The Community QA Committee enables medical and social service providers from independent entities to discuss cases to identify systemic gaps in the delivery of care. QA committees are well established in law and practice within a single entity as in a hospital. Everyone involved in treating a patient can openly discuss what went wrong and what can be improved. Community First created the legal framework which allows and protects such case discussions among representatives from independent entities. Such discussion among medical and social service providers is essential to address both the social and medical issues of complex cases.
The legal framework had two components:
- An Organized Health Care Arrangement, a legal construct between covered entities, such as health plans and providers, enabling the sharing of protected health information for quality improvement.
- Harmonizing the definition of a QA committee in two different parts of the law so that representatives from independent entities could constitute a QA committee and have their discussions protected. This was accomplished with Senate Bill 2487 which passed unanimously.
An OCHA was formed with the following organizations:
Bay Clinic, Hawaii County Fire Department, Hilo Medical Center, Hope Services, HMSA, Ohana, AlohaCare, Ka’u Rural Health Community Assoc., Big Island Substance Council, Hawaii Care Choices, Hawaii County Office of Aging, Hui Malama Ola Na Oiwi, Navvis, and Community First.
We believe the East Hawaii Community QA Committee will provide the feedback loop needed for the community to develop the system of medical and social services needed to provide effective care to high cost, high need patients.