Patient Data Shifts to Digital Records

Phenomenal Networks has engineers to install the routers, phones, firewalls and other networking equipment it uses in its business, but the Eden Prairie company soon will have a new kind of worker hitting the streets. Nurses. Medical records must be digitally accessible at clinics and hospitals by 2014 in order to get full federal reimbursements.

The $19.2 billion Congress set aside in the new stimulus package to jumpstart the digitizing process might help, too. Phenomenal Networks' plans are a small example of how momentum is building to move patient information from manila folders to electronic systems. The move could save billions of dollars in time and wasted procedures once privacy concerns are adequately addressed, experts say.

State health experts say it is too early to say how much of the $19.2 billion might end up in Minnesota. But the state's health information technology leaders point to efforts begun years ago that might give Minnesota a leg up with health IT "shovel ready" projects. All of the hospitals, clinics and doctors' offices in the Twin Cities' major health care systems have electronic records, and all but one are supplied by a single vendor, said Mark Sonneborn, vice president of information services for the Minnesota Hospital Association.

Their records are interoperable, meaning the different systems have the ability to access each other's records if a patient moves, he said. But outside the metro area, it's a different story. Few small-town practices with one or two doctors can afford an electronic system, Sonneborn said. Rural hospitals with fewer than 25 beds don't have the money, either.

But any clinic or hospital without an electronic records system is facing a deadline. By 2014, under the economic stimulus act, they must install systems that meet federal standards or start getting penalized in their Medicare and Medicaid reimbursements.

It's a carrot-and-stick approach, and not surprisingly, everyone is focusing on the carrot. IT vendors could get a rush of orders from health care providers who are using stimulus money to meet their deadlines, said Joanne Sunquist, chief information officer for Hennepin County Medical Center.

But any information system would have to be certified to make sure it can talk to other systems across the country, and the standards are still being hammered out, she said. She doesn't expect stimulus money to start flowing for another 18 months.

Barely a quarter of primary care clinics elsewhere use electronic health records, but 62 percent of those in Minnesota had fully or partially implemented electronic record systems by 2007, according to a survey by the Stratus Group, a Bloomington health nonprofit.

Those clinics and hospitals with systems might need upgrades to meet interoperability standards, LaVenture said. Health care is a labyrinth of insurers, doctors, hospitals, clinics, pharmacies, all using different computer systems.

To solve the interoperability problem, the state in 2004 launched the Minnesota Health Information Exchange, which acts like an old-fashioned telephone switchboard, letting hospitals and clinics connect to patient records. The exchange is owned by six organizations - Blue Cross Blue Shield of Minnesota, HealthPartners, Medica, Fairview Health Services, UCare and the Minnesota Department of Health; but so far, only HealthPartners and Fairview use it, said Mike Ubl, executive director for the exchange.

Minnesota will have to compete with states like Nebraska, where a health information exchange is ready to debut in Omaha and go statewide this year, said Deb Bass, president of Bass & Associates, a health IT consultancy that is working with that state.

Source: Pioneer Press, Leslie Brooks Suzukamo, 3/4/09