Dr. Lonnie Draper knows why he wants Tallahassee Memorial Hospital to have an electronic health record system shared with other hospitals and doctors.
"A good example is like a case yesterday, where someone is in a motor vehicle accident and they arrive unconscious. We have a driver's license on the person. We can look them up," he explains. "So we get a baseline of information about who they are, how ill they are and what medications they have. So if a patient can't tell me anything, I can get a good deal of information about a patient who's never been here before."
Gov. Rick Scott (Photo by Gage Skidmore via Flickr)
At the hospital, old paper-based files are slowly being replaced. Florida is one of the first states to help doctors and hospitals adopt a new way of transferring patient information. The idea behind the Health Information Exchange Network, run by the Florida Agency for Health Care Administration, is "the exchange is the highway, the electronic record is the car," according to Heidi Fox, who is directing the effort.
Individual providers can look up patient records held by a participating provider. When a doctor needs the file, it can be sent through encrypted messaging - the "highway." For the last three years, Florida has been building the network. Right now, three small systems in the state are using it, and the goal is to expand to every health care provider in the state.
But not everyone is a believer, including Gov. Rick Scott.
"There haven't been a lot of studies to date that suggest electronic medical records have saved a lot of cost. They've increased cost because of the way you have to keep all the records. I'm the one who should be taking care of my information and not relying on the government to do it because I believe it will raise the cost of health care without a result," he said on the public radio show "It's About Florida."
Scott inherited the Health Information Exchange from the previous administration, and it was built using federal stimulus money. While development of electronic health records is a fundamental goal of the 2010 federal health law – the provisions call for using health IT to increase the quality of health care as well as standardizing payment and claims information - Fox says the state’s electronic system is not affiliated with the national law.
"The electronic medical record, the incentive program and the health information exchange are funded through the American Recovery Act. The high-tech provision is all through the Recovery Act," Scott said.
The governor is also raising privacy concerns, worrying that the system "will get hacked and things like that." But the Agency for Health Care Administration’s Carolyn Turner notes that’s why the agency has put in extra security measures.
"We don't have access to the content of the emails going back and forth through the network," she said. "Nothing is stored by the Florida HIE. With the patient lookup, there's no central database. It's all maintained by the local participants."
Florida's health information exchange is a voluntary system, and healthcare providers can choose whether to sign up. Registration and participation are also free.
"We expect that every hospital, every doctor, every healthcare provider will eventually connect to a health information exchange," said Tallahassee Memorial's Dr. Lonnie Draper. "We expect for fax machines to eventually disappear. We expect this to replace any other form of movement for electronic records."
Even though Florida is further along in this regard than most other states, the goal of eliminating paper-based records is still a long way off. The state is working to add more providers to the network, something it says will still be a work in progress when the federal funding that supports physicians and hospitals who are setting up electronic medical records goes away… in 2021.