1. Rural Virginia E-health Collaborative Rural Virginia E-health Collaborative (RVEC) Rappahannock General Hospital Kilmarnock, VA Michael Matthews, Project Director

2. Rural Virginia E-health Collaborative Overview The Applicant The Project The Process The Results The Lessons

3. Rural Virginia E-health Collaborative The Community RGH: 76 beds 60,000 residents MUA / HMSA Aging Health indicators Poverty rate Retirement community Medical staff

4. Rural Virginia E-health Collaborative The Project Goals Efficiency Quality Safety Focus E-prescribing Disease registry CCR

5. Rural Virginia E-health Collaborative The Process

6. Rural Virginia E-health Collaborative Structure

7. Rural Virginia E-health Collaborative RVEC begins Dec 04Jan 05Mar 05Apr 05Oct 04 Stakeholder phone surveys Implementation application Timeline Planning Meeting #1 Med staff retreat. Planning Meeting #2 Physician survey Hosp IT assessment Interim Planning Report

8. Rural Virginia E-health Collaborative Pre-Implementation Communication Partnership engagement RHIO development in Richmond E-prescribing review

9. Rural Virginia E-health Collaborative Planning Meeting #1: Revised Priorities 1. E-prescribing –Pharmacy connectivity –Physician buy-in –Internet –Demographic data capture –Medication history –Support (pre- / post) 2. E-results –Physician buy-in –Hospital results –Internet –Support (pre- / post) 3. E-referrals RHIO

10. Rural Virginia E-health Collaborative Medical Staff Retreat

11. Rural Virginia E-health Collaborative Physician Survey Internet –High speed 71% –Dial-up29% PCs in office71% Elec test results18% EMR 4% E-mail –Within practice39% –With colleagues36% –With patients18%

12. Rural Virginia E-health Collaborative Physician Survey Prescriptions Tertiary hospitals Referrals (SCPs and PCPs) Test results from RGH Chronic disease mgmt.

13. Rural Virginia E-health Collaborative Physician Survey Costs Lack of other resources in practices Difficult to choose vendor Lack of IT, computers in office Practice disruption

14. Rural Virginia E-health Collaborative Planning Meeting #2 Confirm priorities –E-prescribing –E-results –E-referrals Implementation grant Confirm RHIO partnership –MedVirginia / Wellogic E-RX market review Measures of success

15. Rural Virginia E-health Collaborative MedVirginia Organizational Purpose -Collaboration in HIT -Clinical data exchange -Practice automation Vision: “…the most electronically integrated medical community in the U.S.”

16. Rural Virginia E-health Collaborative RVEC Priorities E- results E-referrals

17. Rural Virginia E-health Collaborative Confidential and Proprietary - Copyright © 2004 Method Factory Inc. d/b/a Wellogic All Rights Reserved, Worldwide. E- chart E-prescribing RVEC Priorities

18. Rural Virginia E-health Collaborative New Practice Options: “Stepping Stones” to HIT Adoption HIE - view only HIE w/ PM interface Integrated transcriptions Integrated e-RX Integrated electronic chart  HIE feed to other EMR

19. Rural Virginia E-health Collaborative Measures of Success Project Level By technology (e-RX, e- results, e-referrals) –Structure –Process –Outcome UVA Health Evaluation Sciences

20. Rural Virginia E-health Collaborative Next Steps E-RX review Medication history data capture pilot Final planning report Implementation funding

21. Rural Virginia E-health Collaborative The Lessons…So Far Leverage relationships Leverage partnerships Leverage technology “Hit the ground running” –Early findings Listen –Compelling business case for physicians