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WellPoint putting members' medical records online: Access to electronic medical information could reduce health care errrors and avoid unneccesary procedures

August 7, 2006

A benefits package WellPoint Inc. unveiled in July includes an ambitious effort that enables its 34 million members to access their medical records online.

WellPoint's initiative to make the records available electronically is but one example of a national movement, backed by President Bush, to make all medical records available online within the next 10 years.

Advocates say online systems can reduce medical errors and avoid unnecessary procedures by making patients' medical needs and histories available to doctors instantaneously.

Indianapolis-based WellPoint, the nation's largest health insurer, has invested nearly $100 million in what is known as 360-Degree Health, the benefit package that includes the electronic medical records initiative.

"We really want to lead the industry and change the dynamic of how health care is driven," said Joan Kennedy, a senior vice president of WellPoint and president of subsidiary Health Management Corp. "Creating personal health records is an example of that."

WellPoint is not the first insurer to offer members electronic access to health records. Wellpoint says its version is novel, however, because the company inputs the information instead of burdening members with the task.

To comply with federal privacy laws, members must first allow the creation of an electronic medical record and consent to sharing it with doctors and hospitals. A history of medications and lab results are among the records available. WellPoint even created software that simplifies medical jargon for members, Kennedy said.

The company piloted the program last year in New York and will roll it out nationwide over the next 18 months or so. It will be available to Hoosiers sometime next year.

WellPoint announced the endeavor last month while promoting 360-Degree Health, a benefits package it began creating in 2001 that provides personalized information on health care services and counseling options.

Pilot participation rates for 360-Degree Health hovered around 95 percent, while the level of satisfaction was slightly lower, Kennedy said. Connecticut-based Xerox Corp., which employs nearly 30,000 people in the United States, tested several components of 360-Degree Health.

Cutting-edge technology

The Boston-based Medical Records Institute has been promoting patient electronic medical records for the past 25 years. But without a universal health system to coordinate and fund the effort, the responsibility has fallen on the open market.

Less than 20 percent of all physician practices and clinics use electronic medical records, said Peter Waegemann, the institute's CEO, noting that concerns about protecting people's privacy abound.

"It's very complex and it takes some time," he said. "Certainly the movement by WellPoint is one of the more innovative ones. Hopefully their competitors are following."

Insurer Blue Cross Blue Shield has spent $50 million so far to help fund the Massachusetts eHealth Collaborative, a public-private partnership of more than 40 organizations that is in the early stages of designing a statewide electronic medical records system.

The key is to connect clinics and hospitals so they can communicate with one another when treating unfamiliar patients and avoid repeating tests and other procedures that drive up the cost of health care, Waegemann said.

In fact, WellPoint will introduce a feature at the end of the year that enables physicians to instant message one another for quicker response times.

Dr. Greg Larkin, president-elect of the Indianapolis Medical Society and director of corporate health services at Eli Lilly and Co., said the organization supports digitizing medical records.

"We're just such a mobile society," Larkin said. "The classic example is the snowbirds who get care here and go to Florida in the winter. It allows the doctor immediate access to their medical histories."

Central Indiana is at the cutting edge of the technology, said Larkin, citing the Indiana Health Information Exchange as another example.

Indiana is a leader

Led by local hospital networks, the exchange allows doctors to receive test results and other data through a secure computer network instead of by fax or courier. St. Vincent Health and Community Health Network helped launch the not-for-profit in 2004 with the backing of BioCrossroads, Indiana's life sciences initiative.

St. Francis Hospital and Health Centers and Clarian Health Partners came aboard last fall, and Wishard Health Services could join yet this summer. That would boost the number of doctors involved in the nine-county, central Indiana region to 3,500.

Doctors pay nothing to join the network, but each hospital system chips in a flat fee and a separate fee based on the number of results delivered. The five main Indianapolis hospitals could wind up paying a total of $1.5 million each year for the network.

A doctor can log onto the secure network through a hospital's portal, request lab tests and exam results, discharge data or other information, and have it delivered to his account or a practice account.

Accessing medical records electronically is the wave of the future, said Dan Seitz, a partner at Bose McKinney & Evans LLP who represents the Indiana Association of Health Plans, of which WellPoint is a member.

"This whole issue of data, and combining all of the data that is out there into one location for each patient is critical," he said. "I think everybody recognizes that going forward it has got to be an issue that is addressed."

While the expense to fund electronic systems could be a barrier for smaller carriers, Seitz said, most in the industry expect the investments ultimately will be returned as a result of cheaper medical costs and better quality of care.
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