Sunday, February 5, 2006
Area may develop electronic network
By Patrick Howington
A new Louisville group hopes soon to pioneer an electronic network to store the health records of 100,000 or more patients in hopes of reducing medical errors and cutting costs.
Doctors or other caregivers could retrieve the records at a keystroke. That could keep unnecessary or duplicate tests from being performed or dangerous medications from being administered.
For example, a doctor in an emergency room could learn of a patient's drug allergies or see results of a recent CT scan done at another hospital.
The Louisville Health Information Exchange, a consortium of doctors, hospitals, employers, government groups and others, is being formed to implement the network. Last week the consortium invited vendors to submit proposals for building and operating the needed information systems.
The network, a product of two years of study by University of Louisville health-information specialists, could be in operation by next January if enough employers and other parties sign on.
It is being created with the help of Dr. William Yasnoff, a former federal health-care official whose efforts led to President Bush's call for a national electronic health-records system by 2014.
If Louisville's network is successful, it will be "a model for the nation," said Yasnoff, who is now a consultant.
"You will have a parade of visitors to Louisville. Because everyone wants to do this," said Yasnoff, who was a senior adviser for the National Health Information Infrastructure in the U.S. Department of Health and Human Services.
Organizers have been talking to large employers, unions, hospitals, health plans and others to gauge their interest, said Dr. Robert Esterhay, who led the U of L research team on the project.
Esterhay is also board co-chairman of the Kentucky e-Health Network, which is overseeing efforts to establish a state health-records system. The General Assembly created the board last year.
The local network, called the Louisville eHealth Trust, is separate from the state initiative. But the demonstration project could lead to similar efforts in other cities.
Esterhay said the Louisville network will need at least 100,000 patients to make it financially sound.
Each would pay about $60 a year to be included. The fee could be subsidized by an employer or union health plan.
The payoff would be better health care and fewer medical accidents, which could lower health-insurance premiums. Savings also would come from fewer telephone calls and reduced paper flow between care providers, Esterhay said.
Also, researchers and insurers could study the patient-records database to determine what treatments work best -- or consumers could use it to compare the performance of doctors and hospitals.
That appeals to Gary Best, president of United Food and Commercial Workers Union Local 227, which is considering joining the network. The local has about 18,000 members in Kentucky and Indiana.
"It's hard for (people) to get information on where they get the best-quality health care," Best said.
"We certainly think that there's huge benefit across the region to have a single patient record," said Dr. Steven Hester, chief medical information officer for Norton Healthcare, which operates five Louisville hospitals. But he said there are several models for accomplishing that other than Yasnoff's. Norton will have to study the proposal before deciding whether to take part, Hester said.
Yasnoff said some communities mounted electronic health-records efforts long before Louisville, but those efforts stalled because of a key problem.
While hospitals often have electronic records storage, most doctors' offices don't because of cost. So patient records in some networks are incomplete, he said.
Yasnoff said his model, called eHealth Trust, solves that.
It calls for patients' monthly network fees to be disbursed to physicians. Participating doctors are to be paid a few dollars each time they enter a patient's information. They would use the money to buy their own information systems.
With Louisville eHealth Trust, doctors would get about $3 for each patient encounter they entered, Esterhay said.
Yasnoff said Louisville would be the first community to set up a network using payments to doctors and also giving patients control of when their records are released, another feature of his model.
Reporter Patrick Howington can be reached at (502) 582-4229.
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Research funding for this project provided by the Kentucky Science and Engineering Foundation (2004-6), Kentucky Legislature under SB 2 (2005-6) Kentucky Department for Public Health and the Kentucky Hospital Association (2005-6). Additional funding, staff and technologies provided by University of Louisville, School of Public Health and Information Sciences and VisPlex Association, Inc.