Florida first to offer Medicaid claims data online

Florida physicians are the first in the country to be able to access statewide data on Medicaid patient claims through a Web portal.

The Florida Agency for Health Care Administration on Nov. 19 launched the service, which provides up to 18 months of patient records for selected clinical information. Physicians and other health professionals must obtain patients' consent to view the records, except during medical emergencies.

The agency on Dec. 14 also introduced personal electronic health records for Medicaid enrollees, said agency spokeswoman Tiffany Vause. Patients can submit information, such as family medical history and emergency contact information. The system, called My Florida Health eBook, also will include Medicaid claims information.

The projects are part of an effort to provide more comprehensive medical information to physicians and others. "Having access to the clinical history of patients has great potential for improving quality and coordination of the care we deliver," said Ana M. Viamonte Ros, MD, MPH, the state surgeon general.

Physicians and patients will not pay to access or update any of the records. Availity -- the information technology company operating the claims project -- is hoping to learn more about the potential impact of such efforts on quality and cost, according to spokeswoman Shannon Thuren. Availity is a venture by health insurers Blue Cross and Blue Shield of Florida, Health Care Service Corp., Humana and WellPoint. The firm is working with two other health technology companies -- HealthTrio and Healthwise -- on the personal health records project.

Representatives from Florida physician organizations said the networks are a positive step but that Florida is a long way from an interoperable electronic medical records system. Such a network would allow medical professionals and others to access, update and share information for all patients.

Major state efforts are under way to plan for interoperable systems. The most recent federal stimulus package, enacted in February, includes about $19 billion in net Medicare and Medicaid incentives for adopting health information technology. "All the states are working on some version of electronic health records right now," said Ann C. Kohler, director of the National Assn. of State Medicaid Directors.

The Florida Medical Assn. supports the Medicaid claims project -- called the Florida Medicaid Health Information Network -- but doesn't yet have enough information on the personal health records project to judge it, said Linda McMullen, the association's director of medical economics.

McMullen said the claims system should be especially useful in emergency departments and after disasters. Some Medicaid patients don't remember all of their prescriptions and medical histories, she said. McMullen, formerly of the Mississippi State Medical Assn., said that after Hurricane Katrina, many physicians had to chase down patient prescription histories from pharmacists.

Tad Fisher, executive vice president of the Florida Academy of Family Physicians, said the new system could improve care. "We hope it does, but that remains to be seen."

McMullen and Fisher said Florida's Medicaid payment rates for physicians hinder program participation. Medicaid fees for doctors in the state are 50% to 60% of Medicare fees, Fisher said. "It's not where it needs to be if we're going to get doctors into Medicaid."

McMullen said the efforts are small when considering what will be necessary to establish a fully interoperable state network. "It's real incremental. It's a tiny little slice of what can be done."

Vause declined to predict how many of the state's 2.6 million Medicaid enrollees would fill out their personal records. Duval County Health Dept. Director Bob Harmon, MD, MPH, said some will, which is an important start.

"It's a change in behavior. It's an extra step, but once the person starts using it, I think they will continue," he said. Dr. Harmon oversees 30 physicians in the county's public health network. About 40% of their patients are in Medicaid.

Dr. Harmon said having access to patients' prescription histories should be especially useful, because many Medicaid enrollees are on multiple medications.