MidSouth eHealth Alliance questions future of patient information when funding ends

Memphis Business Journal
March 14, 2007
By Toby Sells

Quantifying the value of sharing patient information has become a major focus of the MidSouth eHealth Alliance in its fourth year of a five-year program.

Questions are arising now as to who will pay for that value and keep the technology project afloat once state dollars run out in a year. So far, the "experiment" has been funded with a $4.8 million grant from the federal Agency for Healthcare Research and Quality and a five-year, $7.2 million grant from the state of Tennessee.

The project has made team players of rivals to electronically share patient information among nine Memphis-area hospitals and more than a dozen local clinics. Together they have produced 2.1 million medical records from 880,000 patients.

While the major goal of the project is to improve patient care, another is to control costs. So far, there is anecdotal evidence to suggest the system is working to keep costs down, but the dollar figure is hard to find.

"We can't just go through and count chest X-rays," says Kevin B. Johnson, associate professor and vice chair of the Department of Biomedical Informatics at Vanderbilt University. "A patient might come in today and want a chest X-ray for one thing, but may come in the next day and need a chest X-ray for something acute, like maybe they swallowed a penny."

Johnson and MSeHA will work this year to find those hard numbers. In the meantime, Johnson points to national numbers that show "savings of more than $500,000 can be realized related to lab radiology" alone and money saved from shortened hospital stays.

Numbers from RAND Corp., a nonprofit think tank, estimate that more than $1.7 trillion is invested in American health care every year and that $77 billion could be saved by investing in electronic medical records, the cornerstone of sharing patient information.

Most affiliated with MSeHA agree that cost savings are there and will grow greater if the program continues past its five-year trial period. They also wonder who will pay for it.

"It has to be a two-prong approach," says Antoine Agassi, the director and chair of Gov. Phil Bredesen's eHealth Advisory Council. "If you benefit, you have to pay. If you receive data without contributing data, you have to pay. These have to be the fundamental building blocks."

Bob Gordon, chief administrative officer for Baptist Memorial Health Care Corp., says while hospitals, physicians and patients all benefit from sharing information, there is a role in the equation for insurance companies.

"It will be a difficult task, but I think it will be much easier in that we can show them evidence of what we've been able to accomplish," Gordon says.

But a look at MSeHA numbers shows a simple opportunity for internist Bill Stead, director of the Informatics Center at Vanderbilt.

"You've got close to a million patients involved in this so if you got $1 per (patient) then that gives you a million bucks," Stead says. "I also think the facilities need to pay because if this doesn't have a value, then I'm not sure why we're doing this."

Whatever MSeHA's next move, the nation will be watching. By many accounts, Memphis' regional information organization has succeeded where many across the country have failed.

"This is exciting work that is getting national attention. Other groups that want to hop on the bandwagon are finding us to be a really good pilot site," Johnson says. "This is an experiment in many ways. It's like watching a really good cook do some crazy stuff with crawfish.

"What we're doing is an amalgam of many different projects that have gone on around the country to see if we've got the right special sauce to make this succeed so we can help others."

MidSouth eHealth Alliance

Regional health information organization
Executive director: Thomas E. Duarte
Participating hospitals: 9
Address: 20 S. Dudley
Phone: (901) 448-2570
Web site: www.midsoutheha.org