While Congress debates the best approach to health care reform, Rhode Island already has made a number of innovative steps that can lead the nation toward a better system.
Faced with a 13% jobless rate, rising home foreclosures and one of the highest cost-of-living rankings, the state's local government, business leaders and employees have embraced key efforts to enhance our state's health care.
Award-winning wellness initiatives
Rhode Island Governor Donald L. Carcieri knows that improvements in employee health and lifestyle choices represent a win-win for everyone. Better health status and quality of life for employees and their families translates into health care savings through the prevention/management of costly chronic diseases.
Since most adults spend the majority of their weekday waking hours in the workplace, it is a logical venue for implementing wellness programming - and a smart investment for businesses.
"The benefits of employer investments in workplace wellness are well-documented, and the benefits to employees are often apparent," says Carcieri. "Our health care system must place a stronger emphasis on prevention, and employers have an important role to play in that process."
The governor's commitment to wellness has been embraced by Rhode Island employers and in 2007, the state was named the nation's first well state by the Wellness Council of America after documenting that 20% of its workforce was employed by businesses and organizations certified as "well workplaces."
Accepting the Well State award, Carcieri said, "Businesses across the state are recognizing that health and wellness programs in the workplace benefit everyone, including employers, employees and their families."
Carcieri continues to challenge residents to lead the nation with the Awards for Wellness Innovation, one of the five pillars of his health care agenda. Developed in 2007, the awards recognize organizations, businesses and schools for creative or innovative wellness policies and programs that address areas such as tobacco control, seatbelt use, healthy weight, physical activity and nutrition/healthy eating. Past winners include:
* Mount Hope High School's Healthy Huskies Wellness Center and physical education curriculum, which engaged students and staff in promoting awareness of the importance of regular physical activity while offering activities that were sensitive to the needs of students with disabilities
* Kent Hospital's Kids Choose To Be Healthy, a multidisciplinary program blending nutrition and fitness education to help overweight and obese children learn healthy eating and exercise habits together with their families.
* Johnson and Wales Veggin' Out program, a collaborative outreach and education project designed to address the nutritional needs of seniors and low-income families by instructing children and adults in the preparation of inexpensive, culturally appropriate, nutritious recipes that incorporate fresh, locally grown produce.
An HIE for better health
In 2009, the state implemented currentcare, a health information exchange that encourages the sharing of electronic health records among Rhode Island providers to improve the care and treatment of patients. A service of the Rhode Island Quality Institute, this secure network allows authorized health care practitioners to view more of their patients' most up-to-date health information in one place.
"Providers need their patients' health information to treat them quickly and effectively," said Laura Adams, President and CEO of Rhode Island Quality Institute. "The benefits of currentcare are extraordinary for patients, providers and the entire community, as this service will ultimately improve the quality, safety and value of health care for all Rhode Islanders."
Further, currentcare will help to improve the cost-effectiveness of patient care by reducing medical errors, duplicate tests and adverse drug reactions. In fact, an independent study indicates that, once fully operational, Rhode Island's HIE will generate a return on investment conservatively estimated to be $108 million annually.
To date, over 23,000 patients and 100 physician offices and hospitals have signed up to participate in this free service. Once fully functional, the state hopes currentcare will be the "interstate highway system for the medical economy," supporting advances such as chronic disease management, sophisticated fraud and abuse detection, medical home models, new payment structures and - with consumer consent - cutting edge research programs.
RI citizens shape up
Last year, the Rhode Island Foundation's "Fund for a Healthy Rhode Island" awarded a grant to support physician referrals to Shape Up Rhode Island, a statewide exercise and weight-loss challenge founded by Brown Medical School student Rajiv Kumar on the belief that the solution to healthy living lies in the power of teamwork and peer support.
This annual health campaign encourages Rhode Islanders to pursue healthy lifestyles through increased physical activity and better nutrition. To date, nearly 35,000 residents have taken part.
Unlike gym memberships that lapse or exercise programs that never quite get off the ground, Shape Up RI has built-in ways to help participants stay committed.
"Our program is unique because we don't prescribe a diet or dictate an exercise regimen," says Kumar. "Instead, we use Web technology to connect people with their friends, family and colleagues to build an environment where they can support and motivate each other, as well as provide accountability. By bringing people together, Shape Up RI makes wellness fun, so participants have a better chance at succeeding in behavior change."
Since its launch in Rhode Island, Kumar has expanded this proven approach to all 50 states. Called Shape Up the Nation, this countrywide program focuses on helping employers and health plans improve the health of their populations and reduce costs. "Our core model is the same: using social networking as a model for lasting behavior change," explains Kumar. (Be sure to read the April 1 EBN for a profile of one company implementing the Shape Up the Nation program.)
Rhode Island's efforts to control health care costs and empower individuals to take an active role in their care are the hallmarks of progress. To reform our nation's system, we need to keep our eye on the big picture while not losing sight of the smallest details - or states - that can be central to our success.
Amy Gallagher is a senior consultant at Cornerstone Group, a full-service benefits advisory firm located in West Warwick, R.I.
