Highmark To Assist Providers In Tech Adoption

Having recognized the quality of care improvement opportunities certain technologies can bring to provider offices, Highmark ($12.4 billion in 2007 revenue) recently established a program that will provide financial assistance to its member physicians that implement electronic health records or e-prescribing technology in their offices.

Under the initiative, which was announced in early June, physicians can apply for grants of up to $7,000 or 75 percent of the cost of an e-prescribing system or, better yet, an electronic health record that integrates with an e-prescribing system. According to a press release, Highmark is investing approximately $29 million in the program.

Highmark vice president of provider relations Augusta Kairys says that the goal of the program is to improve quality of care for members, as opposed to improving efficiency for the carrier itself. "Really, it's more benefiting our members in terms of improved patient safety, improved quality of care, and better coordinated care," Kairys relates. "Members' medical records are more accessible and there is stronger clinical decision support at the point-of-care."

Specifically, Highmark expects that, as these technologies are adopted, doctors will be able to more easily identify potential drug-to-drug interactions and determine what kinds of treatment a patient has received from other doctors. "Whether the physician is using e-prescribing or electronic health record technology, they have much more information about the patient available at their finger tips," Kairys says.

The Highmark program is vendor and application agnostic, with the carrier making no recommendations on what specific platforms the physicians should purchase. Instead, Highmark is requiring that the selected software meets certain interoperability and technology standards such as the Commission for the Certification of Health Information Technology (CCHIT) standards on HER functionality.

The company did consider going in the other direction — creating a program that delivered specific software to the offices — but decided that a one-size-fits-all approach wasn't advisable. "When we started this two and a half years ago, the feedback that we heard from the physicians was that not every technology fit in with the way a physician office is set up or the way they practice. They would really rather evaluate the technology on their own and select something that worked better within their own workflow," Kairys explains.

Another benefit of the technology agnostic program, Kairys says, is that some providers are able to use the funds to make the necessary hardware improvements to support the new technology. "We're looking at helping enable the full range of technology that would need to be implemented in some offices that may not have wireless access points or specific hardware to support this," Kairys explains.

The idea of the program was first conceived in 2005, when the Pittsburgh-based health insurer attempted to set up a not-for-profit foundation to distribute funds to physicians for the purpose of promoting more technology adoption. However, with the IRS still conducting a review of that and other similar projects seeking tax-exempt status, Highmark decided to create a similar program internally.

"After two and a half years, we felt that we really needed to be realistic and [we understood] that we weren't going to get approval any time soon," Kairys recalls. "So, we sought another source of funding internally from our board and they agreed to fund [a program] with new money that Highmark itself would administer."

Because many physicians applied for funding under the older program, the new incarnation has hit the ground running. Kairys says that no one who applied under the old grant program had to reapply, and so the early stages of new program have involved many follow-up phone calls to and from those providers. Ultimately, Kairys says that EHRs could lead to a medical care environment where different providers have access to a kind of health information exchange. Important and valuable patient information could be available in all different kinds of situations, from trips to the emergency room to office visits.

This program, she says, does not accomplish that goal, but it does set things moving in the right direction. "We want physicians to already be looking at the next step, which is integrating e-prescribing with electronic health records and going down that full path of health information technology adoption," Kairys says. "By getting physicians electronically enabled, it makes that next step much easier."