California's leadership in healthcare information technology should be replicated nationwide, but quality care can't be compromised to achieve rapid adoption, Kerry Weems, acting administrator of the CMS said at an event in Silicon Valley.
"We're here to learn from your experience and not repeat your mistakes," Weems said at 293-bed El Camino Hospital in Mountain View, Calif.
Some 37% of physicians in California use electronic health records, compared with 28% nationally, according to a report to be released next week by the California HealthCare Foundation, a not-for-profit statewide healthcare policy organization.
But most of the physicians using EHRs in California work in large practices or integrated health systems such as Kaiser Permanente. Of physicians in small practices, 25% use EHRs, while 13% in solo clinics and 3% practicing in community clinics have adopted EHRs, said Mark Smith, president and chief executive officer of the California HealthCare Foundation.
"We may be leaders but it is hardly time to celebrate," Smith said.
Weems met with Smith and other members of what Weems called the "California brain trust of healthcare IT," including Molly Coye, founder and CEO of the Health Technology Center; David Brailer, founder of Health Evolution Partners; David Hopkins, director of quality measurement and improvement for the Pacific Business Group on Health; Don Holmquest, president and CEO of CalRHIO; and Jo Ellen Ross, president and CEO of Lumetra, a not-for-profit quality improvement group. All are based in San Francisco.
Even in California, there is a danger of disparities in healthcare IT, Coye said. "The have and have-nots are not just the physicians, but the patients they care for," she said. "We need to start generating funds to help support small practices and clinics. None of the financing schemes proposed so far can support the small and solo practices."
Weems said he looks forward to preliminary results in six to nine months from the Medicare Care Management Performance Demonstration program, which began in July. In the three-year pilot involving 700 solo, small and midsize practices in Arkansas, California, Massachusetts and Utah caring for chronically ill Medicare recipients, physicians get added incentive payments for implementing Certification Commission for Health Information Technology-certified electronic health records and showing functionality by reporting clinical performance data electronically.
Getting EHRs up and running isn't the final goal though, experts said. "The home run is empowering patients to be more active in their care," said Paul Tang, chief medical information officer of the Palo Alto (Calif.) Medical Foundation.
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