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The focus on moving from paper to an electronic system in healthcare began for Information & Quality Healthcare (IQH) in 2005. IQH, as the Mississippi Medicare quality improvement organization or QIO, started work on the Doctor’s Office Quality Information Technology healthcare project through its contract with the Centers for Medicare & Medicaid Services (CMS), an agency of the U.S. Department of Health and Human Services. The destruction brought about by Hurricane Katrina in hospitals and physician offices on the coast reinforced the project efforts to encourage the transition from paper records to electronic systems. Reminders of the storm aftermath included photographs of healthcare providers spreading out water-damaged medical records to dry.

On the national level, the government set a target date of 2010 to have the electronic health record (EHR) and other electronic features in place since health information technology is perceived as one of the best means in the quest to provide the right care for every patient every time.

IQH team members involved in the project have traveled throughout the state to work with physician offices and clinics, offering information and tools to aid in selection for a system that may cost upwards of $15,000 initially per provider. The challenge is centered on the costs, along with clinical staffs’ acceptance of the movement to an electronic system. IQH team members work with clinics after the purchase and installation of the EHR assisting them in fully utilizing the system to improve patient care and outcomes. The largest barrier for rural practices is often financial.

Members of the DOQ-IT team include Trannie Murphy, Lynn Mitchell, and Bowden Palmer; Dr. Sue Dillon is clinical coordinator for the project.

The IQH Doctor’s Office Quality Information Technology (DOQ-IT — pronounced ‘docket’) project has received attention throughout the state since its pilot phase that began with nine clinical sites. Installation of an EHR system allows clinics to produce electronic clinical information that is secure and reliable. It can provide seamless communication to all providers involved in the patient’s care. This information can provide accurate, readable information for consultants, emergency rooms, hospitals, home health agencies and nursing homes. Accurate information may lead to decreased duplications of tests and procedures for the patient and may lead to revenue savings to everyone concerned with healthcare.

Using tools provided to them, healthcare providers are able to select the electronic system vendors best suited for their needs. IQH’s DOQ-IT project provides vendor-neutral support for clinics and acts as a facilitator to the clinics during the selection process. Clinics also receive assistance to fully utilize the expensive investment that they have made to include care management (both chronic disease management and preventive care). The DOQ-IT team provides information to the clinics about the latest practice recommendations and industry trends for the EHR.

IQH assists clinics in evaluating their workflow and provides support for the clinics’ workflow redesign. DOQ-IT team members share project tools and information that can be of help in selecting appropriate software for an office. The IQH team is currently working intensely with 35 clinics in the state, according to Murphy, a registered health information administrator, who serves as project manager. “Our goal is for the facilities to implement electronic health record systems or to utilize an existing system to produce electronic clinical information and provide care management for the patients,” she explained. “The EHR offers the opportunity for practices to use data to identify patients who are in need of diagnostic studies or those who have abnormal test results and need further attention. The system can also be extensively used to work one-on-one with the patient to provide education about his or her health or illness and establish patient goals for better quality of care.”

In the six-county coastal area devastated by Hurricane Katrina, the team participates in the Katrina-Phoenix project, a partnership with the Health Information Management Systems Society (HIMSS). Through this project, EHR vendor members of HIMSS have made donations for use by clinics. One clinic totally implemented its system through this effort. A community health center has received donations to facilitate its program.

A stakeholder committee composed of persons from various healthcare associations and organizations has continued to be involved with the IQH project, offering input to staff members as they work with clinics. They offer suggestions on development and evaluation of project materials and promote the project. Stakeholders meet with IQH staff and receive updates on the progress of the project.

(Note: Along with the DOQ-IT project efforts, Dr. James McIlwain, IQH president, and Dr. Sue Dillon, clinical coordinator, are gubernatorial appointees to the Southern Governors Association Gulf Coast Health Information Technology Task Force. McIlwain is co-chair for Gov. Haley Barbour’s Mississippi Health Information Infrastructure Task Force established by executive order in March 2007.)

“IQH is proud to have a significant role in collaborative efforts to establish a secure, efficient statewide system for the electronic transfer of health information in the state,” said Dillon. “These efforts will contribute to a reduction in medical errors and improvement in the quality of healthcare delivery in Mississippi.



Dr. James S. McIlwain, president of Ridgeland-based Information & Quality Healthcare, chairs the Mississippi Health Information Infrastructure Task Force.



August 2007

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