Short Circuit Hits Electronic Medical Records

Cal Index is a simple concept: Make electronic medical records universally available for qualified personnel. But the non-profit database provider faces hurdles, including the need to get patients to sign up the program and pushback from a consumer advocacy group. Cal Index started in August with $80 million of seed funding from insurer Anthem Inc. in Thousand Oaks and Blue Shield, a non-profit insurance provider in San Francisco. Both plans are marketing the program to their policyholders, who must volunteer to make their information accessible. David Watson, chief executive of Cal Index in San Francisco, said insurers, including Anthem, believe a statewide database of medical information will save money by avoiding redundant testing and prescription drug incompatibility. For patients, it could save their lives in an emergency if the paramedics need to know about a drug allergy or chronic condition, for example. Currently, a patient may have several doctors who don’t know what medications the other doctors have prescribed, or if the patient has been to a hospital – unless the patient mentions it to the doctor. “With prescriptions, the doctors know what they have written, and the pharmacy knows what has been filled,” Watson said. “If a prescription hasn’t been filled, the person is not taking their medicine and could end up in the hospital. The doctor could improve outcomes and reduce costs with a phone call.” But Carmen Balber, executive director at the advocacy group Consumer Watchdog in Santa Monica, has called for a boycott of Cal Index until it’s clear how this non-governmental entity will use and safeguard the information. “The insurance companies say that they created the database so your doctors can access all your health information in the same place. This kind of central electronic medical record can make health care safer – but it doesn’t have to come at the expense of patient privacy. Until the insurance companies disclose who will have access to sensitive medical information, and how it will be used, no one has enough information to safely participate,” Balber said in an email. Watson responded that the company was “serious”about securing privacy: “If we are good at that, we have a sustainable business model, otherwise we don’t. It’s that cut-and-dried for us.” For now, Watson is working to get more insurance companies, as well as providers such as hospitals and doctors groups, to offer Cal Index to their patients. He hopes to achieve a critical mass and start charging an access fee to the database before the seed money runs out. “The goal is in three years to become self-sufficient,” he said. Anthem did not make an executive available for comment by deadline. Profit From Protocol Strategic Health Group has a consulting job to help Indiana University monetize a protocol for geriatric care. The Burbank consulting firm was contacted because the university’s health system has developed a program, called Geriatric Resources for the Assessment and Care of Elders, or GRACE. According to Henry Osowski, managing partner at Strategic Health, the core element is that a social worker and a nurse practitioner manage the patient, rather than putting a primary care doctor in charge. The protocol itself consists of 12 care plans covering medication management, exercise and other daily-living routines to help patients self-manage their health. “It’s these detailed approaches to care that has been effective at reducing hospital re-admittances and allowing many patients to live independently,” Osowski said. In addition to the university’s hospital, several Veterans Administration facilities and Whittier Hospital Health Center, owned by AHMC Healthcare Inc. in Alhambra, have implemented the system. But so far, the university has charged a fee to train hospital personnel in the new system. Osowski’s job is to find a way the intellectual property developed by the school can provide recurring income. Strategic Health Group has two principals and about eight consultants who work on a contract basis. Eastside Scribes Essia Health, a Woodland Hills company that installs electronic medical records systems and provides medical scribes to doctors, has expanded its footprint with the acquisition of Eastside Specialty Services. Based in Bellevue, Wash., Eastside provides scribes to specialist doctors, including orthopedics and cardiology. Scribes work with doctors typing notes dictated during examinations. Eastside was started by Dr. Brad Kilcline, an emergency room doctor who found specialist physicians wanted to borrow the scribes he hired in the ER. With the acquisition, Kilcline has joined Essia Health as a physician consultant and will work to get new and existing customers to expand their use of Essia Health scribes in the Seattle market. Essia was started in 2008 by Dr. Kathleen Myers, an ER doctor, in Portland, Ore. It is now managed by Chief Executive Matthew Kirchner, who joined in June 2013. Staff Writer Joel Russell can be reached at (818) 316-3124 or [email protected].