Kansas is testing a Medicaid database to aid decision-making

The state of Kansas and FirstGuard Health Plan, a Medicaid HMO, have launched a pilot program giving physicians online access to key medical information of Medicaid patients.

Under the test, approximately 150 physicians at a dozen sites in the Wichita, Kan.-area will be able to access certain information belonging to 30,000 residents of Sedgwick County who are members of Kansas City, Mo.-based FirstGuard. With their patient's consent, participating doctors and hospital emergency department personnel can access patients' demographic information as well as what doctors and diagnoses they have had while enrolled in the Medicaid program. Physicians also can access medication history, allergies and immunizations.

The primary data source is claims data, with physicians entering allergy information into a centralized database, said Robert Day, PhD, director of the Kansas Division of Health Policy and Finance, which oversees the state's health purchasing. Laboratory results and electronic prescribing functionality also will be added to the system within the next few months.

Among the motivating factors for launching the pilot, said Dr. Day, are better patient care and safety and a desire to prepare the state for a future national health information network, an effort pushed by President Bush and the U.S. Dept. of Health and Human Services.

A desire to lower health costs, which make up nearly 20% of Kansas' total budget, also motivated the state to launch the pilot. "If our medical professionals have the information they need at their fingertips, they'll make the best decisions possible. This well-informed decision-making will lead to better health care, while still containing costs," Gov. Kathleen Sebelius said in a prepared statement.

The test, whose startup cost is $750,000, will last for a year or two. Depending on the results of the pilot, the state will either expand or drop it, said Dr. Day. About 350,000 people are on Medicaid in Kansas, including 100,000 insured by FirstGuard, he said.

At least one other state has rolled out a similar records initiative involving Medicaid patients. In 2005, Tennessee contracted with Shared Health, a for-profit subsidiary of BlueCross BlueShield of Tennessee, to make medical records of TennCare patients electronically accessible to physicians. TennCare is the state's troubled Medicaid managed care plan for the uninsured and working poor.

Cerner Corp., a health care technology company in Kansas City, Mo., that's involved in both projects, is discussing similar initiatives with other states, said Jay Linney, the company's vice president for state and regional health initiatives. He would not say which states.

The Kansas Medical Society is waiting to see how the pilot pans out before making a decision whether to endorse it, assuming the state moves the project beyond the testing phase. "We just felt like it'd be premature to take a position on this thing mostly because it's just being done on a pilot basis with the voluntary participation of the doctors and hospitals," said Jerry Slaughter, the executive director of the medical society.

Some participating physicians, however, believe that the project will help them deliver better patient care. "The immediate benefit would be that I could see wherever the patient had visited medically, the diagnosis, and what medicines he or she filled at any pharmacy," said Rahul Singh, MD, a primary care physician at GraceMed Health Clinic Inc., a federally funded community clinic in Wichita. Another benefit of the Medicaid database is that it will help doctors "avoid duplication or an ineffective treatment as you would know already what had been tried," Dr. Singh said.