Adoption of e-health records depends on consolidation of systems

Too many networks place too much of a burden on private clinicians, who provide the bulk of the care under national and military health programs.

To spur the adoption of electronic health records nationwide, federal agencies must work together to reduce the number of health information systems that doctors and insurers need to access to provide care, top officials with federal health care agencies said on Wednesday.

Comment on this article in The Forum.The Centers for Medicare and Medicaid Services works with 700 health care plans providers, which in turn process payments to clinicians, Henry Chao, the agency's chief technology officer, told attendees of a conference sponsored by the Bethesda chapter of the Air Force Communications and Electronics Association. He said CMS needs to figure out how to streamline the way front-line clinicians deal with multiple payers and insurers so they can reduce their workload.

Agencies in the health care field should develop standard systems and interfaces, said Mary Ann Rockey, deputy chief information officer for acquisition at the Military Health System. Doctors who provide health care for active-duty and retired military personnel and their families through the agency's TRICARE managed health care plans also deal with multiple insurers.

Doctors in the private sector, "don't want to access multiple systems" to manage billing, she said. Clinicians in the private sector provide 65 percent of the health care services in the MHS system and 40 percent in the Veterans Affairs Department system, Rockey said.

Although the Health and Human Services Department has adopted more than 50 health care IT standards in the past three years, Rockey said the standards vary and are not widely used, which also inhibits clinicians from adopting the health IT systems.

But agencies are exchanging information, even among complex health care IT systems. Every doctor in VA can access the MHS health records of soldiers wounded in combat, a database called the Theater Medical Record. VA and MHS also are electronically exchanging pharmacy and medication allergy information, according to Rockey.

Two federal hospitals and a private hospital in the Washington area have pooled their resources to handle a potential local disaster, said Dr. Steven Phillips, director of specialized information services at the National Library of Medicine, which is part of the National Institutes of Health.

The hospitals -- the National Naval Medical Center, the National Institutes of Health and Suburban Hospital, all in Bethesda, Md. -- are connected by a sophisticated communications system, which includes dedicated fiber-optic circuits. The system also has an over-the-air free space laser backup, which is part of a project initially funded by Congress in 2004. The three hospitals will use the system to coordinate a response to a disaster, including collecting the identities of patients from radio frequency identification tags that are attached to them.