Electronic health records increasingly used in isles

After years of encouragement, investment and incentives, hospitals and more recently a critical mass of community physicians have made the transition from paper charts to electronic health records (EHR). For optimal benefit to patients, providers and payers, it is critical that providers can use their EHRs to exchange information with one another. The Health Insurance Portability and Accountability Act of 1996, designed in part to protect patient confidentiality, makes the exchange of information a delicate exercise.

How is it possible to share some of the most sensitive facts about a patient quickly, any time, anywhere but only as appropriate and on a "need to know" basis? The state Health Information Exchange (HIE), established in 2006, is a secure electronic network designed for the job. It supports Hawaii health care providers, including physicians, pharmacies, labs and others, to exchange selected patient medical data. The HIE information technology infrastructure was largely funded by the Office of the National Coordinator as part of a collective effort to transform health care in this country.

The Hawai‘i Pacific Regional Extension Center was established in 2009 to assist providers in transitioning from paper to EHR, the prerequisite to participating in the collegial exchange of patient medical information. It supports more than 700 providers to implement EHR, establish privacy and security best practices, redesign workflow and engage in the exchange of health care information.

Implementation of EHR is certainly a challenge, but truly meaningful use of a paperless system is a resource-intensive task and takes time to accomplish. Providers need substantial encouragement to take it on. In Hawaii, as of June, 905 eligible providers received Meaningful Use incentive reimbursement payments from Medicare for a total of $13,699,878. As of June, four Medicare-eligible hospitals that have Meaningful Use incentive reimbursement payments received $5,673,735. Thirteen hospitals that can apply and receive funding from both Medicare and Medicaid received $17,261,437.

The Hawaii Health Information Exchange is hosting its third annual Health IT Summit at the Sheraton Waikiki Hotel today. More than 250 providers are confirmed to attend the event — 100 more than last year. They will participate in readiness workshops and seminars that will help them meet federal reporting guidelines for reimbursement with their electronic health record systems. Summit speakers also will provide valuable updates and information on the Health eNet, the state health information exchange infrastructure that will connect the state’s providers and allow for the secure sharing of patient information.

Summit highlights include a panel discussion with local physicians who have successfully changed from paper records to EHR systems and have qualified for federal incentive payments, and a direct message and referral application demonstration.

Improving the delivery of health care to Hawaii patients is a crucial part of Hawaii HIE’s mission. Discussion topics at the summit will focus on how providers can get the most value out of their EHR systems to provide better-quality, more efficient care to residents. According to a recent survey commissioned by Hawaii HIE, nearly 70 percent of Hawaii residents support the concept of electronic health records. The majority of residents agreed that EHR systems will produce more informed decisions, higher-quality and more efficient care, more up-to-date access to health records, and will reduce unnecessary medical procedures.

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Ira Zunin, M.D., M.P.H., M.B.A., is medical director of Manakai o Malama Integrative Healthcare Group and Rehabilitation Center and CEO of Global Advisory Services Inc. Please submit your questions to info@manakaiomalama.com.