Tuesday, January 30, 2007

North Adams in the news

Today's Boston Globe has a front-page article on MAeHC's North Adams project. The trigger for the story is the launching, next month, of the first comprehensive, community-wide health information exchange in the country.

I think the reporter, Liz Kowalczyk, did an excellent job of capturing a pretty complicated story. The article accurately describes our approach to privacy and security, and the reach-out that we've done to get patient permission. There are some great interviews with patients as well.

I have only two quibbles with the article. First, it exaggerates the income loss that physicians participating in the program have experienced during the transition to their EHR systems. The article claims that physicians have reduced patient loads by "20% to 50%" during the first month. In fact, the vast majority of practices in the project are back at 100% within 2 weeks of going live. And for a capacity-constrained community like North Adams, this isn't a permanent income loss, because some of those patients get crammed into the schedule in weeks 3, 4, and 5 -- they have nowhere else to go, after all. I'm not saying that they don't have some permanent income loss, because they do -- it's just not as high as the article claims.

My second quibble is that the story doesn't focus enough on the key role played by the community to make this a success. Health information exchange isn't going to happen at a state-wide level before it happens within communities. And that requires higher EHR adoption and the creation of local, sustainable HIEs. The article focuses too much on the state-wide network, which isn't where the action is......yet. There's no case for a state-wide (or national) network until we have greater adoption at the local level, as was made clear at a recent national conference sponsored by the federal government.

Nationally, 30 percent of EHR implementations end in failure -- the MAeHC communities won't have anywhere near that level. And that's not just dumb luck. High adoption requires more than just money -- it takes a community.

In each of our communities, MAeHC has created a community steering committee to oversee and monitor the program, community user groups (physician- and staff-level), centralized implementation and IT support, consumer councils to get patient input, and group training sessions -- all of which are helping to get a high level of adoption. It's not the technology that's the real innovation in North Adams, or Brockton, or Newburyport -- it's the greater sense of community, among physicians and patients alike. You don't get that with random acts of technology -- you get it by engaging a community in a conversation about how to use technology to improve their lives.

In the end, these are tiny quibbles -- I think the article was terrific, and we greatly appreciate the Globe's interest in the story. WBZ radio's interest was a little less welcome in their unexpected 6 am call on my home number this morning. Fortunately, I was already awake -- we appreciate their interest as well.......


Anonymous said...

Liz did a great job with this story, Micky, and your personal ongoing involvement and support in this kind of program is really appreciated by us all.

Micky Tripathi said...

Thanks for the kind words Paul. And I couldn't agree more -- this is a difficult, multi-layered topic and Liz got her arms around it quickly and reported it eloquently.

derauf said...

How critical wsa the widespread use of One EMR company for the success (early) in North Adams