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Medical providers trying to reach at-risk populations in the Tri-Cities area soon will have a comprehensive database to help them target their focus.

As part of the state of Tennessee’s eHealth initiatives, CareSpark, a coalition of physicians, hospitals, employers, health plans and community leaders has been working for the last three years to develop an interoperable standards-based network for the secure exchange of healthcare information. The program is funded through a $5.6 million contract from the U.S. Department of Health and Human Services, and $1 million from the state.

CareSpark will serve 17 counties in upper East Tennessee and southern Virginia, an area that encompasses 705,000 residents, 18 hospitals and 1,200 physicians. The program, which will begin collecting and analyzing data in August, has some major goals, one to ensure that at-risk populations such as children and the elderly are getting needed vaccinations and immunizations in a timely manner, said Liesa Jenkins, executive director.

“Having information available electronically will reduce the time required to send data to all of our partner provider organizations,” Jenkins said. “We’ll be able to look at information collectively for the region, not just what the individual organizations are doing, so we can track improvement at every level.”
In Tennessee the CareSpark region includes Sullivan, Washington, Hancock, Hawkins, Greene, Carter, Unicoi and Johnson counties. Virginia counties covered are Lee, Scott, Wise, Washington, Russell, Dickenson, Buchanan, Tazewell and Smyth. The program also will include the city of Bristol and town of Norton in Virginia. In addition, information will be networked with North Carolina healthcare providers through an existing agreement between Tennessee and North Carolina that allows for the sharing of immunization records.

While CareSpark will enhance medical delivery services across a broad range, children and adult immunization will be an early focus.

“We should begin to collect information in the fourth quarter of this year, and as quickly as we can analyze the data we’ll be looking at specific immunization timetables,” Jenkins said. “Probably the start and end of flu season for looking at those particular vaccinations, and the beginning and end of the school year for childhood immunization. Once we see what the numbers are, we’ll be able to see when we need to start getting the word out to people regarding vaccines.”
The goal is to make sure children, the elderly and others who need annual flu shots, childhood vaccines and other inoculations for viruses such as Hepatitis D will be seen, whether it’s at a clinic, doctor’s office, hospital or public health center, Jenkins said.

“We’re working with ETSU’s College of Public Health, which will be training people to look at the data and figure out if we’re doing good, bad or otherwise, and then how to target specific populations and certain geographic areas so we can close any gaps that we see,” she said.

In the area of vaccinations, the program’s initial outreach will be to groups who routinely receive shots, such as school-age children and the elderly.

Reminders will go to physicians and patients, particularly if they are in a high-risk group. An example would be senior citizens 65 and older, who will get notices when they’re due a flu shot or pneumonia vaccination, Jenkins said.

“For children, there are required vaccinations that they have to have before entering the seventh grade in Tennessee, and the schools require some evidence of that,” she said. “One thing CareSpark is going to do is not only send reminders to those patients, but when the full system is in place, they or their parents will be able to go in and check to see what they’ve gotten, and what’s recommended or required, in terms of shots.”

CareSpark will allow the Johnson City Downtown Clinic to tap into area hospital records, reducing by hours the time needed with new patients who’ve been referred there from the emergency room. But, as the system grows in scope, its ability to bolster preventive-medicine efforts also will be tremendous, said Marcy Walker, chairman of the clinic’s board of directors.

“Right now, we take care of indigents and people with no insurance, a lot of the homeless and … pregnant women,” Walker said. “The system for reminding pregnant women and women with small children about shots is going to be part of the system that we’ll be using a lot. We’d love to be more in the business of doing preventive medicine rather than being the place of last resort.”

Multiple area agencies have been working with CareSpark in the early stages of data collection, and say the system will greatly enhance treatment protocols across the board.

“Creating interoperability across healthcare information systems will improve healthcare, population health, and the prevention of illness and disease,” said Mark McCalman, MPH, chief epidemiologist with the Sullivan County Regional Health Department. “These improvements will include immunization and vaccinations. The higher the quality of health information, the better understanding we (public health) have on where to target our limited resources.
“Regional immunization surveillance systems are often fragmented and limited in scope,” McCalman continued. “Through the utility of health information exchange, a more complete picture of immunization rates across a range of demographics is made available.”

Whether it’s a child on CoverKids, a TennCare patient or an individual with private insurance, CareSpark’s Jenkins said the hope is that the entire area’s population will benefit from the automated records system, especially in the area of vaccinations and other core-care issues.

“We’ll be able to see what the percentages are for vaccination, and see where we should be from an epidemiology standpoint,” she said. “If we’re not meeting those targets, then we hope to be able to mobilize resources such as the health departments, colleges of medicine, nurses, pharmacies, employers and health plans in the area to let people know that we’re not getting folks vaccinated like we should be, and then have some public awareness and education initiatives that encourage patients and providers to pay attention to the issue, and increase the numbers that way.”


August 2007

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