By GARY REMAL
Staff Writer Sunday, April 15, 2007

Officials at MaineInfoNet, a nonprofit corporation, are creating an electronic system they say will save money, avoid duplicate tests and procedures, save lives and improve care.

"It's typical to have two or more providers and they're all prescribing and none of them know what the others are prescribing," said HealthInfoNet Executive Director Devore Culver.

"If you talk to pharmacists, they'll tell you it scares the crap out of them because unless you're very faithful to their chain (in filling prescriptions), they don't know what's out there" for drugs being used by a patient, he said.

The new system would bridge that information gap.

But before it can be put into place, officials need $6 million to run a demonstration project, Culver said.

"It would be a combination of dollars coming in from the provider community, hospitals, physicians, private foundations, state government, the federal government and business," said James Harnar of HealthInfoNet, former head of the Maine Hospital Association. "It's a public-private partnership so it's important to draw money from a number of sources."

The group already has spent about $2 million for planning and preparation to get to the point where they're ready to run the demonstration. Most of that money came from public and private grants and foundations.

"It's been a challenge so far," Culver said.

HealthInfoNet recently selected a partnership between 3M Health Information Systems from Salt Lake City, Utah, and Orion Health and Connectria headquartered in New Zealand, to run the complex computer programs underlying the medical-records maintenance system.

Project officials have asked the Legislature to pay $2 million toward the demonstration project, with the remainder expected to come from doctors, hospitals, insurance companies and other users of the system.

Culver recently put on a demonstration of the computer system for legislators, but with other Statehouse activities competing, few showed up.

"We recognize it's going to be a real challenge, given the priorities of the budget," Harnar said. "However, we've gotten substantial interest and support and hopefully we'll find some funding."

After testing the system for about two years with the health networks associated with MaineGeneral Medical Center in the Augusta and Waterville areas, Maine Medical Center in Portland and other locations, Central Maine Medical Center in Lewiston and Eastern Maine Medical Center in Bangor, HealthInfoNet officials expect to spend about six months reviewing and critiquing its operation.

If all has gone well, they plan to bring the system up statewide at a cost of an additional $16 million. Officials hope to pay for it by offering access on a paid subscription basis to hospitals, physicians and other health-care providers, as well as to insurers and federally funded state health-care programs, such as MaineCare and Medicare.

"The reason for the demonstration is to show where the value rests so people can contribute with confidence," Culver said.

The system has been designed to coordinate with the federal Veterans Affairs electronic medical records system to better serve veterans who use services like those offered at the Togus medical center, as well as private physicians around the state, he said.

"Hospitals in Maine, and a lot of doctors' offices, are creating their own electronic medical records," Harnar said. "A lot of hospitals are investing a lot of dollars in their systems. What HealthInfoNet does is creates a system that ties them all together."

Dr. Andrew Coburn, a health policy expert and director of the Muskie School of Public Service Institute for Health Policy at the University of Southern Maine, is a big supporter of electronic health systems like HealthInfoNet.

Such systems will improve the quality of health care, provide better safety and make quick and easy access to patient information by a range of health-care professionals almost unlimited, Coburn said.

But he worries where the money will come from to pay the big price tag.

"The question is, who should pay for that," Coburn said. "When we created the railroads and telephone system, all our infrastructure, whether it was transportation or communication, they were large commercial ventures that served customers who paid for them. The question here is, who is the customer and who is going to be willing to pay for the end cost to build the (electronic health records) system."

Two of the state's largest networks associated with Maine Medical Center and Eastern Maine Medical Center have already announced their intention to work together on a common electronic records system, he said.

Because the two medical facilities provide about 60 percent of the state's health care, Coburn said their collaboration either could become a critical part of HealthInfoNet's statewide system or potentially a competitor.

Coburn is critical of federal officials who have encouraged the creation of electronic medical record systems, but have been stingy in supporting their creation.

"The federal government, I think, has been very deceptive in what they say about the importance of systems like HealthInfoNet," Coburn said. "There has been a lot of talk, but no money."

Security for electronic systems is a big concern, Culver said. Surveys conducted for HealthInfoNet show protection of their medical records is a top concern for patients.

Strict policies and procedures will be in place, he said. An electronic auditing system will identify doctors or other health-care users who access patient records to notify patients and system operators if unauthorized access is made to the system.

Patients can determine the level of access health-care providers have, Culver explained. And they can check the records themselves to see who has been looking at them as part of a self-policing system.

"If I've used the system, you know I've been there," he said.

Culver said patients who have been interviewed in the planning process indicate they want their records maintained by an independent organization like his rather than a government agency or an affiliate of health insurance companies.

A handful of smaller states, including Maine, are on the cutting edge of the recordkeeping effort simply because there are fewer players involved, Culver said.

"It's no surprise that Delaware became the first to get the statewide system started up," he said. "It's no surprise that Rhode Island is very close, as is Utah. They're all small states."

Gary Remal -- 621-5642

gremal@centralmaine.com