EMR Initiative: BCBSMA Steals a March

One Massachusetts community is going find out if electronic medical records really can deliver revolutionary improvements in the quality and cost of healthcare.

Backed by $50 million from Blue Cross Blue Shield of Massachusetts (BCBSMA; Boston; $7.8 billion in revenue), a group of healthcare insurers, doctors, hospitals and others in the state plan early next year to wire one community with interoperable electronic medical records. They hope the pilot project will convince the state's healthcare industry that digitizing and sharing patient records will mean better medical decisions, fewer errors and lower costs.

"A lot of studies say the use of IT has the potential to transform the healthcare industry," says Carl Ascenzo, CIO of Blue Cross Blue Shield of Massachusetts. "But bottom line, unless as an industry we work collaboratively to make this happen, it will happen at an excruciatingly slow pace - like it has so far."

The collaboration includes more than 30 organizations, including health-related state agencies and large employers that pay for health insurance. The community hasn't been chosen yet, but Ascenzo says several already have volunteered.

Massachusetts' effort follows a pledge by President Bush earlier this year to get most Americans e-records within 10 years - a goal Democratic presidential candidate Sen. John Kerry (D-Mass.) says could be reached slightly sooner.

The Massachusetts collaborative's goal is to expand electronic medical records throughout the state within seven to 10 years, Ascenzo says. The pilot will last about 18 months.

Other communities have done pioneering work with interoperable healthcare systems, but none has reached the level of adoption that the Massachusetts effort expects to achieve. The group's plan for getting doctor cooperation is simple: Pay them. Doctors will get payments or grants that compensate for some of the costs and disruption of implementing the technology.

John Halamka, CIO at CareGroup Healthcare System (Boston), which operates five Boston-area hospitals and is part of the cooperative, says that's vital to the project's success. "Doctors need [incentives] in order to foster the adoption of electronic medical records because it's the insurance companies that get the biggest payback in this," he says.

An obstacle to e-records adoption is that healthcare providers bear 80 percent or more of the cost and cultural-change burden, but payers get 80 percent or more of the savings, BCBSMA's Ascenzo says. Insurance companies save through less paperwork, fewer redundant tests, better adherence to preferred drug lists and the like. CareGroup's Halamka estimates a statewide e-records project could cost $1 billion, but he still believes statewide adoption could happen in as few as five years.

The project will involve peer-to-peer communications, where patient data such as lab results can be shared among providers but without ownership of the source data changing. There won't be any centralized database of patient records, and the system will have to comply with the privacy and security regulations of the Health Insurance Portability and Accountability Act (HIPAA).

Marianne Kolbasuk McGee is a former editor for InformationWeek. View Full Bio