FORT LAUDERDALE, Fla.—Maybe some people are starting to “get it.”
Blue Cross of California says it has invested $2 million to bring e-prescribing and “paperwork reduction” technology to more than 1,000 physicians who care for low-income and uninsured patients, according to a report in Health-IT World News last week.
While Blue Cross and Blue Shield plans elsewhere—Massachusetts and New Jersey come to mind—are rewarding medical practices for writing electronic prescriptions, the California program may mark the first time a major payer has helped financially strapped practices pay for information technology.
(I’m making the assumption that those who care for the poor and uninsured do struggle to make ends meet, unless California somehow solved its budget crisis and suddenly bumped up Medicaid reimbursements. I think I’m safe here.)
WellPoint Health Networks, the for-profit parent of Blue Cross and Blue Shield plans in California, Georgia, Missouri and Wisconsin, now has helped nearly 20,000 physicians in those states automate their prescribing, billing, receivables and communications processes since the beginning of the year by purchasing hardware and software for doctors in its provider networks, according to the HITW story.
This gesture helps remove a key argument against investing in IT, that the efficiency and financial gains accrue to health plans, hospitals, pharmacy benefit managers and pretty much everybody else other than physicians themselves.
It’s a good start, but removing some of the paperwork associated with one payer is a rather small gesture as long as the HIPAA transaction regulations remain toothless. Even though CMS has said it really will start rejecting nonstandard claims, the fact remains that true standardization is impossible as long as each payer is permitted to add its own extensions to HIPAA-mandated code sets.
Plus, the WellPoint plan barely begins to address the general lack of technology in the U.S. healthcare system.
A recent poll of CIOs and other health IT professionals conducted by the Healthcare Information and Management Systems Society suggests that it may take a lot more money than even the $100 million President Bush wants in fiscal year 2005 to promote clinical IT. Only 22 percent of the 246 respondents say that $100 million from Washington will significantly boost the utilization of health IT.
Other results from the HIMSS survey send mixed signals. A majority of CIOs indicate that a national health IT infrastructure would be the most effective means of providing health information when and where it is needed.
Some strange political bedfellows, including Bush and Sen. Hillary Clinton, have come together to promote such a vision, but that’s another subject for another time.
However, only 38 percent of the survey pool want federal money to support the development of standards for data interchange, compared to the 42 percent who just want the government to give them the cash to subsidize technology purchases.
A quick glance at the program for this week’s TEPR conference here in Fort Lauderdale does bring some heartening news on the standards front: At least 27 vendors are participating in a demonstration project for the recently adopted Continuity of Care Record industry standard.
The registration goodie bag contains a USB drive loaded with hypothetical patient data in the CCR format. Attendees can take the drive to each vendor’s booth for a demonstration of interoperability when patients move between care settings.
Making the CCR work in a room full of health IT types is one thing. Getting medical practices to save patient records in standard format is another. Then there is the issue of convincing patients to carry USB drives, CD-ROMs, smart cards or even printouts of their medical histories when they switch doctors or get picked up by an ambulance.
At least doctors appear to be paying attention. I am writing this while sitting in on a seminar about implementing EMRs in small practices. Half the people in the room identified themselves as physicians.
That is about five times the number of docs who would have been here two or three years ago.