Companies poised to take part in EMR shift

Posted on Sun, Jan. 21, 2007

Poised to assist the medical sector in connecting the data

By Jane M. Von BergenInquirer Staff Writer
Imagine cradle-to-grave personalized health information, computerized and centralized.
Scary? Or part of the salvation of America's expensive and unwieldy health system? If it saves lives and improves efficiency, as proponents say, it will mean billions of dollars of business for hardware, software and consulting companies.
No wonder companies are positioning themselves to profit from electronic medical records.
Tens of billions of dollars worth of technology - depending on who's estimating and how - would be needed to bridge existing islands of medical information now stored in files in doctors' offices, pharmacies, insurance companies, hospitals, laboratories and workplaces.
Doctors' offices, now notoriously paper-dependent, would need to go digital. So would hospitals, and they would all need help.
Gone would be those under-the-bed cartons of old X-rays, children's immunization records, and medical bills. The pharmacist could log on to see all a patient's prescriptions, avoiding dispensing pills in harmful combinations.
An electronic medical record, linked to hospitals, doctors and pharmacies, would follow someone from her first day to her last. Under some scenarios, the individual would control the record; in others, control would remain with health-care providers.
Whether payers, such as insurance companies, or academics doing broad-based research would be able to link in remains an open question. So does the amount of access that employers would have.
However it is set up, it will cost billions to implement.
BBC Research & Consulting, a Denver market-research firm, predicts that the market for health-information technology will reach $34.7 billion in sales by 2011 - and that does not include computer systems used by insurers, employers or even individuals to keep track of their care.
"It bodes very well for a company like mine, being in the right place in the right time with the right product," said Dennis Gallagher, a salesman for Vitalize Consulting Solutions Inc. in Kennett Square, a 115-employee firm that helps hospitals and doctors convert from paper to electronic systems.
And it also bodes well for Gallagher's former employer, Siemens Medical Solutions USA - a multibillion-dollar unit of the German company with its U.S. headquarters in Malvern. Siemens is one of the nation's largest providers of clinical software coordinating patient care in hospitals and doctor practices.
Earlier this month, Gallagher and 130 other members of the Delaware Valley Healthcare Information and Management Systems Society went to the Siemens corporate campus for its regular monthly meeting.
The speaker?
Former GOP House Speaker Newt Gingrich, whose Center for Health Transformation think tank in Washington has been a major advocate of using information technology to enable patients to receive better care at lower cost. And Siemens, which helps fund Gingrich's center, is trying to boost its presence in the electronic-medical-record market.
"Our commitment is to educate" doctors and hospitals, said Connie D'Argenio, vice president of health services for Siemens, who introduced Gingrich at the event earlier this month. If doctors and hospitals want to spend money on technology, she said, "then we'll be well-positioned to be their partners."
About half of Siemens Medical's $10.3 billion in annual sales derives from the United States, and a sizable portion of that comes from information-technology systems that Siemens sells to coordinate and computerize clinical care in hospitals and doctors' offices.
For example, Siemens showed Gingrich its bar-code technology that requires a nurse, before dispensing medicine, to scan bar codes on her identification badge, on the medicine package, and on the patient's hospital bracelet. That raises the patient's chart on a computer wheeled into the room and confirms that the right patient is receiving the right dose of the right medicine at the right time, while also pointing out any potential counterindications and generating a care record for the future.
Gingrich said the government should finance an electronic medical network as part of the nation's defense system against, for example, a bioterrorism attack, just as Dwight Eisenhower initially funded the interstate highway as a national defense network during the Cold War.
"It is virtually inevitable that we will move to an electronic health record for every person, and that health record will start with prenatal care and end with analytics after you passed away," Gingrich said in his speech, which was Webcast to 803 Siemens customers and employees around the nation.
Although there has been talk of electronic medical records for at least a decade, several factors have been moving it to the forefront.
The rising cost of health care and its effect on the nation's competitiveness, the health needs of aging baby-boomers, leadership from the Bush administration nationally and the Rendell administration in Pennsylvania, and increased technological proficiency are all driving support for such records.
On Wednesday, Rendell included the idea of electronic health records in his sweeping plan to change how health care has been provided and funded in Pennsylvania.
Around the nation, experiments and projects are cropping up - financed by a variety of sources.
"Philadelphia is one of the most innovative leaders in this respect," said Elliot Menschik, founder of Hx Technologies in Center City.
In the second quarter, Hx Technologies' Philadelphia Health Information Exchange will begin to trade patient data - with patients' approval - among several competing health organizations, including the University of Pennsylvania Health System and Thomas Jefferson University Hospital.
Menschik said the launch would build on results from a 20-month experiment completed last year - an experiment that he said showed how electronic health records could improve patient care and cut costs.
His company analyzed medical imaging done in the two health systems, selecting imaging because CT scans, X-rays and MRIs are already digitized and would be easy to share.
The experiment showed that 20,000 patients sought care in both systems. These patients generated 125,000 imaging examinations. Of those, 10,000 would have been useful to doctors at the other hospital.
For example, a doctor at one hospital might have liked to compare older X-rays taken at the other hospital to improve diagnosis. Of the 10,000, 1,520 were straight duplicates that cost $218,000 - an expense that could have been avoided.
"Our company believes the strongest potential is working with the health plans," Menschik said. So far, funding has come from the National Institutes of Health and the hospital systems. He said he has been talking to local insurers.
Some regions, including Boston and California, have established nonprofit organizations to set up similar exchanges, called Regional Health Information Organizations. Next week in Washington, leaders will be sharing business prototypes at a conference sponsored by the U.S. Department of Health and Human Services.
Last month, five major corporations - among them Intel Corp., Wal-Mart Stores Inc. and Pitney Bowes Inc. - announced they would finance the development of Dossia, a Web-based personal health record available to their 2.5 million employees, dependents and retirees.
Controlled by employees, Dossia would cull information from their doctors, hospitals and pharmacies to create a comprehensive health history that would be portable and private.
"As an employer, we've got 50,000 people," said Colin Evans, director of policy and standards at California-based Intel.
Evans said the company's motivation in financing Dossia was more about concerns it has as one of the nation's largest employers, rather than for potential new business it might garner through electronic medical records.
"We spend half a billion dollars on health care every year," he said. "One could argue that it is out of control. The amount we spend on health care is pricing jobs out of the U.S. to other places."
From Paper to Computer
Here's a glossary of some of the most frequently used terms for digital medical information:
Personal Health Record (PHR): Controlled by individuals, these records could include prescriptions, laboratory results, physicians' reports, lab images. Some think these records should also link to sources of relevant medical information, including, for example, help in controlling diabetes or asthma.
Electronic Medical Record (EMR): Controlled by doctors or hospitals, these records keep track of the care given to patients in a clinical setting. These can also assist with billing.
Computerized Physician Order Entry (CPOE): These systems keep track of physicians' orders, partly to ensure that bad handwriting doesn't contribute to medical errors.
Regional Health Information Organization (RHIO): Typically nonprofits, these organizations orchestrate the electronic exchange of information among area hospitals and other providers, with the consent of the patients. They choose standards and protocols.
Health Information Exchange (HIE): The technology infrastructure that a RHIO would use.
Workplace reporter Jane M. Von Bergen and Elliot Menschik, founder of Hx Technologies, chat online at noon tomorrow about how sharing digital patient information could improve care and cut costs.
Read more at http://go.philly.com/hxfiles.
E-mail your questions to: businessnews@phillynews.com.