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Physician community poised to further enhance patient care

by Raghu Ram, MD

The recently announced merger of Kaleida Health and Erie County Medical Center (ECMC) is an important step in a series of critical changes needed to enhance the quality of care in Western New York. However, if we truly want to realize improved quality, better managed costs and the creation of healthcare centers of excellence in our region, hospitals aren’t the only places where duplication, redundancy and inefficiency must be addressed.

We need to take an important physician-driven next step: the implementation of a region-wide medical information exchange connecting physicians, hospitals and insurers.

Providing physicians access to secure medical records via the Internet holds tremendous promise in tackling two of the most challenging aspects of the current system: quality and cost of care.

In terms of quality, there is no other field where handwritten or inaccessible records are so detrimental as in health care, when time and access to accurate, updated information are critical and often lifesaving for our patients.

Emergencies are not the only time that shared information is useful. For example, embedding prevention measures in the medical information exchange for reporting to clinicians and public health officials will help transform our health system from one that focuses on treating illness and disease to one focused on prevention, resulting in improved overall health.

Better utilization of data and information between doctors, hospitals and health insurance companies also enables users to support new prevention and outcome-based reimbursement models. And there are other benefits, such as linking to the New York State Immunization Registry, ensuring the seamless reporting of immunization records to children’s health providers.

Through a grant from the New York State Department of Health, a consortium of health care entities in Western New York – including the region’s major hospital systems and health insurance companies – have banded together to create the health information exchange HEALTHeLINK™, the Western New York Clinical Information Exchange consortium. Through this grant, a technical infrastructure is being constructed to enhance health care while ensuring the privacy and security of any medical information being retrieved.

The critical element for the long term success of this network is physician participation – and without it, no health information exchange system will become a reality.

Despite the many benefits, a recent study by Massachusetts General Hospital in Boston concluded that only four percent of physicians nationally have adopted “fully functional” computerized health records systems. The key reason for this is, computerized medical records in a doctor’s office need to be connected to medical information for a patient that comes from outside the doctor’s office. The health information exchange provides the secure infrastructure to allow this to occur.

A major challenge is the cost for computerized medical records and for connection to a secure medical information exchange (costs for connection to an electronic exchange network start in the tens of thousands of dollars). Additional costs for training of office staff to manage and operate the system will also be significant.

The bottom line is that the more quality of care is enhanced through the use of such sophisticated health information technology, the more we can reduce the cost of operating our health system while improving health and quality of life. The cost of implementation is, at the outset, substantial for physicians. We tackle this challenge, however, because in terms of lives and money, the potential savings are too great to overlook.

Raghu Ram, MD is senior medical director of BlueCross BlueShield of Western New York and Chair of the Physician Advisory Committee for HEALTHeLINK™, the Western New York Clinical Exchange consortium.