Regional Work


Since January 2010, over 12 million dollars have been awarded to the National Capital Area to further work in Health Information Technology. In the District, 5 million dollars in stimulus money was granted to the DC Department of Health Care Finance to establish an electronic medical health record for DC residents. In Maryland, over 9 million dollars of stimulus money was granted to the Maryland Health Care Commission to establish an exchange between the electronic health records in the state.

The District of Columbia, Maryland and Virginia are all engaged in efforts around the development and sharing of electronic patient health records as a way to improve the quality and cost effectiveness of health services.

Electronic Medical/Health Records and Exchanges

As of 2010, many of the community-based primary care health centers and free clinics affiliated with the region’s primary care associations/coalitions are using some form of electronic health records and looking into health record exchanges. 

In the District:
The DC Primary Care Association, with funding from the DC government, is helping health centers implement practice management/electronic health records programs. Clinics are using electronic systems to register clients, make appointments, verify medical histories and current medications, documenting progress notes, order and review labs, prescribe medications, provide reminders to patients, and streamline reimbursement.

With the help of 5 million dollars in stimulus funds, DCPCA will work with the DC Department of Health Care Finance on “Connecting the Capitol Region: The District of Columbia’s Health Information Exchange”. The grant project aims to establish a seamless, integrated, interoperable Health Information Exchange across the District.  The grant will bring together public and private stakeholders to integrate existing health record initiatives in the District including the DC RHIO—the Regional Health Information Organization that was funded by the DC government to set up the infrastructure to allow two hospitals and six community-based clinics to access medical history about patients—and  the Patient Data Hub. The full grant description is available on the DC Department of Health Care Finance website: Click HERE.

In Virginia:
Many of the clinics that are part of the Northern Virginia Health Services Coalition are also using some form of electronic medical record. The Northern Virginia Regional Health Information Exchange was designed to support the use of electronic medical/health records.

The Northern Virginia Regional Health Information Organization (NOVA RHIO) was established in 2006 to improve the health status and health care of those who live and work in Northern Virginia by facilitating the availability of accurate and timely electronic medical records when needed for health maintenance and treatment.

In Maryland:
The Maryland Health Services Cost Review Commission approved $10 million in start up funding to build a statewide health information exchange (HIE). The HIE will be implemented by the Chesapeake Regional Information Exchange for Our Patients (CRISP), a non-profit membership organization. The HIE goal is “to deliver the right health information to the right place at the right time – anywhere in Maryland – providing safer, more timely, efficient, effective, equitable, patient-centered care”.

The Montgomery County Health Information Exchange (MCHIE) group was co-chaired by Dr. Roger Leonard, VP for Medical Affairs and Dr. Tom Lewis of the Primary Care Coalition, with active participation by all the county hospitals, several of the safety net clinics, the Montgomery County Dept. of Health and Human Services, the Prince Georges County Health Department, and many community organizations.Of particular interest are the findings of focus groups conducted among patients and providers for utilizing safety net clinic services as documented in the MCHIE report. The report reflects the perspectives of community hospitals, safety net clinics, and community members on issues of importance for a successful statewide health information exchange.

The Primary Care Coalition (PCC) of Montgomery County, Center for Community-Based Health Informatics (CCBHI) is working with its community health link clinics to put practice management and electronic medical/health records in place and use those systems to exchange relevant health information with other providers in the region. With the support of a Community Access Program grant from HRSA, CCBHI developed CHLCare, an open-source technology product that includes robust demographic information, an appointment-scheduling module, and clinical information including ICD-9 and CPT codes all in a single, shared system usedby many clinicsin the region. It also developed and implemented The Clinical Desktop through an Access to Digital Libraries grant from the National Library of Medicine. This functionality allows clinic staff and patients to easily access quality health information on the Internet. The grant also included training for clinic staff on how to assess the quality of this health information.

PCC is using the Metro DC Health Information eXchange (MeDHIX—which was funded through a Transforming Healthcare Quality through Information Technology grant from the Agency for Healthcare Research and Quality (ARHQ)), to provide the infrastructure necessary to facilitate exchange of electronic health information between CHLCare, other electronic health records, and mainstream health care. The information to be exchanged will include medications, conditions, allergies, and results of laboratory tests. As part of this project, picture ID cards were added to CHLCare and MeDHIX for safety net clinic patients to facilitate care and identify patients to hospital ER staff and consulting specialists. Both the picture ID cards and the MeDHIX “eChart” clinical summary available to ER staff are integral components of the “ED-PC Connect” project that focuses on identifying medical home clinics for ER patients to improve outcomes and reduced costs.

ARHQ funding for MeDHIX ended in September of 2009. A formal report on the MeDHIX project was written and highlights how different and complex confidentiality and privacy laws are governing patient’s health information across jurisdictions that are so close geographically (and whose patient populations migrate across jurisdiction borders quite frequently)—making open sourcing of this data quite difficult and providing a continuum of care for patients across the jurisdictions equally difficult. In the report, the MeDHIX Principle Investigators lay out next steps for the sustainability of the regional HIE project, including the expansion of the DC RHIO and continued funding of safety net EHRs and HIEs across the jurisdictions. The full report can be accessed HERE. Please contact Tom Lewis, Chief Information Officer of the Primary Care Coalition of Montgomery County, for more information at Tom_Lewis@primarycarecoalition.org.