The walls of file folders containing patient records in hospitals and doctors' offices must go.
The federal government says so. Former President George W. Bush pushed for electronic medical records, and President Barack Obama is putting billions of dollars behind them.
Paper records, they say, are unwieldy and occasionally misplaced and sometimes delay treatment.
Nebraska has begun to create a statewide system to connect hospitals and doctors so they can share patient records through computers. Most of Omaha's hospitals, which compete intensely with one another, have agreed to share their patient records electronically.
But getting the entire medical industry to switch from paper to electronic records will be costly and still has a long way to go.
In Nebraska, far from everyone has joined. Lincoln's main hospitals, BryanLGH Medical Center and St. Elizabeth Regional Medical Center, haven't connected to the state system.
Iowa will start testing a program late this year.
The goal is simple. By sharing records, practitioners don't duplicate MRI exams, blood work or X-rays, and thus save patients money. Doctors learn promptly about chronic illnesses and view records immediately rather than waiting for faxes from other offices. They see what medications patients have used and which ones they can't use and get a feel for whether a patient is an addict trolling for painkillers.
Shane Baxter of Council Bluffs went to the Nebraska Medical Center last year with dizziness, lethargy and other symptoms. Blood was drawn and other tests done on the 34-year-old, who despises needles.
“I've hated them all my life,” Baxter said.
Doctors established that he had diabetes and high blood pressure. The good news: Because he was in the medical center's electronic system, and his doctor was connected to it, no more blood draws were taken during his follow-up visit to his doctor's office.
“And I thought that was great,” Baxter said.
Hospitals are getting a nudge from the federal government to go to electronic medical records and connected systems. Billions of dollars in federal stimulus money is being allocated to encourage states and hospitals to work on such systems.
Nebraska will receive $6.8 million for the program, and Iowa will get $8.4 million.
The federal government's goal is eventually to connect all of the nation's hospitals, doctors, MRI centers and other health entities. The New England Journal of Medicine reported a year ago that only about 17 percent of doctors and 10 percent of hospitals in the nation used basic electronic records.
Nationwide, experts applaud Nebraska's effort called the Nebraska Health Information Initiative as a model.
“Nebraska is well ahead of most states as far as connecting all of their players together,” said David Merritt of Newt Gingrich's Center for Health Transformation.
In Nebraska, about 400 of 3,200 doctors are part of the initiative, and about 10 of 90 hospitals in the state are connected to it. Alegent Health System's three Iowa hospitals, as well as its Nebraska hospitals, are connected, too.
“We have the framework in place,” said Ken Lawonn of Alegent, vice president of the Nebraska initiative. “We still have work to do, but we have a very good start.”
However, Nebraska's is not yet a story of everyone working together in peace and harmony.
While most of Omaha's hospitals are electronically hooked up, doctors' private offices are far less likely to be part of the program. Creighton University Medical Center intends to connect this summer.
Nebraska leaders formally launched the initiative's pilot project a year ago at BryanLGH Medical Center in Lincoln to show that it was a statewide program, said Kevin Conway, a vice president of the Nebraska Hospital Association who's involved in the initiative.
“We didn't want this to be perceived as an Omaha project,” Conway said.
Nevertheless, a year later, neither Bryan nor St. Elizabeth has joined the system. Representatives of the two hospitals said last month in written statements that they were thinking about doing so.
Lt. Gov. Rick Sheehy recently said he was confident that the program would get complete, statewide participation.
“Eventually, everyone will connect with (it),” he said. “I can't think of why somebody wouldn't at some point.”
Cost is a concern for some hospitals and physicians. For a doctor's office to join the initiative, each physician pays a licensing fee of anywhere from $20 a month to $52 a month, depending on whether the doctor wants to merely view a patient's record or pump information into the system and extract it for his or her own permanent records.
Depending on its size, a hospital will pay $1,500 a month to $12,000 for the licensing fee.
The monthly fees don't include the thousands or hundreds of thousands of dollars required to buy electronic medical records systems in the first place, or the cost involved in getting a hospital's system to interface with the initiative's software.
The federal Medicare program will provide bonus money to doctors' offices and hospitals connected to a health information exchange from 2011 through 2014. Then penalties are expected to be imposed through Medicare to those who haven't joined five years from now.
World-Herald researcher Jeanne Hauser contributed to this report.
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