WICHITA, Kan. — Federal stimulus money and the promise of incentive payments are pushing health care providers toward digital information. Just as moving from ledgers to computers changed banking, going to electronic medical records is expected to change health care, proponents say.

But going digital is also expensive.

Hillside Medical Office in Wichita, Kan., which has seven physicians and one nurse practitioner, recently signed a contract for a system. Administrator Dave Gordon said it’s “the largest investment this office has ever made, other than the building. … It’s six figures.”

Beginning next year, health care providers can recoup some of their costs from incentives that were part of the stimulus package.

Those making “meaningful use” of electronic records are eligible for as much as $18,000 in fiscal 2011, and lesser amounts in the four years following, to an estimated total of $40,000 or more. Hospitals can get more than $2 million a year for four years.

“That sort of money hanging out there is like fresh meat,” Robert St. Peter of the Kansas Health Institute said in Topeka, Kan., earlier this year. He is a member of the state’s e-Health Advisory Council.

“It’s really lit a fire,” he said. “This is like a big deal now. There’s a lot of money involved.”

Proponents say the benefits are as enticing as the funds. Record-keeping will become more efficient. Tests and X-rays won’t need to be repeated, and staff time won’t have to be spent pulling or filing paper charts.

Information will be mined in ways that can improve health care, by showing which treatments are most effective, for example. And mistakes can be reduced, such as those that can come from misinterpreted handwriting.

Many health care providers can’t afford to go fully digital right away, said Joe Davison, a physician at West Wichita Family Physicians and president of the Kansas Medical Society.

At his office, “We are in a combination stage,” he said, with the ability to share lab results or digital X-rays but not all information with other providers.

The ability to have health care providers’ computer systems “talk” to each other has accounted for some of the delay in the adoption of electronic records — and is pushing it forward now.

Electronic medical records on their own are useful within a practice or hospital, just as computer systems are at a business.

But when they are part of a health exchange, they become more like the health equivalent of banking online or at ATMs, in which information can be accessed by authorized users regardless of location.

The potential to improve health care rests with those exchanges.

Davison said the most valuable exchanges will be at the local level — between a local physician and a local hospital, for example.

But for health information to be valuable on a broader level — for research and analysis –the federal government is pushing for wider exchanges of information.

States and others still are grappling with the issues raised by health exchanges, St. Peter said. Those include who should own the data, whether employers and insurance companies should be able to access it, and whether it should be run by the state, a private entity or a hybrid of the two.

For smaller-scale groups such as the Medical Society of Sedgwick County, Kan., the challenge is to develop a local health exchange.

“We have gained a lot of insights in terms of the statewide plan and how that’s going to work,” said Executive Director Jon Rosell, who also is a member of the state advisory committee.

A nationwide exchange is “years down the road,” Davison said.

But the journey has begun.

Gordon said, “The government is almost forcing people’s hands, between their carrots and their sticks.”

And at some point in the future, he said, a health care provider still using paper charts will be as rare as a bank pulling out a ledger.


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