North Shore-LIJ Health System to implement the largest EHR program in the New York metropolitan area

Oct 1 2009

With national focus on health reform, NY hospital system looks to improve quality and efficiency by subsidizing docs to enroll in NY area's largest automated medical record system

The North Shore-LIJ Health System announced today it is subsidizing up to 85 percent of the cost of implementing and operating an Electronic Health Records (EHR) system in the offices of its more than 7,000 affiliated physicians in New York City and Long Island -- part of a $400 million investment to strengthen the quality of care throughout the region by automating inpatient and outpatient records in all medical settings, including 13 hospitals. In implementing the largest EHR program in the New York metropolitan area and one of the largest in the nation, North Shore-LIJ will provide physicians with individual subsidies of up to $40,000 over five years.

The North Shore-LIJ Electronic Health Record, powered by Allscripts (NASDAQ: MDRX), will be deployed this fall as part of a bold effort to drive unprecedented improvements in the efficiency and quality of care throughout the region. Embedded within the EHR are automated care guides that will help improve clinical care, prevent illness, and avoid medical and drug errors.

"While the Obama administration and Congressional leaders are still negotiating a comprehensive bill, the essence of real health reform is going to happen at the local level by optimizing technology and involving physicians who are directly involved in delivering care to the communities we serve," said Michael J. Dowling, president and chief executive officer (CEO) of the North Shore-LIJ Health System. "We're not going to measure our return-on-investment (ROI) in terms of dollars and cents; our ROI will be based on our ability to improve patient outcomes." As the federal government continues to move toward a system in which provider payments are based on performance, Mr. Dowling said, the financial subsidies tied to the EHR will assist North Shore-LIJ physicians in providing patients with a full continuum of care, addressing all chronic conditions through evidence-based treatment protocols.

North Shore-LIJ will subsidize either 50 percent or 85 percent of each physician's implementation cost and monthly operational fees, with a maximum incentive of $40,000 over five years. "No comparably-sized hospital system in the country is providing this level of financial assistance to so many physicians to integrate an electronic health record," said Robert Williams, MD, director of Deloitte Healthcare Consulting. North Shore-LIJ is able to offer these incentives to doctors because of recent exceptions made to the federal Stark Law, which previously prohibited hospitals from entering into financial arrangements with private physician practices.

In addition to the subsidies they receive from North Shore-LIJ, physicians may be eligible for up to $44,000 in Medicare incentives over five years as part of the American Recovery and Reinvestment Act.

Physicians who receive the 85 percent subsidy from North Shore-LIJ will agree to use the EHR to report and share their performance data, allowing them to compare it against a set of nationally recognized measures for superior care and outcomes. Embedded within the EHR are automated, best-practice treatment guidelines endorsed by North Shore-LIJ physicians and based on recommendations by the US Centers for Medicare and Medicaid Services, the National Quality Forum, the Institute of Medicine and other leading health experts.

The EHR program will provide real-time, situation-appropriate care plans, clinical alerts and preventive care. For example, when a physician indicates a patient's problem, the clinician is provided with a list of diagnostic tests and possible therapeutic interventions that are considered best practices to help support the decision-making process. In addition, once elements of a care guide are selected, the system suggests a long-term plan for ongoing monitoring of the patient, based on their list of medical problems, as well as standard health care preventive maintenance based on the patient's age and gender.

"One of the fundamental flaws of our nation's health care system is underscored by the fact that 75 percent of our health care costs can be attributed to chronic preventable diseases affected by lifestyle choices such as smoking, poor eating habits and physical inactivity," said Lawrence G. Smith, MD, North Shore-LIJ's chief medical officer. "We need to change our focus from treating `sick' people to promoting an integrated approach to wellness, and a comprehensive electronic health record is a critical and necessary tool to achieving this goal."

Glen Tullman, CEO of Allscripts, noted that providing physicians with real-time care guidelines via the EHR increases the probability of achieving fundamental improvements in the quality of patient care. "Physicians are committed to providing the best possible care for their patients, but to deliver, they need just the right information at just the right time," said Mr. Tullman. "With this initiative, North Shore-LIJ is ensuring that physicians across the entire market area it serves not only have immediate access to the latest care guidelines, as well as access to patient information from every care setting, whether it's their own office, the emergency room or a clinic in another town. Connecting providers to each other and to the latest information is the key to helping our health care system do a better job of managing chronic diseases, providing preventative care, increasing the quality of the care provided and removing waste."

Full-time and affiliated physicians who use North Shore-LIJ's EHR will be able to access patient records and scheduling information in real-time from 13 North Shore-LIJ hospitals and other patient-care facilities, laboratories, pharmacies and other physicians.

"The North Shore-LIJ electronic health record system will be an exceptional tool for bridging the gap between the community, physicians and hospitals," said Randolph DiLorenzo, MD, a community-based family practitioner based in Syosset, NY, who was one of the early adopters of the EHR. "Community physicians working from their offices will be able to easily access lab data, scans and other vital medical records when their patients are in the hospital or emergency room, significantly improving their ability to care for their patients."

To market the service to North Shore-LIJ's vast network of physicians, Allscripts is working with Henry Schein Inc., (NASDAQ: HSIC), the largest distributor of healthcare products and services to office-based practitioners. While all physicians are eligible to enroll in the EHR, initial priority will be given to primary care physicians and specialists treating chronic diseases affecting large segments of the population.

The system is expected to be operational this November, according to John Bosco, North Shore-LIJ's chief information officer. Mr. Bosco said the Allscripts' EHR will connect to a separate inpatient clinical information system from Eclipsys Corporation that North Shore-LIJ is deploying at its hospitals and other facilities. The EHRs will exchange clinical data to inform inpatient caregivers when patients are admitted to a hospital or seen in the emergency room, and improve the ability of physicians to provide ongoing care after the patient leaves the hospital. "We are very excited about using these technologies to enable sharing of patient information across our provider network and facilities, and provide appropriate decision support tools," said Mr. Bosco.