NAME OF NETWORK
Lakeland Rural Health Network

Name of Grantee
South Carolina Office of Rural Health

Co-Principal Investigator
Graham Adams, PhD

Address: 107 Saluda Pointe Drive 
City, State, Zip: Lexington, SC 29072 
Phone:  (803) 454-3850
Fax: (803) 454-3860  
Organizational Website: www.scorh.net
E-mail: adams@scorh.net

Co-Principal Investigator
Mark Van Swol, MD

Address: 155 Academy Avenue         
City, State, Zip: Greenwood, SC 29646 
Phone: 864-725-4865
Fax: 864-725-4883
Organizational Website: www.greenwoodfp.org
E-mail: vanswol@selfregional.org

Project Purpose

The Lakelands Rural Health Network (LRHN) is a nonprofit, multi-county vertical network that was developed in 2004 with the guidance and financial assistance of the South Carolina Office of Rural Health, the state Flex grantee, to achieve efficiencies, expand access, coordinate and improve the quality of essential health care services, and strengthen the rural health care system as a whole.

The Lakelands partner organizations include a regional referral hospital, two Critical Access Hospitals, a Federally Qualified Health Center organization with nine medical practices, several Rural Health Clinics, a private foundation, a family practice and residency program, the local public health agency, and the South Carolina Office of Rural Health. The LRHN consists of five segments: 1) a Clinical Leadership Council which is a physician-led, multi-county forum to address clinical issues impacting the service area; 2) a Public Information Collaborative which promotes the LRHN and its initiatives; 3) a Financial Subgroup which plans for long-term network financial viability; 4) an HIT Collaborative which implements the LRHN technology projects; and 5) an HIE Governance and Policy Committee.  LRHN’s geographic area includes Abbeville, Edgefield, Greenwood, Laurens, McCormick, and Saluda Counties. 
The primary purpose of the project is to use HIE to assist health care providers and patients in improving their health status. Other secondary purposes for use of the HIE will include aggregated, de-identified information for the purpose of regional quality improvement initiatives, research grants, and population health outcome measures.

Outcome Measures/Expectations

Quality Improvement Goals:

1. Diabetics will decrease their mortality from stroke and myocardial infarction by improving control of blood pressure, cholesterol and blood sugar. 
2. Individuals with cardiovascular disease will improve life expectancy by improving tobacco smoking cessation, anti platelet use, and blood pressure control.

Quality Improvement Objectives:

1. Decrease HgA1c average by 10% in the MCFM and CHC diabetic population within the first year with the ultimate goal of having an average HgA1c of less than 7 by 18 mos.
2. Decrease average LDL by 12% in the MCFM and CHC diabetic population within the first year with the ultimate goal to have greater than 70% of patients with an LDL less than 100 by 18 mos.
3. Increase the number of patients by 15% in the MCFM and CHC diabetic population within the first year to have systolic blood pressure less than 130 and diastolic blood pressure less than 80 with the ultimate goal to have greater than 40% of diabetic patients with a blood pressure less than 130/80 by 18 mos.
4. Increase by 50% the reporting of an eye examination in the past year in the MCFM and CHC diabetic population within the first year with the ultimate goal to have greater than 80% of patients with a documented eye exam. 
5. Decrease the number of patients by 10% who are currently smoking in the MCFM and CHC diabetic population within the first year and with the ultimate goal of <12% be current smokers by 18 mos.
6. Increase the number of patients by 15% in the MCFM and CHC diabetic population within the first year to have a documented Nephropathy assessment with the ultimate goal to have greater than 80% of patients with a documented nephropathy assessment
7. Increase the number of patients by 50% in the MCFM and CHC diabetic population within the first year to have a documented foot exam with the ultimate goal to have greater than 80% of patients with a documented foot exam in the past year.

Technology Goals

1. A cost-effective HIE will be developed through contract negotiations with a vendor.
2. The implementation process will run smoothly due to careful planning and a complete purchase, setup, configuration and testing equipment and software between Self Regional Healthcare (SRH) and Montgomery Center for Family Medicine (MCFM).
3. The HIE will be able to be activated through the building of the LRHN HIE infrastructure.
4. The residents of the 6-county region will receive enhanced quality of health care by sustaining the LRHN HIE.

Technology Objectives

1. The LRHN will contract with cost-sensitive and knowledgeable vendors to support the HIE by Oct 1, 2007.
2. The LRHN will purchase, setup, configure and test equipment and software to perform web view of registration, lab results and dictated summaries for SRH and MCFM by May 2008.
3. The LRHN will purchase, setup, configure and test equipment and software between SRH/MCFM and Carolina Health Centers (CHC) for minimally defined scope (Web view/discrete data availability of registration, lab results and dictated summaries).

Service Area

The Lakelands Rural Health Network (LRHN) is a vertical network of health care providers located in a rural, economically depressed region of western South Carolina. LRHN was established in January 2004 and consists of a variety of partner organizations: a regional referral hospital, two Critical Access Hospitals (CAH), a Federally Qualified Health Center (FQHC) organization with nine medical practices, two Rural Health Clinics (RHC), a private health foundation, a family practice residency program, the local public health agency, and the South Carolina Office of Rural Health. LRHN’s service area is Abbeville, Edgefield, Greenwood, Laurens, McCormick, and Saluda counties.

Network Members

# Annual Common Patient encounters expected between CAH-HIT Network Providers	250,000 (Shared Service Area)
# Total Network Provider FTEs	77.5 FTE

Equipment/Vendors or Collaborative Partners

CareEvolution Inc. —Vik Kheterpal software for Health Information Exchange
Self Regional Healthcare—Patrick Stewart—housing LRHN hardware and building of adapters to client sites and security around LRHN database.