New York Times

December 30, 2008, 9:18 am
Harnessing Electronic Records for Public Health Goals
By Sewell ChanAbout 1,000 primary-care physicians have given up their doctor’s pens over the past year to collect the smallest details of their patients’ lives in a database as part of a $60 million city health department project.

Experts say it is the most ambitious government effort nationwide to harness electronic data for public health goals like monitoring disease frequency, cancer screening and substance abuse. It follows the Bloomberg administration’s aggressive focus on everyday health concerns — which has included startling anti smoking advertisements in subways and requirements that chain restaurants post calorie counts — and frequent use of statistics to drive public policy on crime, homelessness and other issues.

And echoing the city’s cash-incentive experiments in the school system, the city’s Department of Health and Mental Hygiene will soon start offering doctors bonuses of perhaps $100 for each patient who hits specified targets like controlling blood pressure or cholesterol, up to $20,000 for each doctor.

In April, the city will begin sending participating doctors report cards on how their preventive efforts compare with their peers’ (only the individual doctor being rated will be named, and the rankings will not be public). A prototype was used in 2007 to send electronic messages warning physicians in the Bronx of an outbreak of Legionnaires’ disease. And the city is currently using the system to track the spread of flu infection in New York City in real time — a much more accurate gauge, doctors say, than a Web tool being developed by Google.

Health maintenance organizations, clinics and hospitals here and elsewhere already use electronic records to communicate; Kaiser Permanente, the giant California H.M.O., has a system much like New York’s. Perhaps the one most similar to New York’s initiative is a demonstration project of the Massachusetts eHealth Collaborative that links doctors in three small suburban and rural communities.

But New York is trying to connect the vast majority of medical practices, which have 10 or fewer doctors, particularly in poorer neighborhoods, in hopes that providing them access to a broader base of patient information — and ranking their performance against their peers — will help them make strides in preventive medicine. The health department is providing subsidies for doctors to subscribe to the system and teams of trainers to support the transition; so far, more than 1 in 10 of the city’s estimated 10,000 primary-care doctors have started using the system, and an additional 500 are in the pipeline.

This is truly a great idea. Electronic records also reduce the prescription pad errors, due to poor penmanship. All of the VA records are online so you can go to any VA in the country and they will have access to your records! saves time, money, and trees. Whats not to like?