Innovation Ecosystem

Some stakeholders remained in dark about final IT strategic plan

Communications to stakeholders about finalized strategy seem to have broken down

Image courtesy of Medium

The illustration for a recent article in Medium, "The Office Visit as Dinosaur," about the impact of the coronavirus on health care delivery.

By Richard Asinof
Posted 10/12/20
Even though stakeholders were interviewed about the health IT infrastructure in Rhode Island, it appears that very few received a copy of the final report and implementation plan.
What is the status of the stakeholder committee convened by the R.I. Office of the Health Insurance Commissioner regarding the evaluation of future plans for telehealth policies that reflect changes in response to the coronavirus pandemic? What are the totals in rebates offered by commercial insurers operating in Rhode Island because of an apparent drop in utilization of providers by insured customers? How will the Lifespan/Brown Digital Health program become more inclusive of involving community health centers, Care New England and its Integra accountable care organization, and existing health equity zones backbone agencies such as ONE Neighborhood Builders?
In a recent article in Medium, with a provocative headline, “COVID has made the office visit a dinosaur, the authors raised important questions about the way that the coronavirus pandemic has redefined the concept of the office visit in the delivery of health care. Although an additional report by the private contractor Briljent attempted to add perspective to its work in developing a RI Health IT Roadmap Strategy, written before the pandemic hit, the fact remains that the plan does not address in any concerted manner fundamental changes that are occurring to the health care delivery system as a result of the coronavirus.
Whether you call it an error of omission or an error of commission, the missing “gap” in analysis underscored a bigger problem with the strategic plan: it seeks to preserve the status quo of health care delivery as a wealth-extracting market system.

PART Four

PROVIDENCE – One of the most surprising revelations in writing this four-part series on the plans underway to implement a RI Health IT Strategic Roadmap and Implementation Plan is how few stakeholders, even those that had been interviewed as part of the process, were aware about what was happening.

One communications professional, responding to my request for answers to questions, said: “I hate to ask the question, but what is the RI Health IT Strategic Roadmap?”

[ConvergenceRI had only learned about the HIT Road Map because the project manager, Amy Zimmerman, had given a virtual presentation as part of the new Brown/Lifespan Digital Health program, on Wednesday, Oct. 7. Dr. Megan Ranney, the director of the new digital health project, gave a brief introduction before rushing off for another engagement. One of the points stressed by Zimmerman in her talk was the desire to create public-private partnerships in relationship to both the HIT Road Map as well as the Digital Health Program.]

Surprisingly, many who had been listed as “stakeholders” and had been interviewed by Briljent, the private contractor from Fort Wayne, Indiana, had not seen the final documents and were unaware of the implementation plan and its final content. No one had shared the material with them – until ConvergenceRI had provided the link to the five official documents.

For instance, a spokesperson for a local major nonprofit agency immersed in health information systems told ConvergenceRI: “Our folks were only involved in the interview portion of the Rhode Island Statewide Health Information Technology Strategic Roadmap and Implementation Plan.”

The spokesperson continued: “We also would be happy to help with the public/private committees, if asked,” but they had not been invited to serve. The stakeholder interview process, the spokesperson explained, “That’s pretty much all we’ve been involved in at this point.” What we have here, it seems, is a failure to communicate.

Further, the spokesperson differentiated between the work being done by the new Brown/Lifespan Digital Health initiative and her agency. “The Brown/Lifespan [digital health] center also seems to be more research focused, which is great, but we’re more focused on servicing providers.”

Another key player in the analysis of data from the All Payers Claim Database related to health costs told ConvergenceRI that they had not been invited to participate in the stakeholder interviews and was in the dark when it came to the development of the Health IT Strategic Road Map and Implementation Plan. The player posed the question to be asked about the work: “How will these activities benefit the broader community?”

The player continued: “State government work on this front too often seems insular, and we invest in systems that get very little use.”

Zach Nieder, the Rhode Island Foundation’s Strategic Initiative Officer for the Foundation’s Healthy Lives strategic initiative., offered the followed comments about the project:

“The HIT Roadmap Strategy aligns with our Healthy Lives strategy, and the Foundation has been and continues to be in support of the development and implementation of this work,” Nieder said. “The strategy is an important piece in improving the coordination of care for Rhode Islanders.”

Nieder continued: “One of our goals in convening and continuing to support the Long-Term Health Planning Committee and their collective work, ensuring both public and private-sector stakeholders are involved, is that it can provide an additional platform for discussion on how to carry forward implementation for initiatives [such as] the HIT Roadmap Strategy. We think it is likely that it will be part of conversation moving forward.”

ConvergenceRI reached out to numerous other stakeholders to ask their responses the RI Health IT Strategic Roadmap and Implementation Plan. If and when there are responses, Convergence will plan on writing a follow-up story. Stay tuned.

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