Indiana Health IT May Be Model for Federal Stimulus Grants

Summary:

• One-third of Indiana’s patients have electronic medical records
• U.S. earmarks $19 billion for health IT
• One doctor says he’d never go back to paper records

On a Friday afternoon in 2006, a medical computer network linking 6 million patients noted a surge in cases of an intestinal bug causing nausea and vomiting. Within 24 hours, it was traced to an Indianapolis grocery selling tainted custard-filled doughnuts.

The quick detective work is just one example of the efficiency of the Indiana Health Information Exchange. Launched five years ago, IHIE connects 39 hospitals, 10,600 doctors and millions of patients in a secure computerized network. Medical professionals, wherever they happen to be, can instantly download lab reports and treatment histories. They say the system saves money and helps doctors deliver better care to patients.

IHIE could serve as a model as the federal government infuses $19 billion in stimulus money into health IT infrastructure.

• Only 17 percent of doctors and 10 percent of hospitals nationwide have electronic systems.
• In Indiana, one-third of all Hoosiers’ medical records are computerized — and the number is growing.

“We started down the road earlier than some others,” said J. Marc Overhage, M.D., president and CEO of IHIE. He said IHIE is talking with the new federal health IT agency. “I hope they are incorporating some of what we do in their plans.”

IHIE, a nonprofit based in Indianapolis, got its start as a research project funded by the philanthropic Regenstrief Institute. The institute sought a solution to the problem created by patients moving from doctor to doctor without their records following them.

Advantages of electronic medical records

With electronic messaging, a lab report can be delivered in near real time to a physician’s computer for one-fourth the cost of a paper report. Using patient data trends, health officials have the tools to quickly spot disease outbreaks and pinpoint the source. Physicians can view a patient’s complete medical report, including recent tests, thus reducing errors and test duplication.

It also helps doctors contact patients who should come in for care — for example, by creating a list of patients older than 50 who haven’t had a colonoscopy or women over 40 who haven’t had a mammogram recently.

And it can be a lifesaver for older people, who see an average of six doctors a year and may not be able to recall what year they had surgery or which drug made them sick.

“We think health information technology is a great step in the right direction,” said June Lyle, AARP Indiana state director. “Hopefully it will be a jump-start to a better and less expensive health care system.”

The Obama administration estimates such a system would save more than $12 billion a year and reduce medical errors.

One doctor's testimonial

One believer is Scott Eshowsky, a family practice physician in Granger. His group switched to an electronic system in 2006.

Eshowsky said a patient visit now starts with a nurse asking questions and entering the answers into a laptop with custom software rather than onto a paper chart. The software presents a template of questions for the condition, such as a sore throat. The program then creates a well-organized report that the nurse e-mails to the doctor. After the doctor examines the patient, a test may be ordered. The nurse enters the test results into the program and e-mails the report to the doctor’s laptop. If the test is positive, the doctor chooses a medication and dosage and e-mails the prescription to the pharmacy. The pharmacist doesn’t have to decipher illegible writing, thus decreasing errors.

An electronic system is the way to go, Eshowsky said. “I would never go back. It is light-years better than the old way.”

Nancy P. Johnson is a freelance writer based in South Bend, Ind.