Dr. Lonnie Draper knows why he wants Tallahassee Memorial Hospital to have an electronic health record system shared with other hospitals and doctors.
“A good example is like a case yesterday, where someone is in a motor vehicle accident and they arrive unconscious. We have a driver’s license on the person. We can look them up,” he explains. “So we get a baseline of information about who they are, how ill they are and what medications they have. So if a patient can’t tell me anything, I can get a good deal of information about a patient who’s never been here before.”
At the hospital, old paper-based files are slowly being replaced. Florida is one of the first states to help doctors and hospitals adopt a new way of transferring patient information. The idea behind the Health Information Exchange Network, run by the Florida Agency for Health Care Administration, is “the exchange is the highway, the electronic record is the car,” according to Heidi Fox, who is directing the effort.
Individual providers can look up patient records held by a participating provider. When a doctor needs the file, it can be sent through encrypted messaging – the “highway.” For the last three years, Florida has been building the network. Right now, three small systems in the state are using it, and the goal is to expand to every health care provider in the state.
“No longer will doctors and their staffs have to wait for test results or patient histories to be faxed or mailed from one office to another. Members of the information exchange will simply log on to a computer and access patient records from other members,” the Bradenton herald reported in June 2010 when the Gulf Coast exchange went online. That exchange was created with $50,000 from the Manatee County Commission and patterned after the Big Bend Regional Health Information Organization in Tallahassee, the country’s largest exchange at the time, with 340 physicians and 450,000 patients. “Clinical information, labwork, reports of electrocardiograms, X-rays and magnetic resonance imaging — all at the click of a mouse.”
But not everyone is a believer, including Gov. Rick Scott.
“There haven’t been a lot of studies to date that suggest electronic medical records have saved a lot of cost. They’ve increased cost because of the way you have to keep all the records. I’m the one who should be taking care of my information and not relying on the government to do it because I believe it will raise the cost of health care without a result,” he said on the public radio show “It’s About Florida.”
Scott inherited the Health Information Exchange from the previous administration, and it was built using federal stimulus money. While development of electronic health records is a fundamental goal of the 2010 federal health law – the provisions call for using health IT to increase the quality of health care as well as standardizing payment and claims information – Fox says the state’s electronic system is not affiliated with the national law.
“The electronic medical record, the incentive program and the health information exchange are funded through the American Recovery Act. The high-tech provision is all through the Recovery Act,” Scott said.
The governor is also raising privacy concerns, worrying that the system “will get hacked and things like that.” But the Agency for Health Care Administration’s Carolyn Turner notes that’s why the agency has put in extra security measures.
“We don’t have access to the content of the emails going back and forth through the network,” she said. “Nothing is stored by the Florida HIE. With the patient lookup, there’s no central database. It’s all maintained by the local participants.”
Florida’s health information exchange is a voluntary system, and healthcare providers can choose whether to sign up. Registration and participation are also free.
“We expect that every hospital, every doctor, every healthcare provider will eventually connect to a health information exchange,” said Tallahassee Memorial’s Dr. Lonnie Draper. “We expect for fax machines to eventually disappear. We expect this to replace any other form of movement for electronic records.”
Even though Florida is further along in this regard than most other states, the goal of eliminating paper-based records is still a long way off. The state is working to add more providers to the network, something it says will still be a work in progress when the federal funding that supports physicians and hospitals who are setting up electronic medical records goes away… in 2021.
–Lynn Hatter, WFSU, and Kaiser Health News and FlaglerLive
Kip Durocher says
Scott has privacy issues? Where were they when he proposed illegal privacy intrusions on people getting
state aid? Is he for or against privacy?
This man actually has delusions of himself in the white house. He thinks he can buy that also.
Anita says
Interesting to note this “Right to Lifer’s” first consideration is saving money, rather than the system’s potential for saving life. What is the cost of trying to reach a patient’s doctor (provided the office is open), locating paper records, and having someone take time to fax information to the ER vs. pulling up patient records on a computer screen, particularly when time is crucial? Evidently Scott has no investment in electronic medical records or he’d be its biggest booster.
Melitta says
I go out of the country alot. I can now see my medical documents and show them to doctors when needed. I can just print them out and the doctor cans see it. When did Scott care about privacy. He created a fiasco when he made welfare recipients do drug test. I am glad that I don’t have to wait for that fax that never comes to show my records. He does not know the meaning of privacy.
BeenThereDunit says
Don’t rush to judgemnt on Scott… with 38 yr’s of HC under my belt, I have a pretty good handle on the in’s-n-outs on the subject matter. At first-blush, and in an ideal world, a “working” HIE can be a great thing… and the example of the accident victim arriving in an ED unconscious is a favorite example of mine when little or nothing is known about the patient (Hx, latest lab work, X-Ray’s, PACS images, PCP, etc…. but lets not forget that not everyone showing-up in the ED may be from the surrounding community(s), Counties, much less from out of State. NwHN has not been established as yet as there is so much left to accomplish.
Overall, an HIE is a good thing, but until proprietary disparate Systems and Applications play nice, its all pie in the sky and the good news were getting there slowly. However, the tons of $$ spent soley on EHR’s isn’t the magic bullet in making this all happen, and I believe that is a portion of what Gov Scott is addressing.
The other piece is Security and something everyone needs to be made aware of when it comes to their Medical Records, SSN’s etc. So to put things in perspective… while “we” may have excellent HC in this country, HC as an industry ranks about 4th or in IT technology… which means the Banking, Insurance & Manufacturing Industries rank higher… yet, we have all heard about the Citi Banks, Visa’s and even our own Pentagon firewalls being breached with tens of thousands of individual’s having there personal identities. Whlie not always mentioned in the news (outside of celebrities losing their information like “Dennis Quaid”), HC records are breached frequently… and I believe this is what Gov Scott’s concern is based-on. Doesn’t mean it can’t be fixed or improved, but despite everyone’s efforts, its not what it should be today in HC.
There is another facet of Securing our HC records “everyone” needs to be aware of & concerned about when protecting ones medical history and identify… and that is “who” has access to your personal medical information and how they could possibly use that information against you in determining your eligibilty for coverage and Insurance rates? Yes, HIPAA is in place, but have you read the fine print of HIPAA regulations? or do you just skim over the pages of legalese and sign the document in your physicians office like 90% of the population? I will leave it at that. As a 10+-yr ancer survivor, I have seen most everything from that side of the bed, as well as having worked on the other side for a decade.
As for PACS images, unless you keep a CD chained around your neck, those images outside the Imaging Ctr rarely make it to your PCP’s office and those that do, are a small percentage since PACS images can’t be viewed on disparate PACS viewers.
Kip Durocher commented implied earlier that Gov Scott could care less about a patients privacy , using Welfare recipients as an example with the recent passing of a bill that they had to be tested for drug abuse prior to receiving their checks. As a tax paying citizen of this country, having to flip the bill for those abusing the Welfare system thru my higher insurance premiums and Fed taxes, that is a good thing in halting fraud. Those hooked on illegal drugs are spending “our” money to feed their habits versus putting wholesome food and milk on their tables, which it was designed to do. There is no Privacy issue breached in Durocher’s example… if someone is “clean” they have nothing to fear and they receive their checks… like the Gov’t unemployment check’s, if people show proof that they are “honestly” out seeking employment, they collect their weekly checks, versus sitting at home at others hard work and expense. Its like everything else, there are many out there taking advantage of the system, which drives the cost of healthcare up for everyone. When Welfare was initially established, the estimated cost to the American people was est. at $12B… today, the costs have soard to $120B and climbing. Do you know the percentages of “illegals” collecting Welfare in our Country? A national report from last week reported In CA that its 70%; in AZ 40% and in TX 20% and that doesn’t include the Free HC and Education they are receiving, contributing to our just surpassed $15T deficit. The problem is and has been that nobody in our Fed Gov’t is monitoring or enforcing the legitimacy of the checks going out. All Gov Scott is doing is stepping up to the plate and making sure that is one area that Taxpayers money isn’t abused. BTW, those on Welfare who are abusing drugs are also receiving taxpayer funded aid in assisting them in obtaining treatment for their addiction, so they can continue receipt of their Welfare checks as long as they continue their treatment regimes. More should be done about Medicaid and Medicare fraud as well… but its a billions of dollar business for those abusing the system.
One last note on HIE’s and EHR’s… as most of you reading this know, ARRA is tied to Meaningful Use criterias and with that, those provider’s meeting the phased criterias will receive Stimuls $$, but what they don’t realize is that it is but a fraction of the investment made by the providers and even then, only addresses a portion of what’s needed to establish a fully functional integrated HIE.
Sea dog says
Gov Rick Scott is from the stone age. hes a typical tea party republican a let them die attitude if they dont have insurance or if it might cost a dime to have a data base.