Memphis may help test electronic medical records

The Commercial Appeal
February 1, 2008
By Daniel Connolly

Memphis could be one of 12 test markets nationwide for an experiment in using electronic record-keeping to improve health care quality, federal officials said Thursday.

The new federal program could provide grants to 100 Memphis doctors' groups. In exchange, the groups would use electronic systems to gather and publish information about the quality of the health care they provide, allowing patients to make better choices about which service to use.

"This is a pioneering effort and Memphis is right in the middle of it," said Michael O. Leavitt, secretary of the U.S. Department of Health and Human Services.

Leavitt, a former Utah governor whose duties include overseeing the federal Medicare and Medicaid insurance programs, urged a group of local health care leaders gathered at the Hamilton Eye Institute in the Medical Center Thursday to make a formal application for the new program.

He said he is impressed with the work of the Healthy Memphis Common Table, a group that includes people ranging from doctors to local ministers and is already backing local health care quality initiatives.

"We think that the Memphis area is an extraordinarily good candidate because of the commitments that have been made to become one of those 12 (demonstration sites)," Leavitt said.

The Healthy Memphis Common Table will apply, but it's too early to say which of the 100 doctors groups will be included, said Denise Bollheimer, the group's chair.

The government wants to let consumers looking for medical services use a Web site or similar publication to compare the quality and price of local doctors, Leavitt said.

"This is Travelocity for health care, if you will," he said, referring to the Web site that enables travelers to compare plane ticket prices from different airlines.

The government expects to spend $150 million over five years for the 12 sites in the demonstration project and then apply lessons learned to other parts of the country, he said.

If the dollars were divided evenly, that would mean each of the 100 doctors groups selected in Memphis would receive $125,000, though Leavitt said the payment details aren't final.

The program would focus on Medicare, the federal insurance program for the elderly, but could be expanded to include Medicaid, the program for the poor, and possibly private insurance companies, he said.

Leavitt's proposal reflects a broader trend toward transparency in health care. Research has shown that medical errors often kill or injure patients and that doctors don't always follow best practices for treatment.

To cut costs, the government and private insurers want to improve quality. One way is to publish data that show who is doing the best work. Various groups around the nation are already publishing ratings for hospitals and nursing homes, and to a lesser extent for individual doctors.

So far, local initiatives are gathering quality data on doctors but are not publishing it. Leavitt's proposed initiative could strengthen those efforts. He said he believes doctor quality data would be published within the first two years.

Leavitt said the plan would pay doctors extra in the first year for adopting electronic medical records -- most doctors' offices still use paper files. He said electronic records can save money by preventing errors and miscommunication, such as misreading handwritten prescriptions.

In the second year, Medicare would pay doctors extra for reporting data on quality. In the third, fourth and fifth years, Medicare would pay doctors for improving quality, he said.

He said doctors are understandably nervous about quality ratings and that an initiative run by a local group like the Healthy Memphis Common Table is more likely to gain acceptance.

Bollheimer said having solid electronic systems would make the data more credible and mean doctors would be more likely to accept their publication.

The concept appears to have the support of the Memphis Medical Society, a key group of local doctors. Michael Cates, the group's executive vice president, said doctors are concerned about potential cuts in Medicare payments and are eager for any additional money.

Also Thursday, Leavitt announced that the government has chosen Memphis as the nation's first site for an program called a chartered value exchange. This gives the Healthy Memphis Common Table the opportunity to share health care data with similar groups around the country.

- Daniel Connolly: 529-5296

Healthy Memphis Common Table

Incorporated as a nonprofit in 2003, this organization aims to improve health care in the Mid-South by tackling problems such as diabetes and obesity.

Members include businesses, doctors, faith-based organizations, governments, hospitals, insurers, nurses, schools and universities.

For more information, visit healthymemphis.org.