Medical software from feds could benefit big health care

Low-cost app for small practices could aid efforts to computerize records

Some IT managers at large health care organizations are delighted that the federal government plans to offer its electronic health records (EHR) software to small and midsize physician practices at a low cost. The move is expected to be a significant boon to the efforts of big providers to computerize patient records, the IT managers say.

While many hospitals and large physician practices have deployed EHR software for their patient bases, the systems won't be fully effective unless physicians in smaller medical groups who refer patients for treatment automate their records as well.

The Centers for Medicare and Medicaid Services (CMS) expects to announce the distribution plans for its Vista-Office EHR software this month. The announcement, which has already been widely publicized , was due to take place last week but didn't materialize. Vista-Office has been in use at Veterans Affairs hospitals and clinics for more than 20 years.

Encouraging Adoption

The CMS will allow physicians to license Vista-Office for less than $3,000 for a five-doctor practice, according to a CMS spokesman. The move is designed to address one of the biggest barriers to the Bush administration's goal of computerizing all patient records over the next decade: the lagging adoption rate among smaller practices.

"Vista is a good program, [and] if done correctly, there will be a level of ability to share records across regional health information organizations. It could prove to be a very effective tool for many of our small-practice, community-based M.D.s," said John Hummel, CIO at Sutter Health in Sacramento, Calif. Sutter operates 27 hospitals in Northern California.

Any option that gets physicians to begin to computerize patient records is a good idea, said J. David Liss, vice president of government relations and strategic initiatives at NewYork-Presbyterian Healthcare System.

"Physicians who have rotated through VA hospitals love Vista -- having all the patient data in one place is so compelling," Liss said.

Hospitals and health systems could benefit from the government plan because historically, they capture the lion's share of the benefits from EHRs: They get access to patient histories, while the physician practices that compile them bear most of the costs, said Eric Brown, an analyst at Forrester Research Inc.

As a result, large hospitals have a vested interest in making sure that all the physicians referring patients to them are using an EHR system, he said. Brown and others warned that the capital investment in electronic records often can be dwarfed by the training, implementation and configuration costs involved.

Vendors are ramping up to support physicians who will deploy Vista. In May, the not-for-profit organization WorldVista was awarded a contract by the CMS to provide training to vendors that will install the software.

Medsphere Systems Corp. in Aliso Viejo, Calif., will be offering Medsphere OpenVista, an open-source version of the government's software that captures clinical, financial and administrative data. Medsphere will also be providing an ASP version of the software and services such as training, maintenance and support for Vista users, said Scott Shreeve, chief medical officer and co-founder of Medsphere.

Midland Memorial Hospital in Midland, Texas, will go live in December with its first clinical application based on Medsphere's OpenVista. The hospital plans to use the technology to develop a comprehensive EHR system, said David Whiles, director of information systems at Midland.

"It is an extremely mature, very functionally rich electronic record," he said. "It has been in place for 20-plus years, and it is not one of these new systems that vendors are offering, looking for alpha or beta partners."

The OpenVista project will cost less than half of the upfront capital investment required for a commercial EHR product, Whiles said.

Copyright © 2005 IDG Communications, Inc.

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