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Mass. seeks more use of electronic medical records

Email|Print| Text size + By Jeffrey Krasner
Globe Staff / December 5, 2007

Massachusetts is in danger of losing its lead in implementing electronic medical records, and needs to quickly decide how to pay for the new systems and what role government should play, according to healthcare officials scheduled to attend a conference this morning on healthcare information technology.

The conference, hosted by the Massachusetts Health Policy Forum, will explore ways to apply lessons learned from the Massachusetts eHealth Collaborative, which in 2004 received $50 million from Blue Cross Blue Shield of Massachusetts to install pilot computer systems in North Adams, Newburyport, and Brockton.

"We've been at the forefront of electronic medical records in part because of the work of the collaborative, but that money is about to run out," said Michael Doonan, executive director of the forum. "We potentially could lose our leadership if we don't act."

Electronic medical records would put patients' complete medical histories onto computers, enabling doctors, specialists, and other caregivers to access health histories without waiting for paper records. Many believe that could prevent unnecessary diagnostic tests, streamline care, and save a lot of money.

But the details have proven challenging. The computer systems are expensive, there are no standards for sharing of data between medical systems, and some doctors are resisting the new technology.

"The complexity of technical and confidentiality issues in what seems like a simple and obvious premise are overwhelming," said Chris Gabrieli, the venture capitalist and former candidate for governor who is chairman of the Massachusetts Health Data Consortium. He said a comprehensive plan would enable Massachusetts to start using electronic medical records more quickly.

Doonan said another obstacle to widespread adoption of the systems is how the expense would be divided. Doctors and medical practices would incur most of the costs, he said, while health plans would enjoy most of the savings.

"When this happens, you can't expect the market to accomplish this," Doonan said. "There is a role for the state to play to maximize the social benefits for all of us from having electronic medical records."

Micky Tripathi, chief executive of the eHealth collaborative, said rolling out electronic medical records statewide could cost about $500 million over five years.

"If we leave this to the market, there will be a growing digital divide between doctors practices with fewer than 10 physicians, who don't want to pay for the new equipment, and the large medical systems that already are putting EMR machines in place," he said.

State Senator Richard Moore, Democrat of Uxbridge and Senate chairman of the Joint Committee on Health Care Financing, said state funding is called for.

He said there may be a way to eventually get federal funding when the state reapplies for a waiver from the strict Medicare rules.

"Ideally, you'd like to see the major players support it voluntarily . . . with smaller institutions making up the difference," said Moore.

He said he would consider a funding mechanism built into a more comprehensive law passed by the Legislature.

Jeffrey Krasner can be reached at krasner@globe.com.

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