Ridgeland — Even though President George W. Bush is pushing his plan to have electronic health records (EHRs) and other electronic features in place by 2010, physician offices have been slow to adopt and use e-health technologies.
To help promote the adoption of EHRs and information technology (IT) in primary care physician offices, the Centers for Medicare & Medicaid Services (CMMS), a major payor of healthcare services and sponsor of the nation’s largest national quality improvement program, has undertaken a demonstration project to stimulate innovation in the adoption of IT systems in healthcare: Doctor’s Office Quality-Information Technology (DOQ-IT, pronounced “docket”).
In Mississippi, Ridgeland-based Information and Quality Healthcare (IQH) has enrolled nine clinical sites in the pilot phase of DOQ-IT. The project promotes continuity of care, helps stabilize medical conditions, prevents or minimizes acute exacerbations of chronic conditions and reduces adverse health outcomes, such as adverse drug interactions.
DOQ-IT supports physicians by providing them assistance in reorganizing office workflow to optimize IT use, sponsoring a statewide collaborative plan, dispatching electronically transmitted information regarding practitioner performance, identifying opportunities for improvement, and providing ongoing assistance in office work process changes to use IT to improve the quality, safety, efficiency and cost in managing patients, including those with chronic disease.
“Many questions are arising about how to proceed with EHRs in the physician’s office,” said James S. McIlwain, M.D., president of IQH, a designated Medicare Quality Improvement Organization (QIO) in Mississippi, working under contract with CMMS, an agency of the U.S. Department of Health and Human Services. Nearly 2,000 Mississippi physicians comprise the voluntary membership of the 30-year-old nonprofit organization, whose staff includes physicians, nurses, health information administrators, statisticians, data analysts and communication specialists.
“The IQH staff is working closely with these physician clinics to move them forward to complete implementation of EHRs,” he said. “Clinics will be working to improve workflow efficiencies and patient and population management. IQH staff will work with the clinics after purchase and installation of the EHRs to assist them in utilizing fully the use of their system to improve patient care and outcomes. Many of the clinics are small rural practices with the greatest barrier to embracing the technology being the financial one.”
Initial costs to implement the electronic infrastructure typically varies from $15,000 to $30,000, depending on selections and various vendor offerings, plus service and maintenance or user fees and other annual fees, said McIlwain.
“All are dependent on negotiations, with IQH able to serve as counsel to offices needing information and tools to aid in selection,” he said. “The challenge, of course, is centered on the costs, along with moving staff in the direction of acceptance of the EHR system. The computer literacy of the state in general is also a possible challenging factor, along with the number of physicians in the state who are retiring or making plans to retire in the near future.”
McIlwain pointed out that healthcare providers select the vendors best suited for their needs while IQH’s DOQ-IT project provides vendor-neutral support for clinics.
“(We) will act as a facilitator to the clinics during the selection process,” he said. “Clinics will also receive assistance to fully utilize the expensive investment that they have made to include care management (both chronic disease management and preventive care). The DOQ-IT staff will also provide information to the clinics about the latest practice recommendations and industry trends for the EHRs. IQH will assist the clinic in evaluating itself and provide support and resources for the success of the clinic’s redesign.”
HIPAA compliance is not an issue with this technology because software vendors have written or modified their software modules to meet the guidelines and ensure patient privacy, said McIlwain.
Initially, the IQH emphasis will center on promoting EHRs in physician practices, but “eventually, it will be necessary for all healthcare entities to become electronic,” said McIlwain.
Contact MBJ contributing writer Lynne W. Jeter at email@example.com.
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