e-Health Records Pilot Program Moves Ahead

By Susan Bush
12:00AM / Wednesday, August 30, 2006

Dr. Anthony Smeglin is a Northern Berkshire eHealth Collaborative physician advocate.

North Adams - Adams Internists medical practice doctors are the first to offer patients an opportunity to participate in an e-health medical records pilot program announced in March 2005. The system became active at that office on Aug. 14.

Additional participants are expected to implement their systems over the next several weeks.

Compiling patient information and creating electronic health records propels the health care industry headlong into the technology era, said Northern Berkshire Healthcare President and CEO Richard Palmisano during an afternoon media conference at the NBH office building.

The Northern Berkshire region is one of three pilot program regions selected by the Massachusetts e-Health Collaborative. Similar electronic records programs are underway in the Brockton and Newburyport areas. The MaeHC is described as a private initiative; about $50 million in funding for the pilot program was provided by Blue Cross/Blue Shield of Massachusetts. The three participating regions are sharing in the pilot program funding. Most of the costs associated with e-health record implementation are being covered by the BC/ BS-provided revenues.

Northern Berkshire Participation Complete By December

Palmisano noted that he could likely gain access to personal information such as his financial accounts from almost anywhere in the world thanks to the Internet and electronic communication technologies but his medical records are not available to other health care providers at a keystroke.

The pilot participants are "pioneers" Palmisano said.

Micky Tripathi, Massachusetts e-Health Collaborative CEO

The system is expected to be active at all participating Northern Berkshire medical practice and service provider offices by December, and all three pilot programs should be up and running by summer 2007. The NBH group is the last to get an e-health record system up and running but is expected to be the first to complete the implementation process.

Patients of the internists group are being provided a brochure about the e-health pilot program and are being asked to "opt-in" to the program, meaning give their consent for creation of an electronic medical record. Those who consent are agreeing to have specific information shared with other physicians, hospitals, and additional service providers. The same form will be given to patients of other participating physicians as those groups introduce the e-health records to their practices.

Those who decline to consent to creation of a shared e-health record are advised that failing to give consent may compromise their health care, according to information contained on the form.

Using electronic medical records will improve quality of care and cut medical costs, Palmisano said.

As part of the e-health record, a "private file" that is not to be shared will be created. Private files to be maintained electronically at a physician's office will be created for all patients of participating practices, according to information provided on the consent form and at the media conference.
That record will consist of physician office notes, consultation letters, scanned reports, non-consented items, and growth and immunization information, according to information presented during the conference.

Mitchell Adams, executive director of the Massachusetts Technology Collaborative and board chairman of the MaeHC

Information to be part of an "e-health summary" that can be shared via electronic transmission includes lists of prescribed medications,a "problems" list, a list of allergies, family history, lab test results, radiology [such as x-ray and MRI] results, and procedures.

Anthony Smeglin, a Williamstown Medical Associates pulmonologist and a physician advocate for the Northern Berkshire e-Health Collaborative, said the e-records will reduce the chance of medication errors and allow physicians to make better treatment decisions.

Security

Security measures include system monitoring and access precautions that include confidential patient record numbers and other steps. A system designed to issue automatic alerts about questionable access is in place, said Northern Berkshire eHealth Collaborative Community Advocate David Delano, also the NBH director of information technology.

However, an alert means that the access was questionable and does not mean that access was denied, Delano said.

Physicians who "break through" the security system would have access to information but may be quizzed about the reason for the action later on, he said.

Any physician accessing the system will need a valid identification code and will have agreed to other criteria before being in possession of the tools necessary to gain access, said Dr.Robert Jandl, a WMA physician who has been involved in the pilot program since 2005.

NBH Director of Information Technology and Northern Berkshire e-Health Collaborative Community Advocate David Delano

Precautions include encrypting, which means rendering information indecipherable to those who access the system without proper authorization, intrusion detection, and firewalls. Each time an e-health record is accessed, the access will be recorded. Patients will be allowed to view a record of who has accessed their e-health record upon request.

The system will currently be effective only at participating Northern Berkshire providers. For example, a patient referred to a hospital or doctor in another state or out of the region would not be able to rely on an e-health record for information.

Palmisano said that e-health record benefits are many.
Emergency room physicians will be able to investigate the medical record of a person who is unable to communicate at the time of ER arrival.

Unnecessary procedures may be avoided if a person has an accessible e-health record available, he said. An e-health record is also beneficial during evenings, weekends, and holidays, when a primary care physician is likely to be unavailable to the patient.

Micky Tripathi, the MaeHC CEO, said that the Northern Berkshires are unique because patients are being allowed to "opt in" to the program. Other participating communities have implemented an "opt-out" policy, meaning that a shared e-health record is created without specific patient consent forms and patients must ask to be dropped from the system.

Massachusetts Technology Collaborative Executive Director and MaeHC Board Chairman Mitchell Adams said the pilot program was part of a "10-year vision" to establish patient e-health records "to every patient setting in or out of Massachusetts."

"Everyone is there [in support of the venture], all the stakeholders are there," he said. "And we are determined to do it."

Improving health care and cutting costs are the goals associated with e-health records, he said.

With e-health records in place, physicians can spend more time on patient care, Tripathi said.

"Everyone benefits when more time is spent on patient care and less juggling paperwork around," he said.

Speaking after the formal conference concluded, Palmisano said that e-health record systems are likely to grow as regional programs.

Establishing a nation-wide system that could be used with regularity by most people and most medical care providers could take 20 years, he said.

The NBH has made additional information about the e-health pilot program available at a www.nbehealth.com Internet web site.

Susan Bush may be reached via e-mail at suebush@iberkshires.com or at 802-823-9367.