Florida begins electronic health record pilot program for Medicaid recipients

Washington -- Medicaid recipients in Tallahassee and surrounding Leon County are the test subjects for a bold Florida experiment: a pilot program giving them their own electronic health records.

The initiative, administered by Florida's Agency for Health Care Administration, runs from November to February 2008 and seeks to create EHRs for each of the 25,000 Medicaid recipients in Leon County, said Peter Finney, program manager of the Electronic Health Records Center of Excellence for Electronic Data Systems, a Plano, Texas, information technology corporation.

The effort, called EDS CareNetwork Solutions, is based on an existing EHR system that was created by CentriHealth, a Nashville health information company. The program collects medical information from the diagnostic and procedural codes entered for a patient's Medicaid claim and assembles these data into a single, coherent file, Finney said.

The information already is filed electronically into the state's existing Medicaid Management Information System, said Alan Strowd, bureau chief of Medicaid contract management for the state's AHCA. Up to 98% of Florida physicians who participate in Medicaid file electronically, Strowd said, creating a huge database of information.

In turn, this file will act as the foundation for an individual health record, consolidating key information such as current health records, lab results and x-rays, EDS said.

The current MMIS has existed for 18 years, Strowd said. But Florida will include only claims information from the last six to nine months as part of the pilot program. State officials will use this experience to evaluate whether a longer history would be helpful, he added.

How it works

Florida sent letters to the roughly 300 physicians in Leon County who accept Medicaid patients, asking them to participate, Strowd said. Physicians signing up for the program will receive access to an Internet site allowing them to pull up a patient's claims history. Passwords will protect patient privacy and ensure that medical staff are the only ones who can view the information, Finney said.

Once they log in, physicians will see more than a jumble of diagnostic codes, Strowd explained. The system will combine the patient's data into a report for physicians that suggests the patient's possible ailments or medications. Think of it as a Physicians' Desk Reference in electronic form, Strowd said.

Eventually, the system will generate separate reports for patients and caregivers that are written at a sixth-grade reading level, said CentriHealth Vice President Frank Convertino. For now, the pilot project will focus on physician reports, he said.

EDS is not offering financial assistance to physicians participating in the program because doctors can use the system online and do not need special computer equipment, Finney said.

"This is all Web-based," added CentriHealth CEO Ralph Korpman, MD. "If you have a computer with a Web browser, you are in business."

Florida's EHR project is part of an 87-month, $308 million contract the Florida health care agency awarded EDS in 2006 to design and implement an electric records system for Medicaid. The system, called Florida interChange, is scheduled to start in 2008.

It's too early to estimate how much money or time the system will save, Strowd cautioned. "The pilot project will tell us, but it will take a number of months to see the cost savings."

Florida will keep the patient's paper records, added EDS spokesman Bill Ritz.

At press time, Finney did not know how many records had been generated but said the program began on time and is receiving positive feedback from Leon County physicians.