HIE Chronicles Part III: Patients opt in

This is the third installment in CMIO's exclusive web series exploring the birth of Rhode Island’s statewide health information exchange (HIE), featuring the leading stakeholders and clinical perspectives on its development.
The Rhode Island Quality Institute (RIQI) intends to collect clinical data from as many of the state’s 1.1 million-patient population as possible after it opens the aggregation aqueduct in March.

In order to have their medication history and lab results flow into currentcare, the statewide HIE, patients must consent via an opt-in agreement. About 130,000 patients have already opted into the system, said Laura Adams, president and CEO of RIQI.

The opt-in patient-consent model was the most significant recommendation from the Agency for Healthcare & Research Quality/Rhode Island Health IT Steering Committee to RIQI’s board of policies, said Cedric Priebe, MD, CIO and senior vice president of the Care New England Health System. Priebe was co-chair of the steering committee, along with Carole Cotter, senior vice president and CIO of Lifespan.

It was clear early in the policy-making phase that the Rhode Island clinical community was pushing for an opt-in model so patients could control their participation in the HIE. “Community patient advocates and stakeholders were concerned that an opt-out model could hurt certain patient populations, so we moved toward opt-in consent,” Priebe said.

“The strength of the RI HIE is that practicing physicians are involved with input,” said David Gorelick, MD, an internal medicine specialist at Aquidneck Medical Associates, a Newport-based multispecialty group. “You can’t reshape healthcare without practicing physician perspective.”

Stakeholders’ interests on all sides, including solo providers, multispecialty groups, public advocacy groups, payers, employers and more are on RIQI's advisory boards and committees, providing RIQI with advice on opt-in and a variety of other topics, Gorelick said. “They are doing a very good job having everyone have a say so there won’t be resistance,” he said. “If you exclude any aspect of the healthcare community, someone will be up in arms but with everyone working together, I think it’s going to work. I think the HIE will be very successful.”

Apparently, 130,000 Rhode Island patients believe so, too.