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Electronic health record bill clears first hurdle
(Wyoming Tribune-Eagle (KRT) Via Thomson Dialog NewsEdge) Feb. 16--CHEYENNE -- A $58 million effort to equip Wyoming with a cutting-edge statewide electronic health records system cleared the Senate Labor, Health and Social Services Committee on Wednesday.
Electronic health records take paper medical records and place them into a computerized network. Health-care providers across the state then could access any resident's medical records from any terminal in the state.
The committee's audience contained few doubters of the idea.
"I think there is no question this is the way to the future," said Dr. Brent Sherard, director of the Wyoming Department of Health, in testimony before the committee.
"This would be truly remarkable and make (Wyoming) the leader in the nation," said Zane Heninger, a partner in Rocky Mountain Medical Management, whose group is based in the region and would be interested in bidding to help design Wyoming's system.
His sentiment was echoed by Sen. Charles Scott, R-Casper, who highlighted its advantages for the committee.
If a Star Valley resident crashed a car in Cheyenne, he said, physicians would be able to get immediate access to that person's medical records -- including underlying medical conditions -- under this bill.
That information could save lives, reduce errors and cut costs.
The system also would include a provision for an electronic prescription system that would send prescriptions electronically to pharmacies. The state could expand the system in the future to include such features as a vaccine registry or registry of end-of-life directives.
There are cost savings as well. Fewer tests would be duplicated unnecessarily, and harmful drug interactions could be prevented before they happen through the ePharmacy system, the committee heard.
Physicians who have used such systems have seen up to a 25 percent increase in productivity, Heninger said.
"The savings to the practice comes when physicians' practices can get rid of a filing room this size and two to three transcriptionists," he explained.
Senate File 50 would help make Wyoming the leading state in the nation in this area, the committee heard. But it would come with a price -- $20 million for the development, testing and implementation of the program, and $37 million for financial assistance to hospitals and other health-care providers.
The bill currently says that the system would rely on state funds only until it can cover its own operating costs via earnings and provider fees.
But Scott added an amendment Wednesday that may help timid legislators vote for the bill -- a delay in the distribution of the majority of the bill's funds until after the 2007 legislative session. This would allow time for preparation, proposals and amendments to the legislation; allow consideration of alternative methods of constructing the network; and allow time for the state to pull back should natural-gas tax revenues decline.
"This gives the state a safety valve in case our surplus disappears," Scott said.
But Steve Chasson from the Wyoming Primary Care Association expressed caution over delaying implementation of the bill.
"Right now all these little mini-systems are being built around the state," he said. "We're basically right now building more and more roads, possibly to nowhere."
Allowing that to happen, he said, will ultimately increase the cost and computer code necessary for a statewide health record system.
If legislators are sweating the funding, many members of the public remain uneasy about security.
"When I mention this to people," said Sen. Pat Aullman, R-Thayne, "they say, 'I'm not going to have my records on there,' because there's always this fear someone will crack the system."
That may be, but several security provisions have been included in the bill. The system must comply with the Federal Health Insurance Portability and Accountability Act. In addition, a stipulation within the bill specifically protects the records from the prying eyes of employers and insurance companies, except in cases where the information is necessary to fill insurance claims.
The bill also requires the chief state information officer to conduct periodic security audits of the system to ensure privacy and identify security weaknesses.
One unified system, said Steve Chasson, director of the Wyoming Primary Care Association, also eliminates the many different standards of security currently in place at each hospital and doctor's office.
Currently, anyone who walks into a file room or handles a file can look at medical records, he said. With electronic health records, he said, every time someone checks a medical record, a record of that access will be made.
"The systems we're looking at setting up are going to be a lot more secure than paper files," Chasson said.
In the end, people may not have a choice. Most insurance claims already are submitted electronically.
Chasson said that while people have a choice of where they get care, they will not have a choice about electronic records once they get there.
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