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To Improve Care, Cut Costs, Health Care Providers Coming Together

Posted on: Friday, 24 February 2006, 21:00 CST

By KAREN BUCKELEW

The days of rooms stuffed with patient files are becoming a thing of the past for health care providers.Electronic health records represent the new wave in health technology, storing patient information on computer systems that link to every room in a hospital, or on handheld devices physicians can tuck in their pockets as they work.All these systems are isolated from one another - each hospital in the state of Maryland is its own island of patient data, each doctor's office a trove of records for no one else's eyes.But a nonprofit coalition of Maryland hospitals, physician groups, insurers and laboratories is aiming to build bridges between those islands.Everybody has legacy systems that don't talk to each other, said Dr. Victor Plavner, chair of the Maryland/D.C. Collaborative for Healthcare Information Technology. If everybody was on one information technology system, it would be easy. But everyone has invested millions of dollars in their information technology systems already. No one wants to give this up and buy a new system.Our trick, he explained, is to try to make the systems talk to each other.The group's work is so far along that it could be on the brink of launching a new network if only it could find the funding, he said.The effort is just one of the avenues being explored to connect health care providers, including a newly formed state Task Force on Electronic Health Records mandated by the state legislature last year.President George W. Bush in his State of the Union address spoke in support of electronic patient records, and the federal Department of Health and Human Services has an entire division, called the Office of the National Coordinator for Health Information Technology, devoted to the concept.Founded five years ago, Plavner's group counts Johns Hopkins Medicine, University of Maryland Medical System and CareFirst BlueCross BlueShield among its members.Members have worked for roughly the past two years to design an infrastructure that could connect health record systems in every physician's office, laboratory and hospital in the state, Plavner said.The membership list is one of the organization's most valuable assets, according to T

. Michael Preston, executive director of MedChi, Maryland's doctors' organization.What's exciting about it is the degree of cooperation so far, Preston said. It has been impressive to see the University of Maryland and Hopkins and MedStar and other groups cooperating toward a very difficult goal.Cost savingsInterconnectivity could save money by reducing redundant medical testing. It could improve patient care by giving physicians immediate access to patients' comprehensive records. It also could help to prevent dangerous drug interactions.The biggest thing is the elimination of the little tiny silos in which health data currently now reside, Preston said.The Maryland Hospital Association supports the concept, and its president, Cal Pierson, said new connections could mean big changes.We're firm believers that information and technology in health care need to advance to benefit patients, to improve patient safety, to improve the cost effectiveness of the overall system, Pierson said.It improves patient quality of care by having the right information at the right time, Plavner explained. It improves safety by having all the information available. It decreases the cost of medicine because of redundant medical tests that don't necessarily need to be done.Redundant testing accounts for about 1 percent of total health care spending in the United States, Plavner said. That may seem a small percentage - but considering health care spending in Maryland in 2004 totaled about $28.8 billion, according to the Maryland Health Care Commission, that 1 percent begins to look a little more significant, he added.We're talking about [saving] a lot of money with a very small amount of startup costs, Plavner said.It would take $10 million to bring to fruition the work of the nonprofit, he added.The group is slightly closer to its financial goal after the announcement this month of a $100,000 grant from CareFirst BlueCross BlueShield, which it will use to hone its plan and attempt to design at least a pilot program, said Plavner.Nobody is writing us a check at this point in time, Plavner said of the multimillion-dollar target. If we had the funding, we could launch immediately.But there's just no money, he added. The state health department, the Maryland Health Care Commission and the Health Services Cost Review Commission all are exploring the issue and, with new groups like the task force just springing up, no decisions have been made on a venue for state money.Preston said he doesn't find that surprising.It's understandable there's going to be a certain amount of reluctance among state funding vehicles to embrace any particular approach in light of [the abundance of] efforts under way, he said. That said, this, we think, is a promising start. We'll see if the task force comes up with an approach that is similar to or embraces the collaborative's vision.And the federal government, though it has doled out funds for the formation of so-called RHIOs, or regional health information organizations, throughout the country, those grants have come in small amounts.The collaborative has survived on about $1.5 million donated by its member organizations, a $100,000 grant in 2004 from national nonprofit Foundation for eHealth Initiative and, now, the CareFirst grant.More is needed, said Plavner, so the group may have to change direction.We wanted it to be a public-private partnership, he said, but since state and federal funding does not look very promising, we're going to try a private route.

Source: The Daily Record (Baltimore)

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