By Maureen McKinney

May 20, 2008 | Delhi Hospital, a small rural hospital in Delhi, La., recently became the first successful pilot site of the Louisiana Rural Health Information Exchange (LARHIX) after patient information was transmitted between Delhi and the Louisiana State University Health Sciences Center in Shreveport.

The statewide exchange will allow underserved rural patients—particularly those with chronic diseases and mental illnesses—to receive regular treatment from physicians in Shreveport, said Michael Carroll, Delhi Hospital’s chief executive officer and administrator. Delhi is one of seven facilities in the first group of the initiative, which will eventually expand to include all 44 members of the Louisiana Rural Hospital Coalition.

In a March 27 demonstration at Delhi Hospital, a physician at LSU Health Sciences Center in Shreveport was able to remotely guide a clinician through a complete evaluation of a mock patient, instructing him to check heart rate, skin and blood pressure. Fifty-inch, flat-screen monitors in each examination room provided a live telecast of the patient as well as the remote physician, and a telemetry cart featured a stethoscope and advanced camera.

In addition to an electronic health record solution, LARHIX is utilizing Fusion, a clinical portal from Carefx, Scottsdale, Ariz., which will aggregate patient data from the different locations and put it into a viewable form. Chicago-based Initiate Systems will provide the software for the HIE’s enterprise master person index (MPI) numbers.

The exchange has not dictated specific EHR vendor requirements for members, explained David Pulver, vice president of eastern regions for from Dairyland Healthcare Solutions, Glenwood, Minn. Instead, facilities are free to choose whichever EHR vendor they prefer, as long as the solution is open and can integrate and exchange patient data with other hospitals. Four of the seven pilot hospitals—including Delhi Hospital—have chosen an EHR from Dairyland.

The LARHIX initiative—which was led by Senate President Don Hines and Representative Francis Thompson—was created as a way to provide better quality health care to the state’s rural residents, and that need became even more readily apparent after Hurricane Katrina, said McCarroll.

“We treated hundreds of people that didn’t have any medical records at all after the hurricane,” McCarroll said. “We were starting from scratch and at that point, we realized that we needed portable, transferrable medical records in order to avoid this kind of situation in the future.”

Although Delhi Hospital did successfully transmit information using the exchange, the facility’s patients won’t begin to receive real-time care from physicians at LSU Health Sciences Center until August, said Brenna Guice, Delhi Hospital’s head of information systems. That will mark the end of phase two, when lab results, pharmacy, and radiology have all been implemented and will be accessible to the HIE, she added.

As for the exchange, seven more hospitals will be added this year, and approval for a five-year budget is likely to come soon, said Pulver.

“What is being proposed now and should be approved is a five-year budget to roll out all 44 hospitals,” Pulver said. “Not all facilities will need a brand new system, and some may only need an upgrade. The ultimate goal is, at the end of that five-year period, to have everyone on a state-of-the-art system that can communicate with the hospital in Shreveport.”

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