Florida, Kentucky officials envision state e-health networks

Political leaders in two states have generated separate plans to create electronic health care networks, enabling physicians, hospitals, insurance companies and patients to exchange clinical and financial information statewide.

In Florida, Gov. Jeb Bush announced he will create and appoint an advisory committee to make recommendations for how to establish a network by December 2006.

In Kentucky, Daniel Mongiardo, MD, an otolaryngologist and Democratic state senator from Hazard, has introduced legislation to create a statewide e-health network.

This is the third time in the last three years the senator has pushed for a statewide network.

The network would make the health care system more efficient and less costly, said Dr. Mongiardo, who is running for the U.S. Senate.

No state has created such an electronic health care network.

Gov. Bush's plan is part of a larger package of proposals designed to make health care more affordable and accessible, Florida officials said.

Bush also will ask the soon-to-be-created advisory committee to address cost and privacy issues, and to work with the federal government to ensure its implementation plan is compatible with efforts to develop a national health information infrastructure, including adoption of electronic records, said Rhonda Meadows, MD, Secretary of Florida's Agency for Health Care Administration.

For example, the federal government last year commissioned the Institute of Medicine to design a standardized electronic medical record and endorsed several health data standards. And last month, President Bush urged the industry to use electronic records to reduce medical errors, improve care and lower costs.

Recognizing that cost is one of the biggest barriers for physician adoption of technology, Gov. Bush plans to ask the Florida Legislature to create financial incentives to encourage physicians to adopt electronic systems. Those incentives could include a pay-for-performance program offering doctors higher reimbursement for Medicaid, Dr. Meadows said.

"The people who are in large group practices -- like the Mayo Clinic -- have the funding to do this, [but the question is] what are we going to do for the solo practitioner?" Dr. Meadows said. "That's stuff we need to bring out early on in the advisory panel when we talk about funding."

Gov. Bush has said that he won't mandate electronic records. He will urge insurers to offer financial incentives to encourage doctors to adopt technology, Dr. Meadows said, and he will ask the Legislature to approve $2 million in funding for the committee.

The proposals in Florida and Kentucky both call for patients to grant permission before their information is accessed or transferred electronically. The Florida Medical Assn. and the Kentucky Medical Assn. have not taken positions on the two proposals.

Dr. Mongiardo is hopeful that his bill will pass this time because of the increased interest in electronic records at the federal level.

"This is now ... getting on the radar of just about everybody. There's really no alternative [than to use information technology to fix the health care system]," he said. "I'm very optimistic that we will get something moving, hopefully both in Kentucky and Washington."