E-Health Records Get $50M Shot In The Arm

Blue Cross Blue Shield of Massachusetts hopes to accelerate statewide adoption

One Massachusetts community is going find out if electronic medical records really can deliver revolutionary improvements in the quality and cost of health care.

Backed by $50 million from Blue Cross Blue Shield of Massachusetts, a group of health-care insurers, doctors, hospitals, and others in the state plan early next year to wire one community with interoperable electronic medical records. They hope the pilot project will convince the state's health-care industry that digitizing and sharing patient records will mean better medical decisions, fewer errors, and lower costs.

Carl Ascenzo, CIO of Blue Cross Blue Shield of Massachusetts says providers bear most of E-records' costs, but payers reap the benefits.

Ascenzo says providers bear most of E-records' costs, but payers reap the benefits.
"A lot of studies say the use of IT has the potential to transform the health-care industry," says Carl Ascenzo, CIO of Blue Cross Blue Shield of Massachusetts. "But bottom line, unless as an industry we work collaboratively to make this happen, it will happen at an excruciatingly slow pace, like it has so far."

The collaboration includes more than 30 organizations, including health-related state agencies and large employers that pay for health insurance. The community hasn't been chosen yet, but Ascenzo says several already have volunteered.

Massachusetts' effort follows a pledge by President Bush earlier this year to get most Americans E-records within 10 years--a goal Democratic presidential candidate Sen. John Kerry, D-Mass., says could be reached slightly sooner. Health and Human Services Secretary Tommy Thompson and national health IT coordinator David Brailer will unveil a plan next week to reach the president's goal.

The Massachusetts collaborative's goal is to expand electronic medical records throughout the state within seven to 10 years, Ascenzo says. The pilot will last about 18 months.

Other communities have done pioneering work with interoperable health-care systems, but none has reached the level of adoption that the Massachusetts effort expects to get. The group's plan for getting doctor cooperation is simple: pay them. Doctors will get payments or grants that compensate for some of the costs and disruption of implementing the technology.

John Halamka, CIO at CareGroup Health System, which operates five Boston-area hospitals and is part of the cooperative, says that's vital to the project's success. "Doctors need to be [given incentives] in order to foster the adoption of electronic medical records because it's the insurance companies that get the biggest payback in this," Halamka says.

An obstacle to E-records adoption is that health-care providers bear 80% or more of the cost and cultural-change burden, but payers get 80% or more of the savings, Ascenzo says. Insurance companies save through less paperwork, fewer redundant tests, better adherence to preferred drug lists, and the like. Halamka estimates a statewide E-records project could cost $1 billion, but he still believes statewide adoption could happen in as few as five years.

The project will involve peer-to-peer communications, where patient data such as lab results can be shared among providers but without ownership of the source data changing. There won't be any centralized database of patient records, and the system will have to comply with the privacy and security regulations of the Health Insurance Portability and Accountability Act.

The group hasn't chosen any technologies or standards, but several working groups are hammering these issues out. The group decided not to include any technology vendors as members. Because the whole goal of the project is collecting data that will spur adoption, they wanted to avoid any whiff of conflict that might taint the findings.

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