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Florida pushes for electronic medical records

By Lynn Hatter


Tallahassee, FL – Old paper-based files are slowly being replaced by a newer-model: electronic medical records. Florida is one of the first states to adopt a new way of transferring patient information. Advocates of the new technology say it has the potential to drastically change the way healthcare is delivered. But as Lynn Hatter reports, critics say the move puts privacy at risk.

At Tallahassee Memorial Hospital's Emergency Room it's business as usual. A helicopter is arriving on the roof. Inside the building there's a quiet bustle of activity. But Dr. Lonnie Draper takes a minute to explain how electronic records can help make some order out of the chaos.

"So a good example is like a case yesterday, where someone is in a motor vehicle accident and they arrive unconscious. So we have a driver's license on the person. We can look them up in the Health Information Exchange and see that they've been to three different doctors recently and been to the hospital for X-rays recently. So we get a baseline of information about who they are, how ill they are and what medications they have. So if a patient can't tell me anything, I can get a good deal of information about a patient who's never been here before."

That information came through something called the Health Information Exchange Network.

"The Health Information Exchange infrastructure is the highway, the electronic medical record is the car."

Heidi Foxx heads the office in charge of the Health Information Exchange. The "highway", she's talking about is really a super-encrypted form of email that allows healthcare providers like Draper and Tallahassee Memorial to share patient information.

In the system, individual providers within a network can look up patient records held by a participating provider. When a doctor needs the file, it can be sent through direct-secure messaging or the "highway". For the last three years, Florida has been building up its networking system to link providers across the state. Carolyn Turner is the agency's health information policy expert. She says the system is the future of healthcare.

"Much of the Healthcare Industry has remained somewhat behind in their model. So the thought process is that it will improve the quality of healthcare, coordination, communication."

But while Florida may be dipping its toes into the future of healthcare with its Health Information Exchange, not everyone is ready to dive in, including Governor Rick Scott.

"There haven't been a lot of studies to date that suggest electronic medical records have saved a lot of cost. They've increased cost because of the way you have to keep all the records. I'm the one who should be taking care of my information and not relying on the government to do it because I believe it will raise the cost of healthcare without a result."

Governor Scott has emerged as a strong opponent of the federal healthcare overhaul law. Despite those concerns, Florida is one of three states making any significant move to go digital. But Heidi Foxx with the Florida Agency for Healthcare Administration says the state's electronic system is not affiliated with the federal healthcare overhaul law.

"The Electronic Medical Record, the incentive program and the Health Information Exchange are funded through the American Recovery Act. The High-tech provision is all through the Recovery Act. So all of these provisions are separate from the Affordable Care Act."

Scott inherited the Health Information Exchange from the previous administration, and it was built using federal stimulus money. Then, there are the privacy concerns that come with storing patient information in an electronic format. Governor Scott says it's not something he's very comfortable with.

"I have privacy concerns, that this will get hacked and things like that."

AHCA's Carolyn Turner says the governor's concerns are valid, and that's why the agency has put in extra security measures.

"We don't have access to the content of the emails going back and forth through the network. Nothing is stored by the Florida HIE. With the patient lookup, there's no central database, It's all maintained by the local participants.

Florida's Health Information Exchange is a voluntary system, and healthcare providers can choose whether to sign up. Registration and participation are also free. Right now, three small systems in the state are using the Health Information Exchange. The goal is to have every health provider in the state using it. Tallahassee Memorial Hospital's Dr. Lonnie Draper, who works the ER, admits the system may not save money, but he thinks the rewards are much greater.

"We expect that every hospital, every doctor, every healthcare provider will eventually connect to a health information exchange. We expect for fax machines to eventually disappear. We expect this to replace any other form of movement for electronic records."

Even though Florida is further along in this regard, the goal of eliminating paper-based records is still a long way off. Florida is working to add more providers to its Health Information Exchange, something that the state says will still be a work in progress even when the federal funding that supports the project goes away in 2021.

*This report was produced as part of "Health Care in the States," a special project of WFSU, NPR and Kaiser Health News.