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State budget contains "disappointing" $10 million for electronic medical records

Madison, Wis. - Given the tens of millions in private- and public-sector investments that probably are needed for the full adoption of electronic medical records, and the hundreds of millions that might be needed to complete the state's overall eHealth Initiative, Gov. Jim Doyle's original $30 million proposal for EMRs was seen as a modest first step in moving Wisconsin healthcare providers away from paper charts.

But the downsized $10 million commitment that remains in the 2007-09 state budget, which calls for $57.2 billion in overall spending over the next two years, strikes some as downright paltry.

“Very disappointing,” said Peter Strombom, president of Strombom Associates and former vice president and CIO of Meriter Health Services.

eHealth in eJeopardy?

Earlier this year, Doyle asked lawmakers to provide $30 million in funding to help healthcare providers convert to electronic medical records - $20 million in the form of state “eHealth” grants, and $10 million in tax credits. Only the last piece was left standing after budget negotiators finally reached an agreement on new spending blueprint, and the credits won't be available until the second year of the biennium.
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As part of Doyle's eHealth Initiative, Wisconsin is attempting to become the first state in the nation to move away from paper records and charts and fully adopt electronic health records in all healthcare settings. Among the purported benefits of electronic health records are a reduction of medical errors and improvements in operational efficiencies, including faster communication, that result in reduced costs.

The full adoption of electronic medical records is a crucial first step in the sharing of electronic patient data between healthcare providers, a long-term goal that is part of the eHealth Initiative. The most likely starting point is the electronic sharing of patient medication use in emergency-room settings.

Doyle has called on healthcare providers to help to overcome barriers to a fully integrated electronic medical records system, with the most commonly cited barriers being interoperability challenges, organizational jealousies, jurisdictional and proprietary boundaries, and lingering doubts that it can be done securely.

Some would characterize the lack of state funding as an additional barrier, including Strombom. He characterized the tax credit allocation as a “drop in the bucket,” and has noted that Meriter alone has spent at least $20 million over the past five years in moving toward an electronic medical record.

“The governor's eHealth proposal will not be achieved with this [low] level of state funding,” he stated.

Looking toward 2009

Carla Vigue, a spokeswoman for Doyle, said the Governor - who saw other pieces of his healthcare agenda enacted, including 98 percent insurance coverage through BadgerCare Plus - would continue to pursue additional EMR funding in future budgets.

“The governor's overall healthcare plan was to help make healthcare more accessible and affordable for the people of Wisconsin,” she said. “eHealth is vital to that effort because it helps reduce administrative costs and costly medical errors.”

Given the extensive veto powers of the governor of Wisconsin, Doyle might also choose to take funding from one area and apply it to EMR adoption. He is expected to sign the 2007-09 budget into law on Friday.

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