Less than 15% of Doctors Use RI Health Information Exchange

Less than 15% of Doctors Use RI Health Information Exchange

Eight out of ten physicians in Rhode Island don't use the state's Health Information Exchange, CurrentCare, despite tens of millions in state and federal funding poured into the system since its inception.

Billed as a tool for hospitals and physicians to manage and share electronic health records (EHR), CurrentCare garnered over $25 million in federal funding at its inception six years ago -- and millions from the state since then -- but the state's recent Health Information Technology survey conducted in 2014 showed that "nearly 75% of physicians [in Rhode Island] had not signed up to send or receive data" through the CurrentCare system-- and 14% of those who had, have never used it.  

"It will make docs lives easier - eventually," said Rhode Island Medical Society Government Relations Director Steven DeToy, of EHRs.  "But so far, its only made insurance companies and EHR companies happy."

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READ:  RI Department of Health 2014 Health Information Technology SURVEY HERE

DeToy spoke to what he believed was behind the low utilization numbers. 

"First, not every physician has a computer that they use for EHRs," said DeToy. "Second, some of those who do, have a system that isn't CurrentCare compatible as of right now, but hopefully will be. There have been some proprietary issues. Certain EHRs don't allow physicians to prescribe electronically.  But now that Rhode Island Hospital is on board, having EPIC integrated should speed things along."

The Rhode Island Quality Institute, who manages CurrentCare, recently touted the addition of Lifespan and Care New England's "EPIC" EHR system to CurrentCare -- and last fall announced that CurrentCare enrollment topped 400,000 patients.

Data from the 990s for the nonprofit shows that RIQI, which oversees several other programs besides CurrentCare, had revenue streams between $11 million and $17 million over the past three years, with expenses ranging between $12 and $14 million yearly. The Center for Freedom and Prosperity's Open Gov state spending website show that the state alone paid over $2 million to RIQI since 2010. 

However, the state HIT survey showed that while healthcare providers were familiar with various components of CurrentCare, fewer than two out of ten physicians - of which there are just over 5000 in the state --  utilized the product in 2014.

"Government is simply less efficient than the free market system.  While public ventures generally begin with good intentions, public funding too often results in lack of accountability.  We are not aware of any built-in system that systematically reviews programs for efficacy nor provide any cost/benefit analysis," said Pam Gencarella wit taxpayer advocacy group OSTPA.  "That is why RI government is bloated.  We believe there should be such a system of review and it should apply to all government programs."

EHRs in the Spotlight

Senator Sheldon Whitehouse, who sits on the U.S. Senate Committee on Health, Education, Labor, and Pensions (HELP), was part of a recent hearing last week to explore how the federal government can improve the use of electronic health records (EHRs). 

In release following the hearing, Whitehouse's office said that the Senator had recently "helped convene state health care leaders... [to]develop a series of recommendations for Governor Raimondo and the General Assembly to pursue, which included expanding incentives for EHR adoption and utilization targets."

The HIT survey reported that of responding physicians, despite agreeing EHR's improve many aspects of care, fewer than half of hospital and office-based physicians agree that EHRs improve job satisfaction.

"The promise of EHRs has not been fulfilled as promised," said DeToy. "I can remember talking to doctors, back when these were discussed in the [1990s], and saying if you can control your data, that's the holy grail -- but they haven't gotten yet to interoperability.  It's like me having a Droid, and you having an Apple."

"So doctors spent so much money on [EHRs] and never got the promised [return on investment]. They put the data in and can't get from everyone else.  And yes, there are older generations who haven't taken to the change," continued DeToy. "I spoken with doctors who told me, 'I've spent $50,000 and it hasn't saved me any money, it's cost me money."

DeToy cautioned against reading into the survey responses, which represented 68% of physicians in the state. 

"Remember that in this survey that they are relying on in self-reporting. As human beings we tend to be motivated to report when we're unhappy.  If someone sends me a restaurant survey and I was relatively pleased, I probably won't respond," said DeToy. "There's a grain of salt, but it's the best we have to work with."

RI Taxpayers questioned however the amount of investment to date in CurrentCare, given its utilization numbers. 

"In view of the fact that the ironically named "Affordable Care Act" (ObamaCare) has not led to more affordable healthcare choices, in fact, just the opposite, it has become crystal clear that more taxpayer or customer dollars is not the answer for our healthcare system," said Monique Chartier with RI Taxpayers.  "As the return on investment from "CurrentCare" appears to be far worse than for ObamaCare, it's time to cut all public funding for it.  Privatization might be an option, as long as it is not accompanied by a government mandate on physicians to participate or to pay an involuntary fee."