New York City offers doctors discounted EMRs

The new program is designed to help doctors serving low-income populations, but the program isn't free.

By Doug Trapp — Posted May 14, 2007

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New York City is offering 1,000 physicians discounted electronic medical records software and support in an attempt to improve the health outcomes of the city's most vulnerable.

Doctors qualify for the Primary Care Information Project if at least 30% of their patients are enrolled in state-funded insurance programs, such as Medicaid. Physicians also qualify if their practices are in one of three low-income neighborhoods.

The initiative is funded with $27 million from the city and $3 million from the state. It's designed to bring EMRs to patients who might not otherwise benefit from them. Another aim is to address major public health issues, said Farzad Mostashari, MD, MSPH, assistant commissioner in the Dept. of Health and Mental Hygiene and a nonpracticing internist. "Those two aspects are guiding principles for us," he said.

The program is exclusively offering eClinicalWorks software and two years of technical support. This normally would cost at least $12,000 per physician, said Heather Caouette, spokeswoman for the company, headquartered in Westborough, Mass.

But the package is not free. Physicians must contribute $4,000 to help pay for a city-organized office workflow assessment as a commitment to the program. Doctors also must provide hardware and high-speed Internet connection needed to run the system.

Details of the workflow assessment are still being worked out, Dr. Mostashari said, but the city anticipates using a combination of its own employees and outside consultants to advise physicians on how to use the EMR to meet their practice goals.

New York City isn't the first to offer physicians financial assistance for EMRs, but its program is one of the most significant initiatives out there, said Steve Waldren, MD, director for the American Academy of Family Physicians' Center for Health Information Technology.

The Medical Society of the State of New York has endorsed the project and publicized it, said spokeswoman Lynda Lees Adams. The city's Dept. of Health and Mental Hygiene already has been contacted by 1,300 physicians who appear to be eligible for the EMR program, Dr. Mostashari said.

EMR systems such as eClinicalWorks let physicians automate appointment notices, track test results and provide timely preventive care.

It's not easy to make the transition from paper to computer records, but the benefits are clear, said Gail Cetto, RN, office manager for Grove Medical Associates in Wooster, Mass. The practice, which includes three internists and one endocrinologist, installed eClinicalWorks software in August 2005. "We're just aware of what every single person needs who comes in," she said. "We weren't before."

Gabriel Guardarramas, MD, MPH, a solo family physician in New York City's Upper West Side, has used computers and an early version of EMRs in his office since the mid-1980s. He says adaptability and being knowledgeable about the programs are key.

Dr. Guardarramas has seen a demonstration of eClinicalWorks software and calls the offer a great one -- if physicians believe eClinicalWorks is the program for them. He said doctors considering EMRs should think about the long term. Does the system allow data mining, quality reporting and clinical decision supporting? Is the EMR able to communicate with other software? Dr. Guardarramas plans to upgrade instead to a code-based system, MedcomSoft.

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Who's eligible?

New York City has committed $27 million to help provide 1,000 primary care physicians with eClinicalWorks EMR software and two years of technical support. To qualify for the project, physicians must:

  • Practice in the underserved neighborhoods of South Bronx, Central Brooklyn or Harlem, or have at least 30% of patients enrolled in state-funded insurance programs, such as Medicaid.
  • Commit $4,000 to help pay for an assessment by city staff and private consultants to improve the practice's workflow both before and after the EMR is installed.
  • Provide a high-speed Internet connection and the computer hardware needed to run the EMR.

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External links

American Medical Association on health information technology (link)

New York City's "Health Information" newsletter on the Primary Care Information Project, January, in pdf (link)

Certification Commission for Healthcare Information Technology (link)

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