System will track uninsured patients' care
By Phil Galewitz, Palm Beach Post Staff Writer
Sunday, January 15, 2006
People without health insurance often lack their own family physician and end up bouncing around between hospital emergency rooms and free clinics to see a doctor.
As a result, patients' medical records are often scattered across many locations, which can handicap the doctors and other health-care providers. Without the records, medical tests are often unnecessarily repeated and drugs may be ordered that conflict with patients' other medicines.
To resolve this dilemma here and to make care for the uninsured more efficient, Palm Beach County health leaders are establishing an electronic health record system so hospitals, free clinics and community health centers will be able to instantly retrieve a patient's medical records on a computer.
The effort got a big boost this month when the state awarded a $250,000 grant to the Health Care District of Palm Beach County to set up a shared health records system that can be used by Glades General Hospital and the C.L. Brumback Health Center. The hospital and health center are both in Belle Glade. The West Palm Beach-based Quantum Foundation last year set aside another $550,000 to expand the shared health records system to clinics and hospitals countywide.
Palm Beach County would become one of the first communities nationwide to have such a shared medical records system for the uninsured and people on Medicaid, the state-federal health insurance program for the poor. Local health officials plan to have the system ready for use by early next year.
At the forefront of the effort is the Palm Beach County Community Health Alliance, a 2-year-old group of health-care providers and donors that is trying to improve medical care to the 250,000 uninsured people in the county.
"This is very exciting," said Paul Gionfriddo, executive director of the alliance. "It means we are ready to roll and begin building our system in partnership with the state."
The state funding will speed the completion of a computerized health records database, Gionfriddo said. He said it took three years to build such a system in Austin, Texas, but it should take less than two years in Palm Beach County. The money from Quantum will enable the alliance to hire a director of technology, along with legal, business and technology consultants.
"One of health care's deepest problems is the fragmentation of services and lack of data sharing," said Jeannette Corbett, Quantum's president. "This grant gives our safety-net (medical) providers the opportunity to bridge that gap."
Gionfriddo, who was hired last summer, led a similar effort in Austin, as part of a larger initiative to improve care to the uninsured. He was hired largely to replicate the Austin model here.
Other steps the health alliance is taking to improve care to the uninsured in Palm Beach County include forming a volunteer physician network, which started last fall with 300 doctors, and a common eligibility system that will make it easier for residents to apply for various health, economic and social services programs.
Developing electronic health records is just the beginning of using computers to improve care to the area's uninsured. Eventually, medical-care providers will be able to schedule appointments with volunteer doctors and clinics online and also use the system to locate translators to accompany patients on doctor visits.
Among the clinics that expect to benefit from the shared health records will be the Caridad Center, a migrant health clinic west of Boynton Beach.
"This system will help us provide better care and help us be more efficient," said Pedro del Sol, the center's chief executive officer.
Caridad has recently started to put its own patient records on a computer, but the sharing of the records countywide will be a help when Caridad's patients go to emergency rooms and other places for care, del Sol said.
The computerized health records would include a summary of a doctor's notes about a patient, a list of drugs prescribed, the results of diagnostic tests and other background about the patient's medical history.
In some ways, the system being put together for the uninsured in Palm Beach County will be better than what exists for insured residents.
Storms prove incentive
Though state and federal health leaders have promoted the computerization of health records for the past several years, most private doctors offices have stuck to the traditional paper record because they don't want to spend the money to computerize their records.
Hurricane Katrina has provided a renewed push for a nationwide electronic medical records system. That's because wind and water destroyed millions of paper medical records of residents along the Gulf Coast.
President Bush has proposed spending $125 million to test computerize health records, more than twice what is being spent this year.
U.S. Health and Human Services Secretary Mike Levitt has said wider use of computers for medical information brings "lower costs and fewer mistakes."
The $250,000 in state funding for the Palm Beach County project is part of a $1.5 million budget that the legislature allocated in May toward privacy-protected electronic health records in Florida. Gov. Jeb Bush wants to increase the funding to $5 million in the 2006-07 budget.
"Electronic health records are a vital part of the future of health care in our nation," said Alan Levine, secretary of the state Agency for Health Care Administration. "By embracing the concept, we're making a long-term investment in the quality of health care for each and every Floridian."
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