Development of a regional health information organization to better address patient health needs in rural NC

Background: The Regional Health Information Integration Project (RHIIP) has developed a Regional Health Information Organization (RHIO), named Carolina HIV Information Cooperative (CHIC), which coordinates communication among an existing but loosely-organized network of HIV care providers in rural North Carolina. Objective: The project will improve regional health planning, increase patient recruitment and optimize retention in medical care as CHIC members share electronic data and enhance care via more efficient care management, administration, and billing plus continuous quality improvement. Methods: CHIC comprises one medical clinic and 5 AIDS Service Organizations. These members serve clients in seven rural counties. Increasing communication among these geographically-distal agencies through information technology is an innovative solution to the challenges faced by the rural HIV population. Communication among CHIC members is facilitated by CAREWare software, which allows comprehensive reporting and care management between service providers. Baseline data were collected for eight months prior to CHIC's implementation; an interrupted time series evaluation design, including patient interviews and chart abstractions, will evaluate CHIC's effectiveness and patient health outcomes. Provider interviews will contribute to the CHIC evaluation. Results: The six organizations that comprise the CHIC RHIO, actively share information on 3100 patients via CAREWare. Baseline patient (n=524) and provider (n=27) data were collected. Conclusions: Rural North Carolina faces unique challenges, especially given the disproportionate distribution of resources between rural and urban areas. Through information technology and the improved provider and ancillary care communication, the RHIO is working to reduce these disparities and create a more equitable system throughout the state. The state has recognized these efforts as the CHIC RHIO is one of the only RHIOs in NC and has become a model for state development.