New project encourages use of electronic medical records

Op-Ed by Secretary Leavitt as appeared in the St. Louis Post-Dispatch (Missouri) on March 13, 2008

You trust doctors to figure out what's wrong with you, but they trust you to remember your immunizations, allergies, medications, parents' health histories and other bits of information that may or may not matter. Or they trust scribbled notations in a paper medical file that they might not have in hand when they need it. As a result, you might not receive the care you need.

The federal Department of Health and Human Services has been working with medical professionals to bring the practice of medicine into the information age. This year, we hope to expand adoption and use of electronic health records by as many as 1,200 small and medium-sized medical practices of primary care physicians that, together, treat an estimated 3.6 million Americans. Those who can demonstrate better care for patients by using certified electronic health records will be eligible for incentive payments, in addition to their Medicare reimbursements.

Between now and the end of May, the St. Louis area has the opportunity to apply for this innovative project, for which 12 communities across the country will be selected. Total payments under the demonstration may be up to $58,000 per physician or $290,000 per practice.

I recently met Dr. James King, a Tennessee physician who operates a family practice with a few colleagues in Selmer, Adamsville and Henderson, towns a couple of dozen miles apart. Maintaining multiple copies of health and billing records at all the locations is difficult and inefficient.

Dr. King and his colleagues realized they could offer their customers much more effective health care if they invested in and learned how to properly use electronic health records. Now, regardless of which location a patient visits, the medical staff has instant access to all relevant information.

And electronic health records also improve the quality of the care Dr. King's practice offers. Physicians don't have to read through pages and pages of handwritten notes to find the little details that can make a big difference in treatment. Electronic health records can alert them instantly to possible drug interactions and allergies. The electronic system allows prescriptions to be sent directly from a hand-held device at the medical office to the pharmacy. They also can be used to track the results of specific treatments, providing quick measurements of quality of care and indications of what works best.

One Sunday about a year ago, electronic health records helped Dr. King's practice survive a disaster when the Adamsville office burned to the ground. Not one patient record was lost. The next morning, with the Adamsville location still smoldering, all the scheduled patients were seen at the Selmer location, where their electronic records were readily available.

It's easy to envision the impact this change could have on a larger scale. According to some estimattes, for example, more than half of the medical records in New Orleans were destroyed when Hurricane Katrina hit the Gulf Coast in 2005.

To increase the rate at which medical practices adopt and use health information technology, we're developing common standards and a certification process that will allow physicians to incorporate electronic health records into their practices with confidence, knowing that the technology will perform as expected.

We also are working to help communities measure and publish information on the quality of care, so that consumers can make better decisions about providers and treatment options. We are chartering local and regional collaboratives - we call them Chartered Value Exchanges - to encourage the delivery of high-quality health care that is competitively priced. These new collaboratives will bring together health care providers, insurers, employers and consumers to produce and publish reports on the performance of physicians' practices based on Medicare information and similar results from the private sector.

All this is not just about getting computers into doctors' offices; it is about creating compatible systems connecting doctors' offices with hospitals, labs, pharmacies, researchers and consumers. When we have done that, we will have transformed our growing health care sector into a safer, more efficient, value-driven health care system that provides better care at lower cost for all Americans.

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