Hospitals help physicians convert patient paperwork to computerized systems that could improve care

By Cheryl Powell
Beacon Journal medical writer
http://www.ohio.com

Ask Dr. James Dom Dera for a pen, and he probably won’t be able to find one.

At the beginning of the year, the Fairlawn doctor and his partners at Ohio Family Practice ditched their prescription pads, paper charts and pens in favor of a totally computerized, electronic medical record system.

Summa Health Network, the contracting arm of Summa Health System that negotiates with insurers on behalf of Summa hospitals and participating doctors, provided a $22,500 grant to help the practice buy the $60,000 system.

Summa also provided technical assistance, including access to its server to safely store the electronic patient records.

About 200 doctors in the Akron area have made similar deals with Summa.

“They did all the legwork for us,” Dom Dera said. “They went out and researched all the software programs. They arranged bank financing for the part that wasn’t covered by the grant. We didn’t feel like we were the only guys around, that we would be walking out on this limb with no one else to help us.”

Akron’s hospitals are providing technical expertise — and money, in some cases — to helpprivate-practice doctors in the region switch from paper to computerized patient records.

The move seems to be just what the doctors — = [100.0]and everyone else involved — ordered.

For patients, the change will eventually enable them to talk with their doctors online, access test results, avoid dangerous drug interactions, and request prescription refills via a secure Internet site from the comfort of their home.

For doctors, these systems eventually will cut down on paperwork and let them view important patient records anytime, anywhere.

Several times already, Dom Dera said, he has pulled up vital information about patients who went to hospital emergency rooms on a weekend, when his practice was closed.

“Medicine has advanced so much that it’s hard to keep track of it with pen and paper,” he said. “This really does, at the end of the day, equal better patient care.”

For hospitals, helping doctors adopt costly electronic medical-record systems can build physician loyalty in competitive markets. (That’s critical, considering that doctors typically decide where patients go for care.)

“It’s about how you partner with the physicians, the hospitals and the payers, meaning the insurance companies and the employers they represent,” said Charles Vinos, vice president of Summa Health Network.

Insurers on board

And for insurance companies, the switch to electronic medical records saves money and helps them start “pay-for-performance” programs that reward doctors who provide better care at a lower cost.

“Electronic medical-record systems can reduce duplicate testing,” said Jim Pulgiese, director of contracting and provider relations for Anthem’s northern Ohio region. “They make data really available in a quick and easy-to-access fashion.”

Anthem started a pay-for-performance program this year with Summa Health Network to give participating doctors bigger payments if they switch to electronic medical records.

Doctors are eligible for additional incentive pay from Anthem if they perform better than peers on wellness initiatives, patient satisfaction and the use of generic medicines, Pulgiese said.

Computerized medical records make it easier for doctors to improve quality by automatically sending reminders to patients for tests or by electronically tracking people struggling with chronic illnesses, such as diabetes, said Dr. Michael Maggio, an internal medicine doctor in Stow who is chair of Summa Health Network.

SummaCare, Summa Health System’s insurance arm, also is developing pay-for-performance initiatives. In addition, the health insurer provided some of the $4.6 million in grant money that Summa Health Network is making available to doctors who adopt electronic medical records.

“The key is, we want to focus on quality measures and improving quality,” said Marty Hauser, SummaCare’s president and chief executive. “But by definition, if you’re improving quality, you ought to be improving efficiency and lowering cost.”

Costly system

Getting there, however, isn’t cheap.

The average cost to buy and implement an electronic medical-record system is more than $32,000 per full-time physician in a practice, according to a survey by the Medical Group Management Association and the University of Minnesota School of Public Health. Maintenance costs, on average, are another $1,500 per physician per month.

Complicating matters, the transition from paper to electronic records can be incredibly time-consuming. Thousands of patient charts need to be entered into the computer system — either by scanning the documents or typing in the information.

Consequently, an estimated 80 percent or more of doctors’ offices haven’t converted to electronic medical records, said Rosemarie Nelson, a principal consultant with the Medical Group Management Association’s medical consulting group.

Hospitals nationwide are helping doctors with the transition — and improving their “physician bonding” — by providing technical support and negotiating lower, group-purchasing rates for electronic medical-record systems, Nelson said.

But it’s unusual for hospital systems to secure financing or provide grant money, as is the case with Summa, she said.

Summa’s crosstown rival, Akron General Medical Center, also is taking steps to help area doctors embrace technology.

Akron General is negotiating with RelayHealth to get discounted rates for area doctors who adopt the electronic system, which allows patients to request prescription refills, schedule appointments, maintain a personal health record and have a virtual doctor’s visit via a secure Web site. The hospital started using the system in its family medicine clinic last month.

The RelayHealth initiative is part of a comprehensive plan that Akron General has to ultimately link technology among the hospital, patients and the independent physicians who practice there, said Dr. David Peter, Akron General’s chief medical information officer.

Akron Children’s records

Likewise, Akron Children’s Hospital is helping pediatricians and family practice doctors convert to computerized records.

The hospital has a contract with Allscripts to provide an electronic record system in all 14 of its Children’s Hospital Physician Associates pediatric offices throughout Northeast Ohio, hospital spokeswoman Laurie Schueler said.

The system, which Akron Children’s has launched at four of its pediatric offices, enables doctors to order prescriptions and maintain patient information electronically.

Children’s is negotiating with Allscripts to pass along its discounted rate to area pediatricians and family practice doctors who want to use the same system, Schueler said.

“If we can pass cost-savings on to our medical staff, that’s great,” she said. “The quicker everybody goes electronic, the easier it is for everybody.”
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