Solving the health care computer puzzle

While insurance exchanges are poised to dominate health care discussions in the near future, another set of health information exchanges are arguably more important for providers across the state, particularly as independent physicians and health systems alike ponder implementation of electronic health records.

This and other topics were the center of discussion of Ukiah-based Redwood MedNet’s sixth annual conference, Connecting California to Improve Patient Care, which included discussions on electronic health records, personal health records and health information exchanges.

Redwood MedNet presents the conference each year -- this year in Rohnert Park -- to help a wide range of providers sort out the hype from the helpful when it comes to electronic health records, an issue that is confronting virtually the entire health care field as federal incentives push providers towards some level of adoption.

Much of the push toward full electronic implementation stems from the notion that electronic health records can vastly improve patient outcomes by connecting once-disparate hospitals, health systems and community clinics with one another by way of electronic and personal health records.

But, according to Will Ross, Redwood MedNet’s project manager, many providers and some of the incentives are moving too quickly, often without fully understanding their systems, or installing less comprehensive systems that do more to hinder, rather than help, patient outcomes.

“The rumors that say everything will be electronic are a bit overblown,” said Mr. Ross, who started Redwood MedNet in 2005. “I think some of the physicians who haven’t purchased electronic health records are savvy, not Luddites.”

As part of the American Recovery and Reinvestment Act of 2009, the federal government included what’s known as “Meaningful Use” incentives, a program overseen by the Centers for Medicaid and Medicare Services that encourages health care providers to adopt electronic health records by way of enhanced payments. On the flip side, providers that don’t meet such standards face a lowered reimbursement rate, which in turn is causing health care organizations to move quickly.

“It’s had a pretty huge impact because of the scale of dollars,” Mr. Ross said of the “Meaningful Use” standards.

Mr. Ross and Redwood MedNet hope to help guide providers to make the right decision, not simply the fastest and potentially counterproductive, when it comes to implementation and interoperability.

Smaller practices or clinics in particular face a daunting task in determining when -- and what type of system -- to install, Mr. Ross said, noting that large systems have the institutional resources to train IT staff and providers on a particular system. But large hospitals and systems often also are ill-equipped to either properly implement or maintain electronic systems that are in place, he added.

“The best way to predict whether a facility has electronic medical records is to count how many full-time IT people they have, whether it’s Marin General or a Sutter Health facility,” he said. “If they have IT staff, they’re likely to have a decent system. If it’s a small practice, there’s no one to do IT. So the rate of adoption is trivial for small practices.”

Yet, while the task of implementation may seem daunting, particularly for the smaller providers, Mr. Ross pointed to a couple of local successful examples, notably Healdsburg District Hospital and the Alliance Medical Center, a small federally qualified health center adjacent to the hospital. The two providers can seamlessly interact with one another, which in turn means better outcomes, Mr. Ross said.

Ultimately, Mr. Ross said, the health care sector as a whole needs to embrace the right technology -- not simply the quickest -- to improve outcomes.

“Walmarts are more computerized than a hospital,” he said. “Imagine going to a bank and having the teller handwrite your balance. A lot of providers are still operating at that level.”

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