Plan aims to help doctors go electronic

DEIRDRE CONNER

How it will work

The Duval County Medical Society and Duval County Health Department will start recruiting practices in 2009 to adopt electronic health records. The focus is small primary care providers in the six-county region; up to 100 will receive the incentives from the federal government.

Maximum payment over the five years is $58,000 per physician or $290,000 per practice.

First year: Physicians are paid to adopt Electronic Health Records (EHRs).

Second year: Physicians are paid for EHR adoption, and for reporting 26 clinical outcomes (such as the percentage of diabetic patients with low cholesterol or the percentage of patients age 50-plus who were screened for colo-rectal cancer).

Third and fifth years: Physicians are paid for EHR adoption and paid based on quality of those 26 clinical outcomes.

Source: U.S. Department of Health and Human Services

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Late one recent night, Jacksonville cardiologist Allen Seals got a call that one of his patients was in the emergency room.

In 45 seconds, he was on his home computer, looking up the patient's medical history - then giving life-saving advice to the ER doctors.

That moment, never possible before the advent of electronic health records, could be coming soon to many hundreds of physicians in Northeast Florida, thanks to a new five-year demonstration program here and in 11 other communities nationwide.

Starting next year, officials announced Monday, the U.S. Department of Health and Human Services program will spend millions to reward small doctors' offices for switching from paper files to computerized records.

Seals, past president of the Duval County Medical Society, likes to rattle off the benefits. There are the years of blood test results, the drug interaction alerts that pop up when prescriptions are written, the pre-set reminders of when patients are due for check-ups.

Electronic record-keeping is something that lots of medical providers want - yet most don't have. At least 60 percent of Jacksonville-area physicians don't use electronic medical records, Seals said.

The expense of a new system and time spent training staff are the biggest reasons why physicians, especially in small practices, are still scribbling on paper charts, said Anne Waldron, a family physician who sits on the board for both the Duval Medical Society and the Florida Academy of Family Physicians.

The incentives, paid by the federal Medicare program, are to help primary care practices make the leap. The target size is offices with three to five physicians.

The physicians won't get reimbursed for the cost of the new systems. But they will be eligible for incentive payments that are based on how well they implement electronic health records, and whether their patients' care improves.

Over the five years, the program would pay up to $290,000 per practice or $58,000 per physician. Based on cost estimates provided by HHS officials, that would be enough to convert paper records to electronic records.

Ben Sasse, HHS assistant secretary for planning and evaluation, said Monday the department expects the program to pay for itself by improving patient care. The idea is that improved patient care brought about with the electronic records will produce savings by, for example, reducing errors, hospitalizations and duplicate tests.

Although converting an entire office to electronic medical records would benefit all patients in the practice, physicians would get the incentives based on how many Medicare beneficiaries they have and eventually on 26 different health care outcomes for those Medicare patients.

Nationwide, Sasse said, the five-year program could affect 3.5 million patients.

deirdre.conner@jacksonville.com, (904) 359-4504