Article - July 29, 2008 - Insurance & Technology

Regence Drives Successful EMR Pilot

Portland, Ore.-based Blue Cross Blue Shield insurer Regence demonstrated the economic viability of a Web-hosted electronic medical record system for an entire medical community through a one-year pilot in La Grande, Ore.

By Anthony O'Donnell

DEMONSTRATING the potential for payer-driven electronic medical record (EMR) solutions, Regence has conducted a one-year pilot project to test the feasibility of connecting an entire medical community with a single, Web-hosted electronic health records system. The initiative demonstrated that a communitywide system could be maintained at a cost of about $3,000 per provider per year, according to the Portland, Ore.-based Blue Cross Blue Shield insurer.

Beginning in January 2006, Regence (approximately $8.3 billion in 2007 gross revenue) funded and led the one-year initiative in the Eastern Oregon city of La Grande, connecting Grande Ronde Hospital, clinical laboratory Interpath, 12 provider practices and local pharmacies. Regence paid providers' subscription fees to ChartConnect (Yakima, Wash.), a Web-based electronic medical records system, and RxHub (St. Paul, Minn.), an e-prescribing service. Regence also funded the infrastructure enabling hospitals and physician offices to exchange records and provided training to staff. Further, the insurer also engaged Portland-based Acumentra Health to evaluate the pilot and provide recommendations for the La Grande and future EMR initiatives.

"There's a lot of discussion in the industry about inefficient medical care and variable quality of care," says Ralph Prows, M.D., Regence's senior medical director. "One reason is that our medical information isn't always where we need it to be. Electronic medical records would change that."

By launching the pilot, Regence joined a small number of carriers that have recognized the value of investing in electronic health/medical record initiatives. As Prows suggests, EMRs address not only inefficiencies associated with paper-driven healthcare processes, but also potentially ineffective or dangerous inconsistencies of care and duplication of costly tests. However, the implementation of EMRs requires the cooperation of disparate parties, including providers, patients and payers. Furthermore, there is no customary or legal mandate dictating which party should be responsible for consumers' individual records.

Getting Providers Onboard

"Payers don't often take a role in driving electronic health records," comments Christine Chang, a New York-based analyst with Datamonitor. "Payers tend to benefit financially because of less duplication of tests and more effective care. But, typically, providers have to implement the systems themselves." The costs of doing so are often prohibitive, Chang adds.

According to an article in the New England Journal of Medicine, only 4 percent of physicians nationwide reported having a comprehensive electronic records system, and only 13 percent reported even having a more basic system.

"That's a real headache for the insurance companies because they have found from their own studies that physician practices and hospitals using electronic medical records deliver better care and have better outcomes," says John Moore, managing director, Chilmark Research (Boston). Moore argues that using hosted, Web-based systems to support EMR initiatives makes good economic sense. "The ASP application service provider or SaaS softaware as a service model is a good one for the healthcare industry because so much care does take place at small physician practices," he says.

Full story


Page Information

  • 5 months ago [history]
  • View page source
  • You're not logged in
  • No tags yet learn more

Wiki Information
Update to PBwiki 2.0

An entirely new PBwiki experience, including folders and easier editing.

Convert Now for Free | Learn more