May 21, 2007

Florida physicians have begun supporting a statewide electronic prescribing initiative that aims to use incentives from health plans and the state to help physicians pay for the new systems, Healthcare IT News reports.

The initiative, called ePrescribe Florida, has received broad support from health plans and professional associations, which could make it a potential model for other states, Walt Culbertson, the initiative’s executive director, said. Supporters include:

• AvMed;
• Blue Cross and BlueShield of Florida;
• Cigna Healthcare;
• The Florida chapter of the American College of Cardiology;
• Florida Medical Association;
• Humana; and
• UnitedHealthcare.

“To get them to adopt it, it will take incentives, a groundswell of patients asking for it and payers insisting that it’s part of their responsibilities as a network provider,” Culbertson said.

He said that getting physicians to evaluate the program will be the biggest challenge, adding that “before we get to funding, we have to stop and hear the message and look at the data about saving their staffs and patient time.”

Florida insurers last month also announced plans to develop a statewide multipayer electronic health record system, called the Availity Care Profile. The 23 leading e-prescribing vendors in the state are joining the insurers in the initiative (Bazzoli, Healthcare IT News, 5/21).

Article: http://www.ihealthbeat.org/

 Wednesday, February 14, 2007

By BOB GROVES, Staff Writer New Jersey Record

Sooner rather than later, doctors will have to switch completely from paperwork to computers if they want to treat patients and make a living in the 21st century.

“To do business with the federal government in the future, everything will have to be electronic,” Michael O. Leavitt, the U.S. Secretary of Health and Human Services, told members of the Medical Society of New Jersey.

Electronic medical records and digital drug prescriptions will eventually be a must for all physicians, Leavitt said during a stop-off in Lawrenceville late last year.

Leavitt was on tour promoting the notion of nationwide, computerized “interconnectivity” in the health care industry. The government funds 40 percent of all health care.

Ten percent to 24 percent of doctors in the United States use electronic medical records (EMRs) to varying degrees to track their patients’ health care, according to a recent study funded by the Robert Wood Johnson Foundation, and cited by the Washington-based Center for Studying Health System Change.

Many physicians in North Jersey and nationally want to change to EMRs, but they fear the cost of converting. Estimates for installing EMR software varies among vendors, from about $10,000 to $50,000 for solo physicians, and up to $100,000 for a group practice. Add to this monthly maintenance and annual update fees, installing high-speed Internet hardware, and paying additional staff to input old data from paper records.

Some older practitioners just plain don’t like or trust computers. Meanwhile, decades of patients’ file folders pile up on floor-to-ceiling shelves in their offices.

Dr. Joseph Friedlander, an internist in Teaneck, is a self-professed “gadget person” who has computerized all his practice’s financial transactions, and uses a Palm Pilot to transmit drug prescriptions to pharmacists. But Friedlander, 53, is reluctant to fully digitize his medical records.

“Why should I spend $50,000 and find out they want us to use something totally different?” he said of the federal government and insurers.

Electronic claims transactions between doctors and HMOs are already standardized with portable personal health records used by 70 million consumers, according to the industry group America’s Health Insurance Plans. The organization also supports physicians’ use of EMRs, which are more detailed clinical records.

The American Medical Association said EMRs hold “promise,” and the group expects the number of doctors using them to rise. The AMA has called on Congress and health insurers to minimize the cost of EMRs to doctors, and to ensure security, standardization and interoperability among EMR products.

The Medical Society of New Jersey is encouraging doctors to convert by offering an EMR system at a discount.

Physicians must keep records for patients seven years after their last visit, Friedlander said. “I have records going back 20 years,” he said. “I have a garage full of charts.

“I’ve just started getting rid of them,” he said. “You have to have a shredding company come in” to destroy the records because of federal privacy laws, he said.

An advantage is that a doctor can access an EMR from anywhere, “and it’s readable, which is a big thing,” Friedlander said.

Technophobia deters Dr. Scott W. Zucker, a pediatrician in Mahwah, from EMR use.

“Certain of us are computer-challenged,” said Zucker, 52. “I’m not sure we’d be able to get everybody on the same page to use it.

Also, for his group practice, with three offices, eight physicians and 50 employees, “the cost [for EMR] can be astronomical,” said Zucker, president of the Bergen County Medical Society. “All three offices have to interface.” On the other hand, “that would be a benefit in terms of following patients who go to different offices,” he said.

“I’m trying to get with the 21st century, [but] I really don’t trust it,” Zucker said of the new technology.

Dr. Laurie Nahum, an internist in Wayne, is shopping for an EMR system, but she wonders how it affects a physician’s bedside manner.

“Will you be typing more than listening to a patient while you’re entering their data into a computer?” said Nahum, president of the Passaic County Medical Society.

But EMRs can send data instantly and anywhere. “It’s the way of the future, as far as convenience for patients,” said Nahum, who has been practicing for 23 years.

Once you take the plunge, EMR is “phenomenal,” said Dr. Arnold I. Pallay, a family physician in Montville who converted five years ago.

“It’s pricey, it’s scary, it’s a big hump to get over to computerize your practice,” said Pallay, 48, one of the first North Jersey physicians to try EMR. “But once you’re there, you can’t go back.”

EMR allows Pallay to look at a patient’s chart, while a nurse reviews a lab report, and a receptionist gives referral information to an insurance company. If a patient has chest pains while vacationing in Bermuda, an emergency physician there can compare EMR notes with Pallay in Morris County.

“A key feature is there are no lost, misplaced or misunderstood charts,” he said.

Doctor-patient relations do not suffer from EMRs, Pallay said. “It’s the opposite,” he said. It “allows more time to talk to patients and deal with them, because recording their visit is so streamlined.”

Find the article here: www.northjersey.com

NEW YORK, Jan. 24 /PRNewswire/ — With the ability to make healthcare workflows more efficient, reduce costs, and improve the quality of patient care, the advent of Electronic Medical Records (EMR) is swiftly taking this technological wonder from a $1 billion market in 2005 to more than $4 billion by 2015, according to EMR Technologies in Healthcare, a new study from market research firm Kalorama Information.Nearly a 400% increase over an eight year period, the report reveals double-digit growth projections which begin to escalate significantly as electronic healthcare modalities enter the next decade. With hospitals, physician’s offices, and other healthcare entities increasing their IT budgets to include wireless technology applications — with many focusing on EMR adoption — the stage is set for a market surge.

Among segments within the healthcare industry, the physicians market for EMR is expected to witness the maximum growth as the vast customer base of this segment presents a huge potential market. While cost is currently a key deciding factor for most healthcare sectors — a typical EMR infrastructure requires workstations, servers, PDAs, tablet PCs, computer on wheels, and other networking hardware as well as software — the eventual reduction in costs is expected to expedite the adoption of EMR systems in the next several years.

“The potential not only in the U.S., but globally as well, is enormous, making EMR an exceptional opportunity not only for the current market players but for new entrants into the market,” notes Steven Heffner, the publisher at Kalorama Information. “This is one area of healthcare where regulations such as HIPPA and various other government initiatives will actually help drive adoption of this advanced technology.”

Including extensive hospital IT budget data and over 100 figures and tables, EMR Technologies in Healthcare provides the most comprehensive EMR market analysis available. It profiles key market players and technology innovators, looks at current products and new products on the horizon, and provides extensive insights into the business and regulatory issues catapulting this market from pipedream to reality. It can be purchased directly from Kalorama Information by visiting www.kaloramainformation.com or it is also available at MarketResearch.com.

Four vendors showed off their prototypes to the Department of Health and Human Services

By Grant Gross, IDG News Service
January 23, 2007

Four vendors on Tuesday demonstrated electronic health records, one of the first steps toward making the records widely available in the U.S.

The groups developing electronic health record networks, led by IBM Corp., Computer Sciences Corp. (CSC), Accenture Ltd. and Northrop Grumman Corp., showed off their prototypes to the U.S. Department of Health and Human Services’ American Health Information Community (AHIC) advisory board.

The groups demonstrated a way for a fictional patent to update her e-health record after moving to another state, to import data from a hospital discharge summary and a pharmacy record, and to give a new doctor permission to view her records. The demonstrations worked without significant hiccups, with the networks downloading and updating information with a couple of mouse clicks.

Each of the four groups has developed its own e-health record prototype, with each having slightly different features. For example, the Accenture model stores the data regionally as a way to compare demographic trends, and the IBM prototype doesn’t store patient data in a centralized location, instead leaving it in the hands of patients and local health-care providers.

“Providers get very nervous when you say information is not going to continue to be contained in their offices,” said Ginny Wagner, nationwide health information network coordinator for IBM. “Patients get very nervous when they think about their health-care information being held in a data repository.”

The electronic health records allow doctors to get information on a new patient before seeing the patient in an office or hospital, Wagner said. The e-health records will also allow doctors to check home health monitoring devices, she said. IBM’s prototype is being tested in seven hospitals in North Carolina, Virginia and New York.

The IBM model uses open standards, allowing health-care providers to choose hardware and software providers to support the e-health records, she added. “We did not feel the health-care market could afford to eliminate equipment or systems that they had already put in place, so we have to connect to what was there,” she said.

The CSC group featured a health record system partly developed at Children’s Hospital Boston. The system, called Indivo, will be introduced at the hospital late this year and will allow patients to own and control their complete medical records, according to the hospital.

The Department of Health and Human Services awarded US$18.6 million in contracts in 2005 for the four groups to develop electronic health records. U.S. President George Bush has called on the U.S. government and private health-care providers to work together to provide e-health records to all U.S. residents by 2014.

Members of the AHIC advisory board praised the demonstrations. The e-health records will bring several benefits, including an improved quality of care, said board member Nancy Davenport-Ennis, chief executive officer of the National Patient Advocate Foundation. “There is … a great opportunity to reduce medical errors,” she said after the demonstrations.

Find article here at www.infoworld.com

By Neil VerselJanuary 22, 2007 | By the end of the month, all U.S. physicians should be able to write electronic prescriptions for free, promises a coalition of technology vendors, payers, and large physician groups.

The group, headed by electronic health records (EHR) provider Allscripts (Chicago), will spend at least $100 million over the next five years to make the technology available nationwide. Advocates cite Institute of Medicine statistics that blame preventable medication errors for 7,000 deaths and 1.5 million injuries each year. “Our first objective is to equip every physician in the United States with e-prescribing software that is free,” Allscripts chief executive Glen Tullman said Tuesday at a Washington, D.C., press conference. The profit motive can come later, he said.

The login page is keeping a running tally of errors avoided and estimated dollars saved.

Joining Allscripts in what is being called the National E-Prescribing Patient Safety Initiative (NEPSI) are computer manufacturers Dell and Fujitsu, as well as Microsoft, Cisco Systems, and, for real-time mobile access to the service, cellular provider Sprint Nextel. Wolters Kluwer Health will provide drug-interaction checking, while SureScripts is taking responsibility for connecting prescribers to pharmacies, either by fax or by direct electronic link. Google is embedding a custom search engine for healthcare embedded in the product, organizers said, but few details were immediately available.

Several payers and large, regional healthcare providers have joined as well. “This is the most significant coalition of stakeholders ever to address medication errors,” said Nancy W. Dickey, M.D., vice chancellor for health affairs at the Texas A&M University System and a former president of the American Medical Association.

By Jan. 31, all licensed prescribers nationwide should be able to access the Web-based Allscripts software called eRx NOW, the organizers say. Dickey estimates that most users should be able to complete the online training in 15 to 30 minutes, then start writing electronic scripts on either a PC or personal digital assistant.

“2007 is the year to stop simply talking about e-prescribing and start taking action,” said former House Speaker Newt Gingrich, who may seek the 2008 Republican nomination for president with a promise to modernize healthcare.

Though the software does include real-time interaction checking and, depending on the patient’s health plan, formulary information, most users will have to find a third party to -integrate the Allscripts software with existing practice management and billing systems. “That’s probably the thorniest problem here,” Tullman says, though he says that eRx NOW is “fully interoperable,” based on current certification standards for ambulatory EHRs.

Find full article here at www.health-itworld.com