News Clip

Massachusetts Advances Health Care IT Goals
by Fanen Chiahemen,
iHealthBeat staff writer
January 20, 2005

Over the past year, Massachusetts has made a great deal of progress in advancing its health care information technology objectives, which could help the state become a national leader in implementing health care IT goals.

According to some health care executives, Massachusetts' advancement on health care IT is in part due to some of the state's distinct features, such as its size. With about 6 million residents, implementing health IT programs in Massachusetts is "manageable," said Mitchell Adams, executive director of the Massachusetts Technology Collaborative, a quasi-public development. "We're not California or New York. It's difficult to think of mounting initiatives which would embrace the whole state system if you were dealing with states that are the magnitude of countries," Adams said.

Massachusetts also has some significant advantages that relate directly to health and technology. "Health care in Massachusetts is a massive business," said Thomas Sullivan, past president of the Massachusetts Medical Society. The state is home to some well-regarded health plans, including Tufts Health Plan and Harvard Pilgrim Health Care. In addition, the state is home to some of the country's most renowned academic institutions, including Harvard University and the Massachusetts Institute of Technology. Adams said he believes the state's medical schools play a large role in knitting the health care system as well as the health care delivery system together. That nexus of science and technology and universities has made Massachusetts a hotbed of technological advancement and change, Adams said. "There's a pronounced mindset and culture for innovation," he said.

Last September, the state unveiled a plan to install computerized physician order entry systems within three years in all hospitals across the state. In December, it launched an initiative that will give physicians access to electronic medical records with a goal to implement a statewide system within five years. Subsequently, 34 state organizations came together to form a statewide health information network, called the Massachusetts eHealth Collaborative. The project within five years aims to complete pilot programs to build a foundation for expanded use, adopt interoperability standards and create a statewide EMR infrastructure. The collaborative also will create a financing plan to support electronic records technology investment, and establish best practices to protect the privacy and security of electronic records. The program will begin as a pilot project in three communities to be selected in March.

Wendy Everett, president of the New England Healthcare Institute, said the collaborative was made possible by two crucial factors: a catalyst, in the form of the groups that championed the idea, and seed money from Blue Cross Blue Shield of Massachusetts, which pledged up to $50 million to fund pilot projects. The project's leader, Micky Tripathi, said that while other states, such as Indiana, have regional or citywide initiatives with the same objective to build statewide systems, Massachusetts is in the spotlight most likely because of the funding. "I think in many other places people have always sensed that the key to this is that the payers need to be at the table and coming forward with strong incentives to remove a lot of the barriers," said Tripathi, who also served as founding president and CEO of the Indiana Health Information Exchange.

Robert Mandel, Blue Cross Blue Shield of Massachusetts' vice president of eHealth, said the pressure to reduce health care costs and improve quality influenced the 2.6 million-member health insurer's decision to contribute. "Blue Cross is pretty firmly committed to the fact that significant changes need to happen in the health care system if it's to survive and to provide the quality that our members deserve and if it's going to remain affordable."

Some health care executives have said that support from the state government has boosted health care IT projects in Massachusetts. For example, Gov. Mitt Romney (R) in December announced the EMR initiative, and he has praised the creation of the MaeHC. "He has made this a major platform of his administration," Everett said. "I think having that kind of administrative and political support is very important," she added. Adams said the Legislature has in the current budget year allocated $500,000 to support the hospital CPOE effort, and MTC is "very enthusiastic and hopeful about substantially more in the upcoming budget year."

With all the major stakeholders aligned, some health leaders believe other states will soon be able to look to Massachusetts in developing their own health care IT initiatives. Everett said that the collaborative could take lessons learned within the project's first year to the other five states in New England and then eventually work with National Health Information Technology Coordinator Dr. David Brailer's office to see what can be done nationally. "I think it's a very easy and effective model, and I don't see that there's any reason that it can't be transported to the other states," Everett said.

Despite Advances, Challenges Remain
Health care leaders, however, are aware of the challenges Massachusetts faces. For example, much of the success in adopting health care IT in the state will depend on its residents. "The collaborative can be as committed as it wants, but it needs commitment on the part of the physicians and the hospitals, the people who are going to be using the systems," Mandel said.

Further, having a wired state means having a lot of personal data circulating around it, so patients must be comfortable with the way privacy and security are handled, Mandel said. "We're very committed to making sure that we adhere to the highest standards regarding privacy and security," Mandel said. Also, Tripathi said the collaborative also needs to work on integrating IT systems and making them more usable and interoperable.

Massachusetts health care leaders said they are not deterred by any potential barriers and seem determined to forge ahead with projects. In fact, the MaeHC already is planning the state's next health care IT project, which likely will be announced in a few weeks, Everett said. Although no one knows how these initiatives will play out, health executives are staying optimistic. "We're wary this is a tough road," Sullivan said. "But, there's a good chance of success."