Success of a national health information-technology infrastructure depends on the widespread use and acceptance of electronic medical records in doctors' offices, according to a new federal legislative proposal released by the American College of Physicians that seeks to speed IT deployment in small group practices. The nation's largest subspecialty society says the biggest barriers to IT adoption in these groups are high acquisition costs of the systems, which are upward of $30,000 per doctor; physician and staff time required to transition from paper-based record-keeping systems; and a lack of industry standards for systems interoperability. The ACP estimates one-half of all practicing physicians in the U.S. work in offices of six physicians or fewer. "Tax credits, grant programs, loan programs and reimbursement incentives would make it possible for physicians in small practices to invest in the technology," says ACP President Charles Francis, M.D. The ACP calls on the HHS secretary, through the office of National Health IT Coordinator David Brailer, M.D., to adopt the standards referenced in its proposal.
Mass. partnership connects docs to data
Fallon Clinic, Fallon Community Health Plan and UMass Memorial Health Care, all based in Worcester, Mass., have agreed to partner in creating an electronic medical data connectivity network. The network would allow physicians to access patient medical information kept by any of the three entities. "Our target is within the next six months or so to have a prototype ready for testing within the three organizations," says Rhian Gregory, spokeswoman for the 240-physician Fallon Clinic. "At the outset, it's focused on the region, but it certainly has implications that can go beyond the region to the rest of the state and beyond the state," she adds. One of the models under consideration would allow other providers and plans to have access to the system on a subscription basis, she says. "By working together, our three organizations can make sure that our patients receive well-informed care, even if they are outside of the walls of our individual organizations," said Larry Garber, M.D., medical director of informatics at Fallon Clinic, in a news release. Fallon Clinic is in the midst of an information technology development plan that includes an electronic medical-records system to be available by 2006.
Group suggests IT goals
A public-private coalition for the advancement of healthcare information technology has issued a preliminary "road map" for reaching common IT standards and techniques, so that information in one computer network would be available to other networks in all healthcare settings. The 70-page report by Connecting for Health also addresses the financial challenge for providers, especially small- to medium-size ambulatory-care practices, where IT penetration is the lowest. The coalition says subsidies of $3 to $6 per patient visit or 50 cents to $1 per patient per month would be a sufficient starting point to encourage and sustain widespread adoption of basic electronic-record systems in primary-care practices. The total cost would be $7 billion per year for three years, or 1.2% of the total spent on ambulatory care in 2003. Connecting for Health plans to issue a final road map and detailed plans for action in September.
Leapfrog puts pay-for-performance on Web
There is a new national listing of pay-for-performance programs available online, developed by the Leapfrog Group with support from the Commonwealth Fund and the Robert Wood Johnson Foundation. The Leapfrog Incentive and Reward Compendium database at ir.leapfroggroup.org/compendiumsearch.cfm to date lists 77 programs nationwide, including 17 that incorporate Leapfrog standards of computerized physician-order entry, evidence-based hospital referrals and hospital intensivist programs. The list includes programs with financial and nonfinancial incentives. It is searchable by state for programs targeting hospitals, physicians, consumers and health plans, but it also can create a nationwide list. Each listing has a short description of the scope and methodology of the incentive scheme. "We hope this tool will act as a catalyst by creating greater public awareness and provide an educational avenue to disseminate lessons learned, best practices and program comparisons," Suzanne Delbanco, chief executive officer of the Leapfrog Group, said in a news release.
WebMD acquires ViPS for $160 million
WebMD has agreed to acquire ViPS, a Baltimore-based provider of information technology and clinical decision-support services to health plans and state and federal governments, in a cash deal valued at $160 million including assumption of some liabilities. Customers include the CMS and 65% of the nation's Blue Cross and Blue Shield plans. The company develops databases and computerized tools for managing disease conditions, measuring the performance of providers and detecting healthcare fraud. WebMD says the acquisition will enable the Elmwood Park, N.J.-based company to add health management services to the administrative and financial processing services it already offers to facilitate the claims adjudication and payment process. The deal is expected to close within the month, subject to regulatory approvals.
Breaking barriers to order-entry systems
Physician resistance, stemming largely from fears that their work pace will slow, is among the top barriers to implementing computerized physician order-entry systems, and one solution may be to provide doctors with "help at the elbow" during implementation, according to a report in the July/August Health Affairs. That may mean using house staff and medical residents as facilitators, particularly with community physicians who frequent the hospital less, said the report by Harvard Medical School researchers. Other top barriers are order-entry systems' high cost and incomplete development, the report said. The researchers advised hospital leaders to sell order-entry systems to their boards as an improvement in patient safety that also could strengthen market position, rather than try to justify the purchase by return on investment.