As Health IT Leader, PAMF Helps Shapes National Goals

July/August 2004

Federal officials are using PAMF's experience with electronic health record (EHR) systems as a model as they push to improve the nation's access to health information technology.

Chief Medical Information Officer Paul Tang, M.D., has been working with Bush Administration officials on the president's goal to ensure that most Americans have EHRs in the next 10 years. That goal, announced by President Bush in April 2004, is designed to prevent medical errors, reduce costs and improve overall quality, the administration said.

President Bush has proposed investing $100 million in health information technology projects, and has appointed a new national health information technology coordinator to oversee these efforts.

Only about 10 percent of U.S. health care organizations have a comprehensive EHR in place, said Dr. Tang, who also recently chaired a committee of the national Institute of Medicine (IOM) that studied the topic. PAMF, which implemented its EHR in 1999, is an early adopter of this technology, and remains one of the few physician groups in the Bay Area to have completely deployed such a system. Other area health care institutions, such as Kaiser Permanente, expect to roll out a comprehensive EHR in the next few years.

PAMF's EHR allows physicians and clinical staff members to access patient information from any PAMF department or facility, without chasing down paper records. It can send electronic prescriptions to pharmacies, reducing the risk that hard-to-read handwriting will lead to medical errors. It flags potentially harmful drug interactions; provides physicians with "decision support" tools, such as clinical guidelines; and generates printed post-visit summaries for patients, among other benefits.

The EHR also makes possible PAMFOnline, a secure Internet site through which patients can access key components of their medical records, request prescription renewals and appointments, view laboratory test results and communicate with physicians. If EHR systems were implemented nationwide, patients could more easily transfer their information between health care facilities. For example, physicians treating a patient in the emergency room could call up that person's medical information from another doctor. A nationwide network would also help public health officials more quickly identify disease outbreaks or potential bioterrorism attacks.

Transitioning to an EHR can present hurdles -- paying for a complex new computer system, convincing physicians to change ingrained practice styles, ensuring privacy protections are in place. In November 2003, the IOM committee chaired by Dr. Tang released a report recommending that the government provide financial incentives to encourage physicians, hospitals and other health care providers to make the investment.

The government should also help the private sector establish standards for which tools and information should be included in an EHR, so that organizations with different systems can communicate with each other, the report said.

Moving forward, Dr. Tang will continue working with administration officials and Congress to determine how best to implement these recommendations.