Development and utilization of a health information exchange to enhance communication between ancillary and medical HIV care providers in rural North Carolina

Background: The Carolina HIV Information Cooperative regional health information organization (CHIC RHIO) was developed by the Regional Health Information Integration Project (RHIIP). The CHIC RHIO comprises one medical clinic and 5 AIDS Service Organizations (ASO) serving clients in seven rural counties. Objective: The CHIC RHIO was implemented to improve patient care and health outcomes by enhancing communication among geographically distant networks of HIV care providers in rural North Carolina. Methods: CHIC member communication is facilitated by CAREWare software; information such as lab results, case notes, medical appointments, medications and ADAP status are shared electronically among medical and ancillary care providers. Organizational readiness to change, qualitative interviews, and provider pre- and post-intervention surveys were completed to assess the process-related effects of implementing a data sharing intervention. Results: CHIC RHIO member organizations were ready to engage in the IT intervention prior to its implementation, which probably contributed to its successful adoption. The qualitative findings indicate CHIC RHIO members personally benefited – and perceived their clients benefited – from participation in the information exchange. The survey results echoed the qualitative findings: Improvements were noted in the ASO and medical clinic relationships, information exchange, and perceived patient care following the CHI RHIO intervention. Expectations for what data sharing would accomplish were overly high at the beginning of the project and expectation recalibration was required as the project came to a close. Conclusions: Innovative strategies such as health information exchange can be used in rural communities to increase communication among care providers. With increased communication comes the potential for improved health outcomes and in turn healthier communities.