- The Washington Times - Saturday, June 14, 2008

Government officials last week chose 12 communities to participate in a national pilot program that will provide incentive payments to doctors who use electronic health records to improve patient care, while a new survey found some Americans have privacy concerns about such records and want to be able to access them alongside their doctors.

The new government program comes as the government is pushing doctors toward doing away with paper files and switching to electronic medical records.

“The use of electronic health records, and of health information technology as a whole, has the ability to transform the way health care is delivered in our nation,” Health and Human Services Secretary Michael O. Leavitt said. He said it can increase efficiency of care and reduce medical errors.

Meanwhile, a survey released Thursday by Kaiser Permanente showed 69 percent want both doctors and patients to have access to these electronic records. It also found 61 percent agree the benefits of electronic medical records outweigh the risks. But that percentage dipped 12 points since last year’s survey which found 73 percent felt this way.

The medical community is one of the last industries to still rely largely on paper records, and many medical leaders think electronic health management is inevitable. Electronic health technology includes electronic medical records (EMRs), prescription drug requests sent electronically to the pharmacy, patients finding health information online, and e-mails and texts between patients and doctors.

The question now is how to get there, since it’s expensive and challenging to make the leap.

“Do I think it’s part of our future? Yes, I think it’s part of our future,” Joel Levine, a Colorado doctor and chairman of the Board of Regents for the American College of Physicians, said at an ACP conference in May. “Right now it’s sort of topsy.”

The number of doctors opting for such types of systems has grown in recent years, but remains relatively low. In 2005, 24 percent of physicians reported using either full or partial electronic medical records in their office-based practice - a 32 percent increase since 2001, according to a report from the National Center for Health Statistics.

The office of Dr. Alice Fuisz, who practices internal medicine in Washington, went “electronic” in July 2006 and now all patient information is continually entered into an ever-growing database.

The system was expensive to implement - she estimated about $70,000 plus regular upkeep fees - and her staff still scans patients’ old medical records into the new system. But Dr. Fuisz said it was worth it since she can now check patient data from home, get faster lab results automatically updated in the system, easily check a patient’s history, view drug interactions that pop up on the screen and send refills electronically to the pharmacy.

The HHS department is hoping to spur more of this through efforts like the pilot program, in which state and local communities from Alabama to Washington will work with federal Medicare officials to recruit about 1,200 doctor offices that could receive up to $290,000 each in Medicare incentive payments from the government over 5 years. The offices already may have certified electronic medical records or may be implementing them, an HHS official said, but all must track how they improve patient service.

But privacy rights advocates are highly critical of the push for electronic records.

Dr. Deborah Peel, a psychiatrist and founder of Patient Privacy Rights, said many electronic health systems are not secure as they claim to be, and some companies that sell them to doctors retain control over the information and can sell it to other bidders. “We need to think of our health information as money in the bank,” said Dr. Peel. “Would you trust the banker to decide when to disperse the money? I don’t think so.”

Meanwhile, Dr. Steven Stack, a member of the American Medical Association Board of Trustees, said the AMA supports the voluntary government program to “test viability” of widespread electronic health records. “We want to see this work. This may be one way,” he said.

There are several bills in Congress that deal with health information technology, including one now being negotiated by House and Senate leaders.

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