Division of Clinical Informatics, Duke University
DUMC 2914
Durham, NC 27710
dmi-www.mc.duke.edu

David Lobach, M.D., Ph.D., M.S.
Jennifer Macri, MS
Jan M. Willis MS, MBA
Ph: 919-684-6421
Fax: 919-684-8675
E-mail: clinicalinformatics@duke.edu

Network Partners: Duke (Hospital, Family Medicine Center, Pediatrics, OB/GYN, Outpatient Clinic, Urgent Care North and South), Lincoln Community Health Center (Center, Urgent Care), Durham County (Health Department, Dept. of Social Services), Durham Regional Hospital, Durham Community Health Network, Durham Pediatrics, Regional Pediatrics, Central Family Medicine.

Purpose: Support proactive care management; facilitate communication among clinicians, social workers, care managers, health educators and patients; provide access to personal health information and education materials to patients. Clinical information is collected directly from patients through a computer interface that adapts to fit the native language, reading literacy and computer skills of the user. Thus, care management services will be customized to each patient and will include disease-specific education, health risk reduction programs, and assistance accessing appropriate clinical services and complying with medications.

Outcomes Expected: Expected improvement in HEDIS indicators for cancer screening, immunizations, diabetes care, asthma care, Chlamydia screening, well-child visits and post-partum care will be measured from site encounter data. Decreased emergency department utilization and admissions for ambulatory care-sensitive conditions will be measured from site encounter data. Tested instruments to assess condition-specific health literacy and surveys of patients’ self-efficacy for managing their illnesses will be measured by patient surveys.

Service Area: Durham County, North Carolina. Nine MUAs and one HPSA.

Services Provided: The provider network has been in existence since July of 1998. Members of the network will provide telemedicine services, receive telemedicine services, provide distance education services and receive
distance education services.

Equipment: This project is Internet based. The equipment used includes a specially designed touch-screen patient data entry kiosk. The kiosk includes an output printer and a video camera to provide real time contact to a care manager. Partner sites access the data via the Internet on their office personal computers.

Transmission: T1 lines at the partner sites, over the Internet.

Education and Research Consortium of Western Carolinas
22 South Pack Square, Suite 500
Asheville, NC 28801
www.ercwc.org

Gary Bowers, JD
Amy LeClare
Ph: 828-281-1954
Fax: 828-281-1988
Email: amyleclare@ercwc.org

Network Partners: The 16 hospitals serving western North Carolina: Angel Medical Center, Cherokee Indian Hospital, Harris Regional Hospital, Haywood Regional Medical Center, Highlands-Cashiers Hospital, McDowell Hospital, Mission Hospitals, Murphy Medical Center, Pardee Hospital, Park Ridge Hospital, Rutherford Hospital, Spruce Pine Communit Hospital, St. Luke’s Hospital, Swain County Hospital, Thoms Rehab Hospital, Transylvania Community Hospital.

Project Purpose: Develop and implement a system to electronically access and transfer patient data from the 16 independent, community-based hospitals serving western North Carolina. There is currently no means to electronically transmit or access patient information from one hospital to another within the region. The long-term goal is to create a longitudinal electronic medical record that can be accessed and updated by any authorized health care provider in the region.

Outcomes Expected: The project will improve the delivery of patient care in western North Carolina by speeding access to critical patient medical information, eliminating the potential for transcription errors, speeding the
timeframe for treatment of patients, eliminating the need for patients or family members to repeat information at other providers, and reducing the cost of care by creating efficiencies within the hospitals.

Service Area: The 16 counties in western North Carolina: Buncombe, Cherokee, Clay, Haywood, Henderson, Jackson, Graham, Macon, Madison, McDowell, Mitchell, Polk, Rutherford, Swain, Transylvania, Yancey.

Services Provided: Electronic transmission of patient medical information between western NC hospitals and between local hospitals and their admitting physicians.

Equipment: At remote sites: VPN boxes. At hosting site: 4 servers.

Transmission: Remote sites will transmit to hosting site via VPN lines. Clinical data users will utilize IP via the Web.