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Stimulus to speed shift to electronic medical files

Federal money could accelerate Arizona’s push toward digital health records, making staples such as paper charts, written prescriptions and doctor’s-office clipboards a thing of the past.

As part of its stimulus package, the government will pump more than $19 billion into computers and software systems that promise to connect hospitals, doctors, pharmacies and other health-care players.

Widespread use of electronic health records would save lives and money and eliminate waste in the complex world of health care, medical experts agree.

Arizona doctors appear to be adapting to electronic records faster than the national rate, but getting there can be costly and frustrating.

Arizona’s medical community is poised to collect as much as $500 million in stimulus funds beginning in 2011, local officials estimate, provided health-care organizations adopt “meaningful use” of such digital systems.

“Automation is eventually going to be everywhere,” said David Landrith, the Arizona Medical Association’s vice president of policy and political affairs.

Proponents say electronic health records are superior in many ways.

A physician can verify a patient’s prescription-drug regimen, helping to avoid harmful drug combinations. Nurses can use a hand-held scanner to zap a patient’s medication to ensure they are giving the right drug to the right person.

Multiple caregivers can simultaneously view a patient’s medical charts, making care more efficient.

Still, there are challenges. Some worry that a wide range of computer systems and standards may block effective communication. Systems that cost $100,000 or more are too expensive for smaller doctor’s offices. Comprehensive hospital systems can range from $20 million to $100 million.

Also, worries about patients’ privacy persist.

Studies show varying degrees of adoption rates for computerized records. A New England Journal of Medicine survey indicated that 17 percent of doctors have some type of electronic health-records system, while another survey indicated hospitals’ use of electronic health records vary widely.

Arizona health-care providers have turned to computerized systems at a faster clip, with at least 30 percent of physicians employing some type of digital system, according to Brad Tritle, executive director of the Arizona Health-e Connection, a nonprofit group established to orchestrate Arizona’s digital health initiative.

Tritle said that figure comes from an ongoing survey of licensed doctors performed by Arizona State University and funded by the state’s Medicaid program.

Arizona’s digital health push isn’t new. While governor, Janet Napolitano signed an executive order calling for statewide adoption of digital-records systems for prescribing drugs. Arizona Health-e Connection has spearheaded the effort to research and develop model policies in the state.

Banner Estrella Medical Center was among the nation’s first hospitals to go all digital when it opened in January 2005. Other hospitals that have established digital records include Banner Gateway Medical Center, Mayo Clinic, Cancer Treatment Centers of America and University Medical Center in Tucson.

With federal stimulus dollars providing a tailwind, Tritle said he expects the use of digital health records to accelerate.

Even the biggest backers of a health-information revolution acknowledge that questions remain about cost, training and standards.

Sources: eHealth Initiative, Arizona Health-e Connection, Republic research


$19.5 billion boost from stimulus cash

The American Recovery and Reinvestment Act provides $19.5 billion to set up electronic health records systems.

How the money will be distributed:

$2 billion: Discretionary funds controlled by Health and Human Services. Part of that pool may include $300 million for states or agencies to establish “health-information exchanges” that coordinate electronic health records standards.

The rest: Incentives paid by Medicare and Medicaid to physicians, hospitals and other health-care providers to establish electronic records systems.

How it will be paid:

Doctors: Physicians who demonstrate “meaningful use” of electronic health records can receive up to $44,000 over five years through Medicare beginning in 2011. Doctors also can get a Medicaid payment of $55,250 over five years.

Hospitals: The nation’s largest hospitals would be able to secure Medicare payments up to $11 million, based on patient discharges, in-patient days, revenue and free care for the poor.

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