Vermont patients are beginning to see results from a $27 billion federal program that offers incentives for physician practices and hospitals to use electronic health records systems, according to US Senator Patrick Leahy. Those benefits include Vermonters receiving more reminders about important preventive care.
Senator Leahy spoke during a visit to Middlebury Family Health Friday, the first Vermont physician practice to meet all of the federal program's criteria for improving patient care using its electronic health records system.
"I am delighted that this targeted federal investment has enabled Middlebury Family Health to become the first Vermont practice to receive incentive payments from Medicare for using an electronic health record system," Leahy said. "Better records mean better patient care and patient safety for Vermonters. With breakthroughs like this, we are beginning to shift to a higher gear in health reform. The federal partnership with Vermont Information Technology Leaders and local physician practices has the potential to benefit every Vermonter. Vermont has been in the front ranks of health care reform, and Middlebury Family Health's adoption of an electronic health record system is an excellent example of this leadership."
As part of the American Recovery and Reinvestment Act of 2009, Congress appropriated $27 billion to fund the Medicare and Medicaid Electronic Health Records (EHR) Incentive Programs. To participate in either of the programs, eligible health care professionals must use federally-certified EHR technology, and meet a number of criteria for becoming "meaningful users" of EHRs and improving patient care. Once documenting that they have achieved meaningful use, eligible professionals receive up to a total of $44,000 in incentive payments from Medicare over the five years they choose to participate in the program or up to $63,750 in incentive payments from Medicaid over the six years they choose to participate in the program. Hospitals may also participate in the programs, receiving incentives based on a number of factors, beginning with a $2 million base payment.
All four physicians at Middlebury Family Health recently achieved meaningful use of their EHR, and each has received the maximum first year incentive payment of $18,000 from Medicare, making them the first eligible professionals in Vermont to do so. The physician practice will use the federal funds to pay for the EHR technology and to continue to make investments in improving patient care.
"Our electronic health records system has streamlined communication in the office between physicians, nurses, and other staff," said Eileen Doherty Fuller, MD, a partner at Middlebury Family Health. "We've also greatly enhanced communications with our patients. Using the EHR, we can better track which patients are overdue for physicals, mammograms, and checkups for high blood pressure, diabetes, and high cholesterol." When the electronic health records system flags an overdue preventive service, Middlebury Family Health contacts the patient to schedule an appointment. "Often patients don't realize it is time for them to come in, so we are able to be more proactive about reminders," Dr. Fuller said.
Other general criteria for meaningful use that directly affect patient care include: eprescribing and the ability to immediately check drug-to-drug and drug allergy interactions; maintaining up-to-date patient medical problem lists and medication lists; and providing patients with a clinical summary of their visit, including any changes to medications, instructions and other relevant information. One feature of Middlebury Family Health's electronic health record system that has been particularly beneficial is its ability to track whether ordered lab tests were actually completed, Dr. Fuller said. If a patient fails to show up for a scheduled test, the EHR will alert physicians who can follow up with the patient.
Middlebury Family Health has also met the standards for being a patient centered medical home, and attained the highest level status in that National Committee for Quality Assurance program, Dr. Fuller noted. As a result, Middlebury Family Health will receive the highest level of payment for participating in the Vermont Blueprint for Health program. "Without the EHR, we could have never done that," she said.
"Middlebury Family Health worked with VITL and the state of Vermont using collaborative workgroups for meaningful use and the medical home. We included four staff members and two doctors to learn and implement this system. Joining me on this team were Dr. Linn Larson, Medent Specialist Michelle Clark, and Office Manager Stacy Ladd. They kept the staff involved and excited throughout the process. In addition, Christine Fuller and Connie Billings were an important resource to the team. The efforts of all our employees and this core team were critical to our success," Dr. Fuller said. The other two physicians in the practice are
Jean Andersson-Swayze, MD, and Dayle Klitzner, MD.
Assistance from VITL
Physician practices and hospitals around the country receive assistance in implementing EHR technology and achieving meaningful use from 62 non-profit regional extension centers funded by the federal government. Vermont Information Technology Leaders, Inc. (VITL), an independent non-profit organization based in Montpelier, is the only such center serving Vermont.
VITL's staff worked with Middlebury Family Health to implement its EHR system and connect it to the Vermont Health Information Exchange, a secure statewide health data network operated by VITL. Middlebury Family Health's four physicians received information and guidance from VITL on achieving meaningful use and qualifying for federal incentive payments.
"VITL congratulates Middlebury Family Health for being the first Vermont practice to achieve meaningful use. While you are in the vanguard, there are many other practices following in your footsteps," said David Cochran, MD, VITL's president and CEO. "We're working with more than 750 of the state's 1,000 primary care providers and expect that Vermont will have one of the highest percentages of health care providers in the country achieving meaningful use. That's great news for Vermont patients and the state's health care reform efforts," he said.
The transition to advanced electronic health records systems is also happening in the state's 14 hospitals, Dr. Cochran noted. Copley Hospital in Morrisville announced on June 29 that it was the first hospital in Vermont to achieve meaningful use. VITL is working with Copley and the rest of Vermont's hospitals on meaningful use and health information exchange.
VITL assisted Porter Medical Center with implementation of the hospital's new EHR system, which went live on August 1, as well as the installation of a lab system interface to the Vermont Health Information Exchange so that Middlebury Family Health and other physician practices in the hospital's service area can receive lab results immediately in electronic format.
"Through the efforts of Porter Medical Center and area physician practices, including Middlebury Family Health, Addison County is well on the way to becoming one of the most connected communities in Vermont for medical records," Dr. Cochran said. "Patients in the Middlebury area will experience better health care because of the increased use of health information technology, everything from smoother check-in at the front desk to greater information sharing among authorized providers, which will result in fewer duplicated tests and quicker diagnoses of medical problems."
VITL Middlebury, Vt. (August 12) -