Commuting weekly from his Birmingham home for nearly four years—a distance of more than 200 miles—in order to shepherd a worthy project reflects commitment with a capital “C.” Rodney Holmes has leveraged his persistent passion for information technology into a master’s degree project, a career, and a Memphis-based alliance of healthcare providers that is gaining increasing respect and recognition.

 

An Alabama native and Auburn graduate, Holmes earned his undergraduate degree in accounting, but his fascination with technology led him to minor in computer information systems. Operating independently as a CPA specializing in accounting software and technology services for small businesses and medical practices, Holmes became acquainted first with the early push toward electronic medical records (EMRs) and then the burgeoning field of informatics.

 

Inspired by the potential he envisioned, Holmes pursued a master’s degree in informatics through the University of Alabama-Birmingham’s health administration program. The program required a project internship, and Holmes discovered the perfect choice: a Vanderbilt project that aimed to resolve problems that were driving the MED toward bankruptcy—in part, by developing a model for a health information exchange (HIE) within the Memphis community. 

 

Holmes promptly got on board with the federally- and state-funded project in 2007, and when his internship ended a few months later, he stayed on as a Vanderbilt employee, continuing to develop the project for another two years.

 

When the MidSouth eHealth Alliance needed an executive director for their Memphis-area HIE, it was a perfect fit—both for Holmes and for the Alliance: Sustainability, ambulatory strategy, developing a business model—those were things Holmes had already been working on at Vanderbilt, so his transfer into a Memphis office, wearing an executive director’s hat, hardly caused him to break stride.

 

In June 2009 Holmes took the MidSouth eHealth Alliance helm and has continued the process of collecting data from Memphis-area patients to be included in a bank of securely protected information designed for sharing among hospital emergency departments, ambulatory clinics, physicians and authorized medical personnel. The Alliance’s goals include improving patient care, decreasing emergency departments for primary care, reducing hospital stays, reducing redundant tests, and controlling costs.

 

Currently, information stored with the Mid-South eHealth Alliance comes from 35 different MidSouth facilities and more than 400 clinicians who can access the data collected by those contributors.

 

Only patients who give permission for this protected sharing of their information can be included in the HIE, Holmes stresses; patients may opt out and decline to participate.

 

With ready access to Vanderbilt’s significant technical resources, we were able to change directions, explore new possibilities, and modify the software to meet our needs very quickly. We are currently transitioning to ICA’s (Informatics Corporation of America’s) commercial HIE solution and, once it is implemented, we’ll follow a much more structured software change management process. We are initially implementing a scaled-down version of ICA’s solution, but once we get participants comfortable with the new version, we’ll start adding some of the bells and whistles to give clinicians more flexibility with how they use the product.

 

Since we are not a primary clinical system for any of our participants, we are not always high on their priority list; maintaining and upgrading their existing internal clinical systems must come first. The challenge for us is working within our participants’ time and resource constraints—advancing the Mid-South eHealth Alliance without being a burden on them.

 

Our lack of self-promotion within the Memphis community and nationally, for that matter, is one of the things that has held us back. Although people may have heard of us, they don’t understand what the Mid-South eHealth Alliance is, so getting the word out is important. We are currently developing a communications plan that focuses on informing providers that we exist and the benefits from participation—but also explaining our purpose to consumers/patients so they can feel safe in trusting us with their data.

 

It’s certainly to their advantage to make that choice, and we’re fully supportive of more doctors and hospitals utilizing EMRs. If they choose to participate in the Mid-South eHealth Alliance, our database is that much broader and richer, and that benefits everyone—both patients and clinicians.

 

Initially our focus was on hospitals—specifically, emergency departments (EDs); now it’s on the physicians’ offices.

 

What we have hung our hat on is our ability to facilitate the providers meeting the (CMS) meaningful use requirements, specifically the requirements that the physicians exchange health information with unaffiliated providers. That’s the need that MSeHA can fill.

 

Most office-based physicians have ties to a hospital in some way. Our hospital participants have been very helpful in guiding us to those physicians whose participation with the Mid-South eHealth Alliance would be most helpful from a community perspective.

 

On a larger scale, QSource, the Tennessee Regional Extension Center (REC), is focused on getting EMRs into doctors’ offices. As part of their strategy in helping doctors through the process, they advise them that by participating in the Mid-South eHealth Alliance they can more readily meet the meaningful use requirements. We’re working with QSource to help us reach out. We have a similar agenda, and continue to find ways to work together to bring more providers in.

 

The biggest challenge is to figure out how to become a sustainable organization without relying solely on grant funds—identifying the business model that will keep us going. We’ll still pursue grants, of course, but we don’t want that to be our primary method of funding.

 

So we’re looking at what the future funding model should be. Is it a participation fee? Is it transaction fees? There are multiple ways one could fund an HIE, although few HIE’s have really settled on a model that works, and no one model works for everyone. It’s a real challenge for us.

 

A requirement of the Agency for Healthcare Research and Quality’s (AHRQ’s) funding is the formal assessment of the impact our HIE has had on the community. This evaluation has numerous aspects, but parts of it measure the impact on quality of care, the efficiency of care, and the level of quality improvement. 

 

Although the results haven’t been published as yet, they will show that we’ve made a positive impact in all the measured aspects.

 

The thing I’m most proud of is the commitment of our participants to put aside their competitiveness and come together to focus on a common goal. When they come into the boardroom, they put their organizational concerns aside and focus on what’s best for the patients and the community as a whole.