Teamwork Key to Long Term Sustainability of Health IT Systems
Researchers who sustain health IT projects are able to demonstrate their benefits to organizations and to clinicians and show their cost benefit, according to a new AHRQ report. The report, Effective Teamwork and Sustainability in Health IT Implementation, highlights the experiences of over 100 grantees that implemented major health IT projects between 2004 and 2007. It reviewed grantee experiences related to planning, long-term use, partnerships, vendor relationships, and end-user perceptions following the conclusion of the project period. Grantees reported that most health IT products that were implemented and upgraded during the study continue to be used. However, clinician buy-in and support must be established early in the planning period and be sustained during implementation and maintenance phases. Effective planning, including completing a detailed workflow analysis, implementation plan and process redesign assessment prior to implementation were strong markers of long-term viability. Strategic partnerships were another indicator for success; trusted partners with implementation experience provided practical advice that helped grantees navigate challenges in health IT implementation. Most grantees reported that health IT upgrades were beneficial to the organization and that ongoing investments in health IT infrastructure were warranted. Select to access the report.
Transforming Healthcare Quality through Health IT
Transforming Healthcare Quality through Health IT
Under the Agency for Healthcare Research and Quality's (AHRQ's)
Transforming Healthcare Quality Through IT (THQIT) program, 118 grantees
planned, implemented, and studied health IT implementations across a
wide range of care settings, communities, and types of health IT systems
(2004-2009). AHRQ and its contractors, Mathematica Policy Research and
Geisinger Health System, worked together to synthesize the experience of
the THQIT grantees. The team completed a systematic review of the
planning and implementation grantee final reports and other available
publications, surveyed the grantees, and conducted semi-structured
qualitative interviews with a subset of grantees.
Eight Quality Improvement Stories | Review of Peer-Reviewed Literature | Health IT Implementation Stories
In 2004 and 2005, AHRQ funded 118 grants and cooperative
agreements under the Transforming Healthcare Quality through Technology
(THQIT) program to support health IT implementation. AHRQ contracted to
prepare a synthesis of the evidence and lessons learned from the program
and disseminate examples of projects with useful results that reflect a
variety of technologies, settings, and patient populations.
As part of this work, eight THQIT grants were selected for the case summaries presented here. They represent the positive potential of a diverse set of technologies and applications and point to some issues and challenges that must be addressed to realize the potential more broadly. They include projects focusing on electronic health records, clinical decision support, telehealth, computerized provider order entry, health information exchange, a Web-based quality reporting system with feedback, and an electronic continuity-of-care record used to help overcome barriers in accessing care.
In late 2003, the Agency for Healthcare Research and Quality (AHRQ) published four requests for applications (RFAs) (HS-04-010, HS-04-011, HS-04-012, HS-05-013) that comprised the AHRQ-sponsored Transforming Healthcare Quality through Information Technology (THQIT) initiative.
This report addresses the initial peer-reviewed published findings of the Demonstrating the Value of Health Information Technology RFA (HS-04-012), known as the THQIT Value RFA. The primary purpose of this RFA was to fund projects to increase knowledge and understanding of the value of health IT in improving patient safety and quality of care.
This review provides a snapshot of the value of health IT as it is being implemented, discussing the opportunities for and impediments to the realization of Transforming Healthcare Quality through Information Technology.
AHRQ-funded health IT projects are helping to revolutionize everyday
clinical practice. Following are the stories and lessons learned from
some of these pioneering projects. If you have questions, or if you have
a story about your project that you'd like to be profiled here, please
contact us at NRC-HealthIT@ahrq.hhs.gov.
AHRQ IT Project Helps Bridge Distance for Native Americans Seeking Health Care
For Native Americans in California, getting medical treatment at a nearby clinic or hospital can be difficult. But a new project to use electronic health records could help bridge the distance and provide better care for patients.
Principal Investigator: Linda Aranaydo, M.D.
PROJECT ECHO: Bringing Specialty Care to Rural New Mexico
Learn how an AHRQ-sponsored project is supporting rural physicians' co-management of patients with chronic diseases in New Mexico using telehealth.
Principal Investigator: Sanjeev Arora, MD
West Virginia Medical Institute: Using IT to Improve Patient Safety in Small, Rural Hospitals
This project expands the reporting of medical errors and near misses, monitors safety event reporting, and develops a learning network among small, rural hospitals and their associated ambulatory care facilities, long-term care facilities, and home health agencies.
Principal Investigator: Gail Bellamy, PhD
The Taconic Health Information Network and Community of the Hudson Valley
Learn how an IPA is using its AHRQ grant to connect additional small practitioners to its health information exchange network and study the impact of this network on quality of care and patient safety.
Principal Investigator: John Blair III, MD, President and CEO, Taconic IPA, Inc.
AHRQ-Supported Telewound Care Networks Aims To Speed the Healing Process
An AHRQ-supported project is helping patients in rural Oklahoma get faster and more efficient treatment for chronic wounds through a web-based telecare network that links nursing home aides, home health workers, and other providers to wound care and other specialists.
Principal Investigator: Charles Bryant
A Clearer Picture: Sharing PACS Helps Improve Care in Maine
A shared Picture Archiving and Communications System in Maine that allows hospitals to store and transmit a patient's imaging records in real-time may form the basis of electronic sharing of other medical information across the state.
Principal Investigator: Robert Coleman
Sarah Bush Lincoln Health Center Connects Hospital, Clinics Through EMRs
The Sarah Bush Lincoln Health Center in East Central Illinois has implemented an ambulatory electronic medical record software application that provides shared access to computerized patient health information across hospital services, home health organizations, hospice, and physician practices. It's all part of an effort to provide better patient care and improve the way the health care system shares critical information.
Principal Investigator: Michael DeLuca
Health Information Exchange Links Records For Better Health
The MidSouth eHealth Alliance aims to improve patient care and reduce costs through eliminating duplicate or unneeded tests, reducing hospital stays, and decreasing ED utilization through health information exchange.
Principal Investigator: Mark Frisse, MD
Pioneering AHRQ-funded Project Is Helping Patients with Heart Failure Manage Their Condition
This study compares remote telemonitoring with standard care for patients with chronic heart failure (CHF). The analysis focuses on clinical outcomes (quality) and cost (efficiency).
Principal Investigator: Lee Goldberg, MD
Making Medication Safe for Elderly People in Long-Term Care
Researchers from Samaritan North Lincoln Hospital, a facility of Samaritan Health Services, and Oregon Health & Science University are leading the AHRQ project, which focuses on ways to use information technology (IT) to improve medication safety for the chronically ill elderly.
Principal Investigator: Paul Gorman and Karl Ordelheide
Long-Term Care Facilities Embrace Health Information Technology
Eleven nursing homes participating in a project supported by the Agency for Healthcare Research and Quality (AHRQ) to integrate new information technologies into everyday care have seen rates of pressure sore incidence among their residents drop by 33 percent.
Principal Investigator: Susan D. Horn, Ph.D.
HANDS Care Plan Tool Seeks to Improve Nurse Communication at Handoff in AHRQ-Funded Study
An AHRQ-supported project is testing whether a standardized, computerized tool can help nurses document patient care better and communicate more effectively at handoff. So far, the new tool -- called HANDS -- has proved extremely useful for documenting care. The next step: using HANDS to guide communication at handoff.
Principal Investigator: Gail Keenan, Ph.D., R.N.
AHRQ-Funded Study Explores the Value of Health Information to Communities
What's the value of health information to a community? Potentially, a great deal, in terms of both quality and cost. The trick, though, is not to share too much information too fast. That's just one of several lessons learned from this AHRQ-funded project.
Principal Investigator: David F. Lobach, M.D., Ph.D.
Telemedicine Project Connects, Kids, Doctors for Better Care
Learn how an AHRQ-funded project in Rochester, N.Y., is using telemedicine to connect child care centers and elementary schools to physician offices.
Principal Investigator: Kenneth McConnochie, M.D.
AHRQ Project Seeks To Cure What Ails Electronic Health Records
A new project is examining whether information technology tools that provide both clinical-decision support and population-based performance feedback will increase the value of electronic health records to clinicians while improving patient safety and quality.
Principal Investigator: Blackford Middleton, M.D., M.P.H., M.Sc.
AHRQ-Funded ParentLink Project Aims to Make Pediatric Emergency Care More Patient-Centered
One AHRQ-funded project has learned that IT can be used to involve patients, and their families, in the care delivery process through better communication and collaboration.
Principal Investigator: Stephen Porter, MD, MPH, MSC
Chicago Alliance of Community Health Centers Pioneers EHR Implementation with AHRQ Support
An AHRQ-supported project is transforming population and disease management for safety net providers using electronic health record and clinical decision support systems.
Principal Investigator: Fred Rachman, M.D.
St. Josephs Community Hospital: Using Health IT To Field Test Patient Safety Design
Learn about how one AHRQ grant has redesigned an inpatient facility around patient safety goals and how health IT played a critical role in making the new design a reality.
Principal Investigator: John Reiling, MHA, MBA, President/CEO, SynergyHealth, St. Joseph's Hospital
Master Visit Registry Helps Improve Transitional Care For Patients In Hawaii
This AHRQ project is developing a master visit registry - a form of health information exchange - to improve the coordination of care between hospitals and community health centers for Hawaii's vulnerable populations.
Principal Investigator: Christine Maii Sakuda, MBA
The Community Chronic Care Network of Santa Cruz County
Discover how a diverse partnership of healthcare organizations is attempting to stem chronic disease in the community using a health IT grant from AHRQ.
Principal Investigator: Wells Shoemaker
Integrated Reporting Technology Speeds Clinical Information Retrieval for Rural Vermont Health Providers
Orion Health's technology allowed the Mt. Ascutney Healthcare Consortium to improve the way they collect, store and transfer patient information. The Consortium hopes the system will help keep costs low while maintaining the highest standard of care.
Principal Investigator: Thomas R. Sims
AHRQ-Supported Electronic Record System Focuses on Best Practices for Vision Rehabilitation
When it comes to providing rehabilitation care for the visually impaired, data describing quality or outcomes of treatment are few and far between. But a unique computerized record system developed and implemented by New York-based Lighthouse International with funding from the Agency for Healthcare Research and Quality (AHRQ) aims to change that.
Principal Investigator: Cynthia Stuen, PhD
Washington's Everett Clinic: E-Prescribing in a Fast-Changing Health IT Environment
Discover how a community-based, physician-owned integrated health system is using electronic prescribing to improve patient safety and ambulatory provider workflow.
Principal Investigator: Sean Sullivan, Ph.D.
East Cleveland's Huron Hospital: Using Health IT to Improve Care for Underserved Patients
In East Cleveland, a grant from the Agency for Healthcare Research and Quality (AHRQ) is helping one of America's oldest hospitals use some of the newest health information technology (IT) available to improve everyday patient care.
Principal Investigator: Michael Waggoner, M.D.
Researchers Help Rural Hospitals Get Health IT Boost
When it comes to using information technology (IT) in hospitals, there is no one-size-fits-all approach. This is especially true for rural hospitals, which often lag behind their urban counterparts in adopting health IT.
Principal Investigator: Marcia Ward
Michigan Electronic Medical Records Project Provides Lessons Learned for Data Exchange
Ten critical access hospitals in Michigan's Upper Peninsula are working together to create a regional health information network that will allow for the communication of patient data with physicians. The network is designed to solve a major barrier to improving the quality care in a place where access to advanced health care services can be difficult.
Principal Investigator: Donald Wheeler, FACHE
The Rural Hospital Collaborative for Excellence Using IT
This project brings multiple stakeholders together to standardize electronic reporting of data in rural Texas hospitals to improve quality of care. The impact of training will be evaluated, and the project plans to create tools for rural hospitals in other parts of the nation.
Principal Investigator: Josie R. Williams, M.D., M.M.M.
Last Modified: December 2012
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Sustainability, Partnerships, and Teamwork in Health IT
Implementation: Essential Findings From the Transforming Healthcare
Quality Through IT Grants [View the full report (PDF, 6.12 MB)  ] PDF Help. This report synthesizes findings across several sources, focusing specifically on sustainability, partnerships, and effective teamwork—which were recognized by THQIT grantees as critical aspects of successful health IT implementation. The goal is to provide relevant information to those currently working toward health IT implementation. |
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Appendix B: Getting Ready - A Planning Checklist for Rural and Community Hospitals Considering Implementing Health IT (PDF, 2.14 MB) PDF Help. This checklist is designed to help rural and/or community-based hospitals assess their level of preparation for health IT implementation. |
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Appendix C: Success Story - Partners Use Electronic Health Records to Steer Quality Improvement (PDF, 2.03 MB) This case story describes how an EHR with evidence-based decision support technology and an electronic data warehouse for tracking quality of care was implemented by 32 community health centers across 11 States. |
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Podcasts highlighting three grantees’ successful projects are also available:
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Eight Quality Improvement Stories | Review of Peer-Reviewed Literature | Health IT Implementation Stories
As part of this work, eight THQIT grants were selected for the case summaries presented here. They represent the positive potential of a diverse set of technologies and applications and point to some issues and challenges that must be addressed to realize the potential more broadly. They include projects focusing on electronic health records, clinical decision support, telehealth, computerized provider order entry, health information exchange, a Web-based quality reporting system with feedback, and an electronic continuity-of-care record used to help overcome barriers in accessing care.
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Emergency Medical Service Responders Use Health IT to Improve Cardiac Care Principal Investigator: Harry P. Selker (Grant No. UC1HS015124) Emergency Medical Service agencies use a Web-based quality reporting system and clinical decision support technology to improve the timeliness and quality of care provided to patients experiencing or at risk of a heart attack. |
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Nursing Home Health IT Reduces Pressure Ulcers and Increases Staff’s Job Satisfaction Principal Investigator: Susan D. Horn (Grant No. UC1HS015350) Nursing homes bring health IT into long-term care to improve quality and provide guidance on translating health IT implementation lessons to new settings. |
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Project ECHO: Extension for Community Healthcare Outcomes Through Telemedicine Principal Investigator: Sanjeev Arora (Grant No. UC1HS015135) Through telemedicine clinics, Project ECHO provided new access to high-quality local care for rural New Mexico residents with hepatitis C. Building on this experience, the project has also initiated telemedicine clinics for other complex conditions. |
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Network of Rural Hospitals in Iowa Redesign Patient Care Workflow to Use Electronic Health Records Principal Investigator: Donald K. Crandall (Grant No. UC1HS015196) A rural referral center implemented an EHR system and simultaneously redesigned many aspects of care delivery, improving patient safety and producing a host of new knowledge and tools for more effective EHR implementation. |
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Public-Private Partnership Creates Web-Based System to Improve Rural Children’s Access to Health Care Through a Medical Home Principal Investigator: Gregory W. Bergner (Grant Nos. UC1HS016129 and P20HS014908) A Web-based application that enables community health workers to ensure that patients obtain needed access to health coverage and primary care. |
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Replication of Health Information Exchange Framework Across Oklahoma Principal Investigator: Mark H. Jones (Grant Nos. UC1HS016131 and P20HS015364) Using a "network of networks" model in Oklahoma makes a statewide health information exchange possible. |
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Electronic Prescribing: Lowering Patients' Prescription Drug Costs Principal Investigator: Joel S. Weissman (Grant No. R01HS015175) Providing prescribers with real-time information on the relative costs of drugs can significantly increase the use of lower cost medications. |
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Integrated Telemedicine System Demonstrates Reduction in Children’s Emergency Department Visits Principal Investigator: Kenneth M. McConnochie (Grant No. R01HS015165) A telemedicine system to connect schools and child care centers to primary care physicians for telehealth consultation is expanded, resulting in reduced use of emergency departments. |
The AHRQ Health IT Value Grant Initiative: A Programmatic Review of the Peer-Reviewed Literature (PDF, 260 KB) PDF Help.
PDF Help. In late 2003, the Agency for Healthcare Research and Quality (AHRQ) published four requests for applications (RFAs) (HS-04-010, HS-04-011, HS-04-012, HS-05-013) that comprised the AHRQ-sponsored Transforming Healthcare Quality through Information Technology (THQIT) initiative.
This report addresses the initial peer-reviewed published findings of the Demonstrating the Value of Health Information Technology RFA (HS-04-012), known as the THQIT Value RFA. The primary purpose of this RFA was to fund projects to increase knowledge and understanding of the value of health IT in improving patient safety and quality of care.
This review provides a snapshot of the value of health IT as it is being implemented, discussing the opportunities for and impediments to the realization of Transforming Healthcare Quality through Information Technology.
AHRQ IT Project Helps Bridge Distance for Native Americans Seeking Health Care
For Native Americans in California, getting medical treatment at a nearby clinic or hospital can be difficult. But a new project to use electronic health records could help bridge the distance and provide better care for patients.
Principal Investigator: Linda Aranaydo, M.D.
PROJECT ECHO: Bringing Specialty Care to Rural New Mexico
Learn how an AHRQ-sponsored project is supporting rural physicians' co-management of patients with chronic diseases in New Mexico using telehealth.
Principal Investigator: Sanjeev Arora, MD
West Virginia Medical Institute: Using IT to Improve Patient Safety in Small, Rural Hospitals
This project expands the reporting of medical errors and near misses, monitors safety event reporting, and develops a learning network among small, rural hospitals and their associated ambulatory care facilities, long-term care facilities, and home health agencies.
Principal Investigator: Gail Bellamy, PhD
The Taconic Health Information Network and Community of the Hudson Valley
Learn how an IPA is using its AHRQ grant to connect additional small practitioners to its health information exchange network and study the impact of this network on quality of care and patient safety.
Principal Investigator: John Blair III, MD, President and CEO, Taconic IPA, Inc.
AHRQ-Supported Telewound Care Networks Aims To Speed the Healing Process
An AHRQ-supported project is helping patients in rural Oklahoma get faster and more efficient treatment for chronic wounds through a web-based telecare network that links nursing home aides, home health workers, and other providers to wound care and other specialists.
Principal Investigator: Charles Bryant
A Clearer Picture: Sharing PACS Helps Improve Care in Maine
A shared Picture Archiving and Communications System in Maine that allows hospitals to store and transmit a patient's imaging records in real-time may form the basis of electronic sharing of other medical information across the state.
Principal Investigator: Robert Coleman
Sarah Bush Lincoln Health Center Connects Hospital, Clinics Through EMRs
The Sarah Bush Lincoln Health Center in East Central Illinois has implemented an ambulatory electronic medical record software application that provides shared access to computerized patient health information across hospital services, home health organizations, hospice, and physician practices. It's all part of an effort to provide better patient care and improve the way the health care system shares critical information.
Principal Investigator: Michael DeLuca
Health Information Exchange Links Records For Better Health
The MidSouth eHealth Alliance aims to improve patient care and reduce costs through eliminating duplicate or unneeded tests, reducing hospital stays, and decreasing ED utilization through health information exchange.
Principal Investigator: Mark Frisse, MD
Pioneering AHRQ-funded Project Is Helping Patients with Heart Failure Manage Their Condition
This study compares remote telemonitoring with standard care for patients with chronic heart failure (CHF). The analysis focuses on clinical outcomes (quality) and cost (efficiency).
Principal Investigator: Lee Goldberg, MD
Making Medication Safe for Elderly People in Long-Term Care
Researchers from Samaritan North Lincoln Hospital, a facility of Samaritan Health Services, and Oregon Health & Science University are leading the AHRQ project, which focuses on ways to use information technology (IT) to improve medication safety for the chronically ill elderly.
Principal Investigator: Paul Gorman and Karl Ordelheide
Long-Term Care Facilities Embrace Health Information Technology
Eleven nursing homes participating in a project supported by the Agency for Healthcare Research and Quality (AHRQ) to integrate new information technologies into everyday care have seen rates of pressure sore incidence among their residents drop by 33 percent.
Principal Investigator: Susan D. Horn, Ph.D.
HANDS Care Plan Tool Seeks to Improve Nurse Communication at Handoff in AHRQ-Funded Study
An AHRQ-supported project is testing whether a standardized, computerized tool can help nurses document patient care better and communicate more effectively at handoff. So far, the new tool -- called HANDS -- has proved extremely useful for documenting care. The next step: using HANDS to guide communication at handoff.
Principal Investigator: Gail Keenan, Ph.D., R.N.
AHRQ-Funded Study Explores the Value of Health Information to Communities
What's the value of health information to a community? Potentially, a great deal, in terms of both quality and cost. The trick, though, is not to share too much information too fast. That's just one of several lessons learned from this AHRQ-funded project.
Principal Investigator: David F. Lobach, M.D., Ph.D.
Telemedicine Project Connects, Kids, Doctors for Better Care
Learn how an AHRQ-funded project in Rochester, N.Y., is using telemedicine to connect child care centers and elementary schools to physician offices.
Principal Investigator: Kenneth McConnochie, M.D.
AHRQ Project Seeks To Cure What Ails Electronic Health Records
A new project is examining whether information technology tools that provide both clinical-decision support and population-based performance feedback will increase the value of electronic health records to clinicians while improving patient safety and quality.
Principal Investigator: Blackford Middleton, M.D., M.P.H., M.Sc.
AHRQ-Funded ParentLink Project Aims to Make Pediatric Emergency Care More Patient-Centered
One AHRQ-funded project has learned that IT can be used to involve patients, and their families, in the care delivery process through better communication and collaboration.
Principal Investigator: Stephen Porter, MD, MPH, MSC
Chicago Alliance of Community Health Centers Pioneers EHR Implementation with AHRQ Support
An AHRQ-supported project is transforming population and disease management for safety net providers using electronic health record and clinical decision support systems.
Principal Investigator: Fred Rachman, M.D.
St. Josephs Community Hospital: Using Health IT To Field Test Patient Safety Design
Learn about how one AHRQ grant has redesigned an inpatient facility around patient safety goals and how health IT played a critical role in making the new design a reality.
Principal Investigator: John Reiling, MHA, MBA, President/CEO, SynergyHealth, St. Joseph's Hospital
Master Visit Registry Helps Improve Transitional Care For Patients In Hawaii
This AHRQ project is developing a master visit registry - a form of health information exchange - to improve the coordination of care between hospitals and community health centers for Hawaii's vulnerable populations.
Principal Investigator: Christine Maii Sakuda, MBA
The Community Chronic Care Network of Santa Cruz County
Discover how a diverse partnership of healthcare organizations is attempting to stem chronic disease in the community using a health IT grant from AHRQ.
Principal Investigator: Wells Shoemaker
Integrated Reporting Technology Speeds Clinical Information Retrieval for Rural Vermont Health Providers
Orion Health's technology allowed the Mt. Ascutney Healthcare Consortium to improve the way they collect, store and transfer patient information. The Consortium hopes the system will help keep costs low while maintaining the highest standard of care.
Principal Investigator: Thomas R. Sims
AHRQ-Supported Electronic Record System Focuses on Best Practices for Vision Rehabilitation
When it comes to providing rehabilitation care for the visually impaired, data describing quality or outcomes of treatment are few and far between. But a unique computerized record system developed and implemented by New York-based Lighthouse International with funding from the Agency for Healthcare Research and Quality (AHRQ) aims to change that.
Principal Investigator: Cynthia Stuen, PhD
Washington's Everett Clinic: E-Prescribing in a Fast-Changing Health IT Environment
Discover how a community-based, physician-owned integrated health system is using electronic prescribing to improve patient safety and ambulatory provider workflow.
Principal Investigator: Sean Sullivan, Ph.D.
East Cleveland's Huron Hospital: Using Health IT to Improve Care for Underserved Patients
In East Cleveland, a grant from the Agency for Healthcare Research and Quality (AHRQ) is helping one of America's oldest hospitals use some of the newest health information technology (IT) available to improve everyday patient care.
Principal Investigator: Michael Waggoner, M.D.
Researchers Help Rural Hospitals Get Health IT Boost
When it comes to using information technology (IT) in hospitals, there is no one-size-fits-all approach. This is especially true for rural hospitals, which often lag behind their urban counterparts in adopting health IT.
Principal Investigator: Marcia Ward
Michigan Electronic Medical Records Project Provides Lessons Learned for Data Exchange
Ten critical access hospitals in Michigan's Upper Peninsula are working together to create a regional health information network that will allow for the communication of patient data with physicians. The network is designed to solve a major barrier to improving the quality care in a place where access to advanced health care services can be difficult.
Principal Investigator: Donald Wheeler, FACHE
The Rural Hospital Collaborative for Excellence Using IT
This project brings multiple stakeholders together to standardize electronic reporting of data in rural Texas hospitals to improve quality of care. The impact of training will be evaluated, and the project plans to create tools for rural hospitals in other parts of the nation.
Principal Investigator: Josie R. Williams, M.D., M.M.M.
Last Modified: December 2012
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