The development of a health information exchange to enhance care and improve patient outcomes among HIV+ individuals in rural North Carolina.
BACKGROUND
The Regional Health Information Integration Project (RHIIP) has developed the Carolina HIV Information Cooperative regional health information organization (CHIC RHIO). The CHIC RHIO was implemented to improve patient care and health outcomes by enhancing communication among geographically disconnected networks of HIV care providers in rural North Carolina. CHIC RHIO comprises one medical clinic and five AIDS Service Organizations (ASOs) serving clients in eight rural counties.


METHODS
Communication among the CHIC RHIO members is facilitated by CAREWare software. The RHIIP team assessed organizational readiness to change, facilitated relationship-building for CHIC RHIO, created the CHIC RHIO and used both qualitative and quantitative approaches to evaluate the process-related effects of implementing a data-sharing intervention.


RESULTS
We found the CHIC RHIO member organizations were ready to engage in the IT intervention prior to its implementation, which most likely contributed to its successful adoption. The qualitative findings indicate that CHIC RHIO members personally benefited - and perceived their clients benefited - from participation in the information exchange. The quantitative results echoed the qualitative findings; following the CHIC RHIO intervention, quality improvements were noted in the ASO and medical clinic relationships, information exchange, and perceived level of patient care. Furthermore, hopes for what data sharing would accomplish were overly high at the beginning of the project, thus requiring a recalibration of expectations as the project came to a close.


CONCLUSIONS
Innovative strategies for health information exchange can be implemented in rural communities to increase communication among providers. With this increased communication comes the potential for improved health outcomes and, in turn, healthier communities.
Center for Health Policy and Inequalities Research, Duke University, Durham, NC 27705, United States. lynne.messer@duke.edu
Lynne C
LC
Messer
Heather
H
Parnell
Renee
R
Huffaker
Rich
R
Wooldredge
Aimee
A
Wilkin
D003299:Cooperative Behavior; D004059:Diffusion of Innovation; D015658:HIV Infections / Q000628:therapy*; D006801:Humans; D016347:Medical Records Systems, Computerized; D009657:North Carolina; D012424:Rural Population; D016896:Treatment Outcome