Survey shows most rural doctors in Southern Kentucky aren’t ready for electronic health records; grant will help them switch

A recent survey found that 63 percent of rural health providers in Southern Kentucky have not installed electronic health records software, so more than 280 of the small and rural doctor practices surveyed could face financial penalties from Medicaid and Medicare if they do not install it by 2015. Federal grant money will help them make the switch.

Many rural Kentucky providers are near retirement and are deciding between making the necessary investment of capital and personnel that is required to make the switch to electronic records or to just close their practice, according to a release from Kentucky Highlands Investment Corp., which led the effort to get the grant

Decisions to close practices and to avoid using electronic health records could be problematic to rural areas in Kentucky, since the state already has doctor shortages, especially in rural areas. If the state expands the Medicaid program under federal health reform, the number of insured patients could increase much more than the number of physicians in Southern Kentucky, an area where many people are uninsured.

“Large hospitals in the region such as ARH, Baptist Regional and others have successfully installed this software, and they are using the system with quality results,” Richard Murch, an IT consultant who specializes in electronic health records and is working on the project, said in teh release. But he said the process is complicated and requires extra staff and resources that are sometimes difficult to find in the area.

The U.S. Department of Agriculture has funded a project called Stronger Economies Together to improve the biomedical and life-science practices in the region. SET plans to provide resources and training to help providers and health systems make a successful switch to electronic health records, which the release said could create about 100 jobs over the next few years.

The survey showed 73 percent of doctors’ practices have asked for help transferring to and using electronic records. “SET reviewed industry sector research to determine health care and health related businesses as the fastest growing business segment of our rural economy,” said Jerry Rickett, president and CEO of Kentucky Highlands. For more information about SET and its partner programs, click here.

Report: Electronic health records haven't cut health costs

The conversion to electronic health records isn't producing savings in health-care costs predicted by a 2005 report, and it's had mixed results in improving efficiency and patient care, according to a RAND Corporation report. The company's 2005 predictions helped drive growth in the EHR industry and encourage billions of dollars in subsidies from the federal government to hospitals and doctors to implement such systems, Reed Abelson and Julie Creswell of The New York Times report.

The 2005 report predicted that widespread use of EHRs could save the U.S. health care system at least $81 billion a year. "But evidence of significant savings is scant, and there is increasing concern that electronic records have actually added to costs by making it easier to bill more for some services," Abelson and Creswell write. Health care costs have risen $800 billion since the 2005 report, according to federal data.

Authors of the new report, published in this month's issue of Health Affairs, said they didn't attach dollar amounts to how much electronic record keeping has helped or hurt efforts to reduce costs. "But the firm's acknowledgement that its earlier analysis was overly optimistic adds to a chorus of concern about the cost of the new systems and the haste with which they have been adopted," Abelson and Creswell report.

There are several factors why the switch has not created significant savings, report authors said. Those factors include use of commercial record systems, slow rates of system adoption, and the fact that electronic records "do not address the fact that doctors and hospitals reap the benefits of high volumes of care," Abelson and Creswell report. (Read more)

UK creates nation's first cancer-reporting system that uses electronic health records

Kentucky has the highest incidence of cancer in the United States, but it is about to be a national leader in delivering information about cancer cases to researchers.

With the help of an almost $1 million Centers for Disease Control grant, the University of Kentucky has created the nation's first working model for electronic reporting of cases to the state cancer registry. Kentucky's cancer doctors will be able to feed clinical data to the state's epidemiologists immediately so that they can see and analyze cancer statistics more quickly that ever before.

“This project is laying the groundwork for electronic reporting not only in Kentucky but across the United States,” said Eric Durbin, director of Cancer Informatics at the Kentucky Cancer Registry and one of the investigators who created the model. (Read more)

Hospitals are not reporting cases of harm to patients; electronic health records may be key to solving the problem

By Tara Kaprowy
Kentucky Health News

Hospitals aren't reporting cases in which medical care harmed a patient, making it difficult for providers to identify problems and fix them, according to a report to be released by the U.S. Department of Health and Human Services.

The report indicates many hospitals are ignoring state regulations by not reporting preventable problems. In Kentucky, there are no mandatory public reporting requirements for hospitals. They must only inform the state Department of Public Health about infectious outbreaks, but the definition of an outbreak varies from facility to facility, based on the number of patients seen in a specific period of time.

Dr. Kevin Kavanaugh, a retired physician and chairman of Health Watch USA, said the report points to "the need for greater health care transparency and state government engagement."

The study's lead researcher, Lee Adler, is looking to electronic health records to set things right since "we may be able to prevent events, we may be able to ameliorate events, and (electronic records) may become your surveillance system," he said.

The software can be designed to "catch triggers for potential errors," Kelly Kennedy reports for USA Today. One example could involve a patient that is given an antidote after a medication overdose. The fact that the antidote was used would trigger an alert to a hospital quality control officer, who would them follow up in turn. (Read more)

About half of doctors are using EHRs nationwide, the latest survey from the Department of Health and Human Services shows. "That's a pretty high number, historically speaking," reports Sarah Kliff for The Washington Post. "As recently as 2005, just about a quarter of doctors' offices had gone digital."

In February, Health and Human Services Secretary Kathleen Sebelius said the percentage of hospitals using electronic health records has doubled in two years, Medical News Today reports. The shift at doctors' offices and hospitals stems from a provision in the federal health-care reform law, which gives financial incentives to facilities that switch over to EHRs.

In Kentucky, 723 eligible professionals and 15 hospitals have already been paid their incentives, which totaled more than $155 million as of May. In February, Sebelius said almost 2,000 hospitals and more than 41,000 doctors had received more than $3 billion in incentive payments to use health information technology. The proportion of hospitals that now use EHRs went up from 16 percent in 2009 to 35 percent in 2011. More than 80 percent of hospitals said they intend to advantage of the incentives by 2015.

Kentucky Health News is a service of the Institute for Rural Journalism and Community Issues, based in the School of Journalism and Telecommunications at the University of Kentucky, with support from the Foundation for a Healthy Kentucky.

Electronic patient records may not save money, study finds; critics question methodology

Though officials tout otherwise, a study has found electronic health records do not cut costs "and may actually encourage doctors to order expensive tests more often," reports Steve Lohr for The New York Times. (Photo by Keith Srakocic for The Associated Press)

The study, published in the journal Health Affairs, found doctors using EHRs to track tests, such as X-rays and MRIs, ordered 40 percent more tests than those using paper-based records. Doctors with access to a patient's previous image via a computer "ordered tests on 18 percent of the visits, while those without the tracking technology ordered tests on 12.9 percent of visits," Lohr reports. And when it came to more expensive and advanced tests, like MRI and CT scans, doctors using EHRs ordered more tests 70 percent of the time.

The study was based on a survey conducted by the National Center for Health Statistics, and included data from 28,000 patient visits to more than 1,100 doctors in 2008. It contradicted a 2005 study from RAND Corp., which estimated that EHRs could save as much as $80 billion a year. The Obama administration used that study as justification for $19 billion in federal spending to help providers switch to digital technology.

EHR supporters were critical of the latest study for using the NCHS data, which they say is used to assess how medical care is practiced, not how well computerized patient records work. It also "included any kind of computer access to tracking images, no matter how old or isolated the function," Lohr reports. Modern EHRs are more integrated in their function and must meet federal standards for "meaningful use" — guidelines that were not in place in 2008.

Dr. David Blumenthal, professor at Harvard Medical School and former national coordinator for health information technology for the Obama administration, found 92 percent of articles published in professional journals on EHRs were "positive over all" regarding whether the technology would improve efficiency and quality of care. Dr. Danny McCormick, lead author of the new study and assistant professor at the same school, argued his analysis "looked at not just a few cutting-edge institutions, but a nationally representative sample." (Read more)

Medical records of 1,018 patients stolen at Lexington Clinic, but no apparent identity theft

One of the fears of electronic health records is that personal information can be stolen en masse, a possibility that became a reality when a laptop computer was stolen at the Lexington Clinic.

The machine was taken Dec. 7 from the clinic's neurology department at the St. Joseph Office Park. Letters were sent to the 1,018 affected patients last week about the theft, Mary Meehan of the Lexington Herald-Leader reports.

The laptop contained the names, contact information and diagnoses from patients from as long as five years go. Not among the data were Social Security numbers, credit card or bank account numbers. So far, there is no sign of identify theft. 

The clinic said it took six weeks to informing patients because it took time to "pinpoint exactly what information was on the laptop, which was used in conjunction with the clinic's electromyography machine," Meehan reports.

Another theft happened at UK HealthCare in June, when the medical records of 3,000 patients were taken from the Department of Pediatrics' newborn screening program. Patients were not informed of that breach until two months later. (Read more)

Kentucky center helps more than 1,000 providers get electronic health records

The Kentucky Regional Extension Center has helped more than 1,000 health care providers transition to electronic health records, with specialists advising providers so they can meet the federal standards of "Meaningful Use."

"Quick access to electronic health records can make the difference in a provider's ability to treat the patient, whether it means checking a patient's cholesterol during a routine examination or identifying a medication allergy during an emergency," said Dr. Carol Steltenkamp, who directs the KY-REC and is the chief medical officer and pediatrician at UK HealthCare.

The adoption of EHRs by providers doubled from 17 percent in 2008 to 34 percent in 2011, the National Center for Health Statistics reports. As of Nov. 30, 2011, the Centers for Medicare and Medicaid Services had paid out more than $920 million in Medicare EHR incentives and $916 in Medicaid incentives, UKNow reports. The use of electronic prescribing, which allows physicians to generate, transmit and file patient prescriptions, has increased from 0.8 percent in December 2006 to 40.2 percent in September 2011, the nation's largest e-prescribing network Surescripts reports. (Read more)

Electronic health records are helping nurses provide better care, big study finds

Electronic health records are helping nurses get better health outcomes and are improving nursing care, the first big study on the subject has found.

The study conducted by the University of Pennsylvania School of Nursing involved 16,000 nurses at 316 hospitals in California, Florida, Pennsylvania and New Jersey. It found that "implementation of an EHR may result in improved and more efficient nursing care, better care coordination, and patient safety," wrote lead author Ann Kutney-Lee, a health-outcomes researcher at Penn Nursing.

The study, which was published in the Journal of Nursing Administration, also found, "having a basic EHR was associated with better outcomes independently of nurse staffing, indicating that they both play an important role in quality of care."

Nurses in hospitals that had comprehensive EHR systems were "significantly less likely to report unfavorable patient safety issues, frequent medication errors, and low quality of care," research-reporting service Newswise reports.

The most current estimates show just 12 percent of U.S. hospitals have an EHR system in place, but that will change with the Health Information Technology for Economic and Clinical Health Act. Starting in 2011, hospitals and physicians received incentive payments from Medicare and Medicaid to switch over to EHRs. The study did not measure outcomes in rural vs. urban settings "although we do know from other studies that hospitals that used electronic health records during this time period were less likely to be in rural areas," Kutney-Lee said. (Read more)

Health reform means millions more will be covered and more illness will be prevented, federal health official says at UK

By Tara Kaprowy
Kentucky Health News

What will the healthvcare system look like in 2020? Assistant Secretary of Health Dr. Howard Koh told a packed house in Lexington Monday that millions more people will have insurance, the patient will be at the center of a coordinated system, and there will be a great emphasis on prevention and public health "so the patient doesn't become the patient in the first place."

Koh talked about federal health-care reform during a panel discussion at the University of Kentucky's Albert B. Chandler Hospital. It also included Dr. Steve Hester, senior vice president of Norton Healthcare; Dr. Richard Lofgren, vice president of health care operations and chief clinical officer at UK HealthCare; and Stephen Wyatt, dean of UK's College of Public Health.

Koh said the current health-care system "is fragmented, it's episodic, it's not as coordinated as we would like, and there is still not enough attention to quality outcomes." But he said implementation of key parts of the health-care law would address those issues.

He said insurance is already more accessible, since companies can no longer refuse children with pre-existing conditions. By 2014, the same will be the case for adults. State insurance exchanges, which he called "a one-stop shop where buyers can compare plans," will inject "transparency in the whole market" and will ensure basic levels of coverage.

Insurance will also become more affordable, he said. The Medicare prescription "donut hole" is being covered; young adults can stay on their parents' plan until the age of 26; insurance companies must assure that 80 percent of their expenses go toward medical care and not overhead; and there will be a rate-review process, in which insurance companies wanting to increase their rates by 10 percent or more must formally defend their request.

Patient-centered medical homes will put the patient at the center of care and accountable care organizations, and "voluntary networks who have agreed to care for a defined Medicare population and also share in savings," will make coverage more coordinated, Koh said.

The law also puts systems in place for prevention and public health. On the individual level, new plans must cover "high-value preventive services and screenings," Koh said. Businesses are being encouraged to focus on wellness. The Centers for Disease Control and Prevention are offering community transformation grants so communities "can designs ways to make the healthy choice the easy choice," he said. And a national prevention counsel has been formed dedicated to public health.

The law also provides millions for health-care technology, which Hester said will revolutionize the health-care landscape and "the way we respond to patients." Koh agreed, saying a paper-based system "was another example of fragmentation. . . . prevSometimes you could find the chart, sometimes you couldn't. The electronic-based system will coordinate."

Hester said patients have recently become more equipped to accept the technology of electronic health records because they've become used to devices like smart phones. Logren said that, traditionally, patient records have been "proprietary." Electronic records will get information moving from place to place and will no longer be "owned."

Koh acknowledged one of the greatest challenges of the health-reform law is sustainability, but by 2020, he said "We will see stable funding and stable results" in public health and prevention. While the law has created divisiveness in the political arena, Koh said strong opinions about health care are a good thing because they generate discussion and passion. "We can debate many parts of the health reform law," he said, "but in the meantime, we are making progress."

Several pieces of federal health reform law taking effect in 2012

At the beginning of the new year, family doctors started facing a 1 percent cut in Medicare reimbursement if they hadn't nixed their paper-based prescription pads in favor of an electronic version. The change is part of another piece of the federal health-care reform law taking effect, USA Today reports.

"There will be a significant number of folks that will incur the penalty," said Robert Tennant, senior policy adviser with the Medical Group Management Association.

E-prescribing, which allows physicians to generate, transmit and file patient prescriptions, is part of the federal government's effort to get doctors to use electronic health records. Last year, doctors received bonuses from Medicare and Medicaid to set up EHRs, but this year they will start being penalized if they haven't already done so — 1 percent this year, 1.5 percent in 2013 and 2 percent in 2014.

Another piece of the federal health care reform law that will begin falling into place in 2012 involves Medicare's Shared Savings Program, "under which groups that qualify as accountable care organizations will be eligible for shared savings in 2013," USA Today reports. "Under the program, savings from participants in an ACO — including hospitals and doctors working together to improve patient care and reduce costs — would be shared between Medicare and the providers."

One study showed Kentucky already has three ACOs established, though several Kentucky experts have said no ACOs have been formed in the state yet.

Jan. 1 also marked the beginning of consumers being eligible for rebates if their insurer spent less than it should have on medical care. As per the new law, insurers have to spend 85 percent for large group plans and 80 percent for small groups and individuals on medical care as opposed to administrative and other costs. Kentuckians will not be privy to these rebates this year, however. Kentucky got a one-year break from the rule after applying for an exemption. (Read more)

Data leaks are a risk with electronic health records; state says it has safeguards to protect privacy

As hospitals and other health-care providers in Kentucky and across the country are adopting electronic health records to save money and improve care, they do so at some risk. The medical files containing insurance forms, Social Security numbers and doctors' notes of about 300,000 Californians were posted recently on the Internet, available to anyone who might stumble across them or know how to search for them. "At a time of mounting computer hacking threats, the incident offers an alarming glimpse at privacy risks as the nation moves steadily into an era in which every American's sensitive medical information will be digitized," The Associated Press reports.

"When things go wrong, they can really go wrong," said Beth Givens, director of Privacy Rights Clearinghouse, a nonprofit that tracks data breaches. "Even the most well-designed systems are not safe ... This case is a good example of how the human element is the weakest link."

Generally, data breaches are the result of hackers who break into computers or thieves who steal the actual equipment. Sometimes they can just be be caused by human error. Leaks can also happen as data passes through health industry networks. "Dozens of companies can be authorized to handle a single person's medical records," the AP reports. "The further away from the health care provider the records get, the flimsier the enforcement mechanisms for ensuring the data are protected."

One of the biggest breaches was in 2006 when a laptop containing data for 26.5 million veterans was stolen from the home of a government employee. The computer was recovered. This year, hard drives containing personal information of 1.9 million Health Net insurance customers were taken. They contained health histories, financial information and Social Security numbers. The matter is still under investigation.

In the wrong hands, "health records can be used for blackmail and public humiliation," AP notes. "The information can also be used by insurance companies to inflate rates, or by employers to deny job applicants."

Preventing data leaks is on the minds of Kentucky officials setting up the Kentucky Health Information Exchange, the state clearinghouse for EHRs. Participating providers have to sign several agreements in which they attest the information they obtain will be used responsibly. "The golden rule is this data will only be viewed by a provider who is providing care to a patient," said Jeff Brady, executive director of the Governor's Office of Electronic Health Information. To make sure that is happening, Brady said the software has an audit function, in which administrators are able to see who looks at a patient's data, when they did, from what computer and what piece of data was examined. (Read more)

Switch to electronic medical records not without concerns

Though touted as a way to improve patient care and supported by federal funding, Kentucky physicians have concerns about switching to electronic medical records. Doctors are worried about cost, lost productivity, the possibility that the technology becomes obsolete and that systems can't share information, The Courier-Journal's Laura Ungar reports.

"The main reason is financial. It's just so expensive," Dr. Emily Johnson of Kaplan Barron Pediatric Group, told Ungar. "Also, we'd have to take time out of the day and do training. It would be expensive to learn this new thing." Johnson's group plans to stick with its paper-based patient charts (Photo: Rebecca Dorwart, medical receptionist and recordkeeper, by C-J's Matt Stone)

But the Obama administration and health professionals say EHRs will "help reduce costs and make health care safer by avoiding such problems as duplicate medical tests and allergic reactions to medications," Ungar notes. The new health law will pay $20 billion in incentives to eligible doctors and hospitals who make the switch. Thoe who don't will get smaller Medicare and Medicaid reimbursements.

Last year, a Kentucky Medical Association survey of rural doctors (left) showed 45 percent didn't have an EHR system, and about half said they had no plans to have one. "The most frequently cited barriers to e-record adoption were lack of initial capital for software and training, concerns about loss of productivity and lack of technical support within the practice," Ungar reports. (Read more)

Electronic health records are the new frontier in health care

By Tara Kaprowy
Kentucky Health News

Just two years ago, the acronym EHR didn't mean much to many people. But since Congress passed the health-care reform law last year, physicians and hospitals have become intimately acquainted with it — and patients may follow suit.

EHRs are electronic health records. They are quickly being adopted by hospitals and physicians as the federal government begins to pay out $19 billion in incentives: extra Medicare and Medicaid payments. Kentucky health care facilities and providers have been especially eager to sign up, perhaps because so few of the state's doctors had adopted EHRs. Kentucky doctors' offices were the least digitized in the nation last year, according to a national survey.

An EHR is a digitized copy of a person's health record, essentially replacing the file folder that has typically held handwritten information about a patient. It generally contains information about a patient's laboratory and radiology results, diagnoses, prescriptions and other treatment.

EHRs' advantage is their easier accessiblity. Rather than being locked in a doctor's office, the information, in theory, can be accessed by other health-care providers, regardless of which one the patient is seeing. "It's about the information always moving with you," said Nancy Szemraj, spokeswoman for the Office of the National Coordinator for Health Information Technology.

"That's like the pot of gold," said Jeff Brady, executive director of the Governor's Office of Electronic Health Information. "If you've been to six different hospitals and three different doctor's offices, literally all of that data can be viewed."

EHRs are expected to reduce unnecessary tests and treatment because they will list tests that have been performed, and to reduce the potential for medical errors, because they containing such cautionary information as the patient's allergies.

Protecting your information

One risk of electronic health records is the potential for the information being leaked, lost, altered or merely read by an unauthorized person. Leaks can be purposeful or by accident. In January, the private information of thousands of people who visited the Green River District Health Department in Owensboro was found online, where it had been mistakenly available for several months.

Brady acknowledged the danger of unauthorized access, but said safeguards have been taken to avoid it. Participating providers in the Kentucky Health Information Exchange, the state clearinghouse for EHRs, have to sign several agreements in which they attest the information they obtain will be used responsibly.

"The golden rule is this data will only be viewed by a provider who is providing care to a patient," Brady said. To make sure that is happening, he said, the software has an audit function, in which administrators are able to see who looks at a patient's data, when they did, from what computer and what piece of data they examined.

The national network will not be a database, and thus not in danger of being hacked, said Szemraj, of the national office. "It's simply a means to securely push and pull information as needed," she said, citing an example of a person traveling around the country and falling ill in New York City. "At that time, they would be able to tap into your medical record in your home base and say, 'I want to pull your medical information.' It's not literally sitting out there in a repository where anybody could hack into it."

To set up EHR systems, hospitals and doctors choose from a list of federally approved software. The programs don't "necessarily have to communicate with each other," Brady said, "but they do have to conform to certain standards that would allow them to communicate with a health information exchange."

The state's exchange has been operating in the pilot stage since April 2010. It will act as a "middleman" between hospitals and health care providers, Brady said. "We will be the hub and all information will flow from a provider, to us, back to another provider."

Under ideal circumstances, Brady said he hopes to see half of the state's hospitals and doctors' offices connected to the exchange by the end of the year, with the other half signed on by the end of 2012. That may be ambitious, since a recent survey showed Kentucky had the lowest percentage of doctors' offices that have adopted EHRs, just 38 percent, compared to 51 percent nationwide.

While Kentucky builds its exchange, other states are doing the same. Eventually, the goal is to create a National Health Information Network that will allow information to flow from state to state. That will be especially beneficial to Kentucky, Brady said, "because we have so many hospitals and medical facilities on our border. We're talking to Tennessee and Ohio about exchanging data with them. There's going to be a lot of development in the next 12 months."

But when will the state information exchange or national network be useable? Brady said no date has been set for the state exchange, and Szemraj said of the national network, "We are truly just beginning."

Cost savings?

The Obama administration and other supporters of the health-reform law say EHRs will save money. A 2005 study by the RAND Corp. indicated that implementing EHRs and networks could eventually save more than $81 billion per year by improving health care efficiency and safety, but that study was theoretical in nature and assumed 100 percent compliance, Drs. Jerome Groopman and Pamela Hartzband wrote in an op-ed piece in The Wall Street Journal.

Some data show EHRs do not necessarily improve patient care, the doctors wrote, pointing to a study published in the journal Circulation that reviewed the influence of EHRs on the quality of care received by more than 15,000 patients with heart failure. It concluded that "Current use of electronic health records results in little improvement in the quality of heart-failure care compared with paper-based systems."

Another study looked at the Department of Veterans Affairs' health information technology investments and estimated a potential value of $3.1 billion "in cumulative benefits net of investment costs." But Brandon Glenn of Medcity pointed out "the study's lead researcher stressed the dollar amount reflects only what's possible — not actual savings."

The prevailing opinion in the industry is that EHRs will save money, but no one is really sure how much. On the expectation of savings, the health-reform law calls for extra Medicare and Medicaid payments to providers as incentives to adopt the technology. Providers have until 2014 to adopt EHRs. If they don't, Medicare will start penalizing them by paying them less in Medicare payments.

A rural equalizer?

Since the Centers for Medicare and Medicaid Services started distributing EHR incentive payments in January, Kentucky hospitals and other health-care providers have received more than $18 million of about $38 million handed out nationwide so far. University of Kentucky Healthcare and Central Baptist Hospital, which together received $4.1 million, were the first facilities in the nation to receive the extra payments. In the next four years, Kentucky hospitals are expected to receive more than $100 million in incentives.

For a spreadsheet of incentives paid to Kentucky providers through last week, click here.

To receive the incentives, which can mean up to more than $60,000 for eligible professionals and millions for hospitals, applicants must prove their EHR systems are being used in a meaningful way. To show "meaningful use" in the first of three stages — the only stage that, so far, has been officially defined — eligible professionals must show "continuous quality improvement and ease of information exchange," according to regulations in the Federal Register. Professionals must meet 25 measures, hospitals 24, to prove meaningful use. One measure, for example, is the ability to send electronic data to the state's immunization registry.

The list of incentives already paid shows providers in the most rural to the most urban areas areas of Kentucky are switching over at equally rapid rates. In fact, two of the few hospitals already linked up to the Kentucky Health Information Exchange are Pikeville Medical Center and Murray-Calloway County Hospital, both outside metropolitan areas.

Brady said the Office of the National Coordinator for Health Information Technology "is very interested in rural areas, the critical-access hospitals, the very small but important hospitals . . . that typically get left out on technology. This an effort to bring them along and be the equalizer."

Kentucky doctors' offices are the least digitized in the country; increase expected nationwide

Kentucky has the lowest percentage of doctors' offices who have adopted electronic health record systems, says a survey released by the Office of the National Coordinator for Health Information Technology.

Just 38.1 percent of Kentucky health clinics are digitized, compared to 51 percent nationwide. Louisiana (39.1 percent) and Florida (39.4 percent) were second and third lowest, respectively. Minnesota tops the list, with 80.2 percent of its offices paperless, followed by Massachusetts (77.3 percent) and Wisconsin (75.4 percent). The survey data were compiled by the National Center for Health Statistics.

Those numbers are expected to grow nationwide. Hospitals and physicians can now register for the Medicare and Medicaid EHR incentive programs, which give federal funds to facilities that have adopted EHRs. Kentucky physicians and hospitals are among the first nationwide to be eligible to receive incentives from both programs. University of Kentucky HealthCare and Central Baptist Hospital in Lexington were the first hospital systems in the country to receive funds — which totaled $4.1 million — from the incentive programs. Another 25 Kentucky providers have started the application process.

Interest in EHR systems, which are believed to improve the quality of health care and patient outcomes, is growing nationwide. A survey by the American Hospital Association found that 81 percent of the nation's hospitals plan to take advantage of the incentive programs. NCHS numbers showed 41 percent of office-based physicians are planning to do the same. (Read more)

The changeover is expected to create a substantial surge in EHR software technology. World Market Media reports the market for electronic health record software is expected to reach $3.8 billion by 2015. (Read more)

Private information of Owensboro-area patients found on Web

The private information of thousands of people who visited the Green River District Health Department has been mistakenly available for perusal online since October.

Owensboro's Messenger-Inquirer found 9,986 names and personal information, including birth dates and Social Security numbers, of Daviess County residents last week after receiving a tip by Mickey Franzman, who stumbled on the information while doing a Google search on one of her relatives. The information included a database of health department clients.

The problem was fixed immediately by Intregranetics after the company was informed of it. "The information that was out there from the health department, it was nothing they did," President Michael Hobson told reporter James Mayse. "It was my responsibility ... It wasn't anything done intentionally."

Debbie Fillman, health department director, said Thursday that steps were in place to inform people who could have been affected. (Read more)

UK, Central Baptist get millions in federal incentives to use electronic health records

University of Kentucky HealthCare and Central Baptist Hospital in Lexington are the first hospital systems in the United States to receive funds from the Centers for Medicare and Medicaid Services' electronic health records incentive program.

UK received $2.8 million, Central Baptist $1.3 million, according to a press release from the state Cabinet for Health and Family Services. Kentucky is one of only four states to begin receiving the federal dollars, which are meant to encourage hospitals and physicians to transition to computerized patient records. The funds are part of the 2009 economic-stimulus legislation.

Another 25 Kentucky providers have started the application process. In the next four years, Kentucky hospitals should receive more than $100 million in incentive funds, the release states. "Electronic records can do so much to improve efficiency, reduce medical error and, ultimately, change the face of the American health care system," Gov. Steve Beshear said.

Kentucky is among the first to receive the funding because its providers were "farthest along in the process in moving down the path to adopting these types of systems," said Beth Fisher, spokeswoman for the Cabinet for Health and Family Services. "This means we're pretty far ahead than a lot of other states." (Read more from Business First; for the original press release, go here.)

Kentucky is one of 11 states with federal incentives for using electronic records in Medicaid

Medicare is now offering incentives to hospitals and eligible health-care professionals for the use of electronic health records, but Medicaid is doing so in only 11 states. Kentucky is one of them.

Dr. Donald Berwick, administrator of the Centers for Medicare and Medicaid Services, said the change from paper records will be challenging, but CMS and the Office of the National Coordinator for Health Information Technology "have taken steps to ease the transition."  

The federal programs encourage physicians and hospitals to transition to computerized patient records, because they are believed to improve the quality of health care and patient outcomes. Through Medicare, Mosquera reports physicians can get up to $44,000 over five years by participating. For Medicaid, eligible professionals can receive as much as $63,750 over six years. Under both programs, participating hospitals may profit by millions of dollars, Government Health IT's Mary Mosquera reports.