Rhode Island
ORIGIN AND MISSION
In 2001, former Rhode Island Attorney General and now United States Sen. Sheldon Whitehouse brought together the highest ranking leaders of health care stakeholders, including hospitals, health insurers, state government, physicians, employers, nurses, academia, Rhode Island’s Quality Improvement Organization (QIO), and professional organizations. He challenged the group to work collaboratively to dramatically improve the quality, safety, and value of health care in Rhode Island. The Rhode Island Quality Institute (RIQI) was formally launched in May 2002 as an independent 501(c)(3) organization. The RIQI aims to:
• Demonstrate how the health care system can be improved through collaborative innovation;
• Foster connectivity between the health care team and the patient;
• Increase accuracy, responsiveness, and effectiveness in health care by using technology to standardize, streamline, and accelerate the retrieval and delivery of patient data statewide;
• Help the health care team consistently deliver care that is based on best-known practices; and
• Create a system that inspires and rewards improved professional performance.
GOVERNANCE
RIQI is governed by a 24-member board of directors made up of influential leaders in health care who represent health systems, health insurance providers, a Medicaid health plan, the business community, providers, consumer advocates, Quality Partners of Rhode Island (the state’s QIO), and both current and former state officials (two of whom are non-voting, ex-officio members). Sixteen committees help guide the work of RIQI. The board-level committees include Executive, RIQI Operations, Regional Health Information Organization (RHIO), Oversight, Nominating and Governance, Audit and Compliance, and Public Affairs. Project committees include Statewide e-Prescribing, Health IT Adoption, Clinical IT Leadership, Policy and Legal, Technical Solutions, Consumer Advisory, Rhode Island ICU Collaborative Leadership, and Steering Committees for Rhode Island Health Information Exchange and Rhode Island Network of Care.
RIQI has raised approximately $7.7 million in funding, exclusive of any Agency for Healthcare Research and Quality (AHRQ) funds. Major financial contributors include CVS/Caremark, health insurance providers, health systems, and foundations.
ACTIVITIES AND ACCOMPLISHMENTS
RIQI’s main activities include statewide health information exchange, electronic medical record adoption, electronic prescribing, intensive care unit improvement, and management of the Rhode Island Network of Care for Behavioral Health. In 2004, RIQI approached the Rhode Island Department of Health (DOH) to pursue an AHRQ contract for statewide HIE. The state and RIQI entered into a public-private partnership, and the State was awarded the grant. The DOH subcontracted with the RIQI to provide community governance, and, in 2007, it formally designated the RIQI as Rhode Island’s Regional Health Information Organization. As the RHIO, RIQI will provide the necessary operation leadership and administer and operate currentcare, Rhode Island’s HIE (www.currentcareri.org).
The Rhode Island ICU Collaborative is a partnership of the RIQI, Quality Partners of Rhode Island, Hospital Association of Rhode Island, the state’s acute care hospitals, Blue Cross and Blue Shield of Rhode Island, and UnitedHealthcare of New England. The collaborative, which includes every adult ICU in every hospital in the state, involves peer-to-peer ICU teams sharing strategies and best practices, guidance and training from experts (e.g. Johns Hopkins University), project management and support, and rigorous data collection/outcomes reporting.
In conjunction with a group of community partners, RIQI also manages the Rhode Island Network of Care for Behavioral Health, a web-based resource for those struggling with mental health and addiction issues either personally or within their families. This virtual community and resource directory, available in 14 different languages, offers confidential web access; comprehensive behavioral health information; support and advocacy for children, adults, and families; and a customized Rhode Island program and service directory. This initiative is part of the Trilogy Network of Care, which was selected as a finalist in the “Stockholm Challenge,” an international competition that honors information and communication technologies that show convincing benefits to people and communities.
For individuals living with complex, often chronic conditions, and their families, palliative care can provide relief from symptoms, improve satisfaction and outcomes, and help address critical mental and spiritual needs during difficult times. Now more than ever, there is growing recognition of the importance of palliative care services for individuals with serious illness, such as advance care planning, pain and symptom management, care coordination, and team-based, multi-disciplinary support. These services can help patients and families cope with the symptoms and stressors of disease, better anticipate and avoid crises, and reduce unnecessary and/or unwanted care. While this model is grounded in evidence that demonstrates improved quality of life, better outcomes, and reduced cost for patients, only a fraction of individuals who could benefit from palliative care receive it. 
