While the earliest adopters of digital records have shown the technology can save money, few New Jersey physicians have implemented all the software, equipment and infrastructure needed to meet federal standards.
That's where Colleen Woods comes in.
Woods, coordinator for New Jersey Health Information Technology, said the Camden Coalition of Healthcare
Providers started sharing data long
before it was a key part of health care reform. By using data from all of Camden's providers to identify frequent users, social workers from the coalition were able to identify a Medicaid patient only taking half the medication she was prescribed; the unused medicine was worth about $11,000.
"Sharing data is really beginning to show real savings," said Woods, who is now coordinating how the state connects health care providers so they can share electronic health records, improve care and save money.
Whether those providers see the same kind of success as Camden did relies on the infrastructure, training on using electronic records and the time frame from the federal government on when requirements will need to be met.
Woods said electronic health record adoption is like walking down three roads at once. Individual physician practices and hospitals have to adopt the technology — in New Jersey, 35 percent of physicians have gone digital; the figure is 86 percent for hospitals — before the practices can be connected through a local health information organization. The third path to coordinated data mining is connecting the local health information organizations to share information across the state.
"Physicians are not technologists, and they are doing this while they are seeing patients," Woods said at the Princeton Regional Chamber of Commerce Healthcare Symposium earlier this year. "So many that I talk to are doing this on weekends and nights. The nurse practitioners, the office folks are working unbelievably long hours just to get these systems in place. Once they do, and the workflow changes, they predominantly say it's been a tremendous choice, in terms of adopting."
Anthony Bossolina, vice president of service development and delivery at American Surgisite, in the Somerset section of Franklin, said he's seen the same reaction to providers who go digital. American Surgisite owns, operates and manages ambulatory eye surgical centers, where it implements ophthalmologic-
Bossolina said to surgical center providers, it is "more and more clear the future is electronic health records." Surgisite nurses, surgeons and office staff are spending less time looking in file cabinets and storage sites for files, and more time with patients.
Being able to view the schedules of multiple surgeons and caseloads also can help practices use their operating rooms more efficiently. And there are related savings, too: Bossolina said some digital offices spend 75 percent less on office supplies like paper, folders and staples.
It's those smaller wins, like supplies savings, that convince physicians to move ahead with electronic record implementation. Supporting experts, like regional extension center NJ-HITECH, are helping primary-care physicians find the best software, the easiest implementation and the best way to use digital records in their practices.
"Not one doctor that has become a meaningful user has thrown this stuff away," said Bill O'Byrne, executive director of NJ-HITECH.
"They find they can ultimately have a closer relationship and a more productive relationship with their patients, and also bring to bear some of the latest medical information and helpful value to their patients," he said.
NJ-HITECH, which is based at the New Jersey Institute of Technology, in Newark, has the most digital primary-care physician members of any extension center in the country. More than
6,300 primary-care doctors are members of the group, 4,600 of whom are using electronic records in their practices and 1,432 of whom have met the federal government's first round of "meaningful use" objectives.
"Our studies show that the real long-term savings come not just by automating your practice, per se," said Dr. Don Sebastian, chair of HI-TECH and senior vice president for research and development at NJIT. "The real savings come from the interconnectivity to the pharmacies, to the hospitals, to the specialists … it's the ability to move the information."
Sebastian said telling physicians to use digital, instead of paper, records is like telling them to use the telephone instead of shouting out the window — but the telephone is useless unless it is connected to something. The local networks are the "telephone lines" physicians will be using to move that information.
Woods' office is helping five local networks of providers in the state to get set up and share information. Jersey Health Connect, which connects providers in North and Central Jersey, is operational; Healthy City, in Newark, will be operational in December; and Trenton's network will need to be functional soon, as the Healthcare Team's local ACO will be looking to operate as a Medicaid-designated organization soon. A fifth network has yet to receive a grant award to begin preparations.
Moving information throughout these networks is a cornerstone of the second round of meaningful use rules, announced by the government in September. Woods said New Jersey's networks are on schedule to meeting many of the 2014 deadlines in round two, when federal incentives will be on the line.
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