Federal, State Officials Prescribing Digital Health Care Records

From the San Diego County Medical Society to the president of the United States, a flurry of steps are being taken by officials toward data sharing systems for the health care industry.

Last week, information officers from local hospitals and officials from the San Diego County Medical Society met with Cindy Ehnes, director of the California Department of Managed Care, which oversees the state’s HMOs, to tell her of local efforts to create an electronic Regional Health Information Organization. The system would link health records among medical professionals. Medical Society President Tom Gehring said his group did not make any official requests to Ehnes and called the meeting a “fact-finding session.”

“We want to let her know how one county has grappled with this problem,” Gehring said. “So she can go back to Sacramento and use this as she formulates policy.”

One of the main obstacles to building the RHIO is hospitals and doctors who cannot afford to participate or do not want to invest in the technology out of fear it will not be compatible with state or federal systems once national standards are mandated.

But that might be coming soon.

In May, Michael Leavitt, federal Health and Human Services secretary, came to town and met quietly with health care executives and other community leaders, promising San Diego a likely role in a pilot project on health care information technology and price transparency.

He said a request for proposals to participate would be issued within a couple of weeks, attendees had said. But several local leaders who were at the meeting say they haven’t heard a peep.

Changes May Be Coming

But that might be changing. On Aug. 22, President Bush signed an executive order to require the HHS and other federal agencies by January to adopt and use health information technology standards, including “quality improvement measures and price aggregation and transparency initiatives.”

“That sounds like the exact terminology (Leavitt) used when he was here,” said Duane Roth, chief executive officer at Connect, the region’s technology and life sciences technology transfer and networking group. “What you are seeing is probably the beginning of this project. I think the RFP will be announced soon.”

Leavitt was in San Francisco two weeks ago, meeting with members of the California Health Association, said Ehnes, whose deputy director represented her department.

“He was discussing initiatives that would encourage health (information technology) to be able to better approach health care and consumers’ ability to shop,” Ehnes said of Leavitt.

Leavitt is expected to announce that health care purchasers , private employers, unions and state governments , that wish to do business with the federal government must commit to the standards Bush announced last week.

In late July, Gov. Arnold Schwarzenegger issued an executive order declaring that an e-health action forum be held by the state Health and Human Services Agency and other leaders to identify the role state government should play in implementing a health care information technology system.

Funding Available

Schwarzenegger’s order said that in the next 10 years, all of California’s insurers, health care providers, consumers and government agencies should be able to exchange data electronically.

The governor’s order also said these leaders will develop a way to allocate $200 million in investment funds and $40 million in grant money from California health plans to benefit rural communities, medical groups, safety net providers and others who may not be able to afford adoption of sophisticated computer systems on their own.

Ehnes said that as high-deductible health plans become more popular among employers, the need for customers to have more information about health costs increases.

“That allows them to shop,” said Ehnes. “This has already happened in most other areas of consumerism. In health care, there are black holes where information cannot be transported easily.”

San Diego’s main RHIO champion is Steve Carson, pediatrician and chief medical officer at the San Diego County Medical Society Foundation, who did not return phone calls for the article.

In February, the foundation licensed software from Santa Clara-based Sun Microsystems Inc. for $100,000, plus a monthly fee to be paid by hospitals that sign on. Carson has said the fee will depend on the complexity of the hospitals’ needs. That agreement was negotiated after a lack of financial commitment from hospitals caused Sun to withdraw its offer to weave together all San Diego hospitals’ electronic records systems for $1.2 million, according to Sun and Carson. In the spring, the Foundation received $315,000 in donations from the Blue Shield of California Foundation and $50,000 from Long Beach-based Molina Healthcare , to pay for phase one of the RHIO, which Carson has said would cost about $350,000.