairlawn Rehabilitation Hospital, Worcester
Family Health Center of Worcester
Holy Trinity Nursing & Rehabilitation Center, Worcester
Jewish Healthcare Center, Worcester 
Kindred Hospital Park View – Central Massachusetts, Rochdale
Life Care Center of Auburn
Millbury Healthcare Center
Notre Dame Long Term Care Center, Worcester
Overlook Visiting Nurses Association
Radius Healthcare Center, Worcester
Reliant Medical Group (formerly known as Fallon Clinic), Worcester
Saint Vincent Hospital, Worcester
UMass Memorial Health Care, Worcester
VNA Care Network and Hospice, Worcester