Community-wide Implementation of Health Information Technology: The Massachusetts eHealth Collaborative Experience

Abstract

The Massachusetts eHealth Collaborative (MAeHC) was formed to improve patient safety and quality of care by promoting the use of health information technology through community-based implementation of electronic health records (EHRs) and health information exchange. The Collaborative has recently implemented EHRs in a diverse set of competitively selected communities, encompassing nearly 500 physicians serving over 500,000 patients. Targeting both EHR implementation and health information exchange at the community level has identified numerous challenges and strategies for overcoming them. This article describes the formation and implementation phases of the Collaborative, focusing on barriers identified, lessons learned, and policy issues.

A Survey Analysis Suggests That Electronic Health Records Will Yield Revenue Gains For Some Practices And Losses For Many

“…Additional details on the pilot have been presented elsewhere. 7,8 Data The data supporting our return-oninvestment projections came from the following two sources: a survey completed by pilot practices and internal accounting documents maintained by the Massachusetts eHealth Collaborative that captured spending on behalf of pilot practices.We used the survey to collect costs and benefits realized by pilot practices as a result of EHR adoption. Our survey, modeled on the Medical Group Management Association's annual cost survey, 9 asked practices to report retrospective financial data from fiscal years 2005 (before adoption) and 2008 (after adoption).…”

Adoption and use of health information technology in physician practice organisations: systematic review

“…Concerns about the privacy and confidentiality of patient information stored and accessed within an electronic system remain obstacles to EMR implementation. 1,3,17,50,56,64 A 2006 survey of paediatricians noted that practitioners were apprehensive about maintaining patient privacy within an EMR system, and expressed reluctance to share the possibility of HIT utilisation with patients in their practices. 15 Findings from ten physician focus groups also highlight concerns about the technical capabilities and overall 'fit' of HIT to physician group environments.…”

“…11,14,15 There are also issues with the lack of standards for how patient data should be managed, coded and represented within an electronic record. 4,15,56 To mitigate this, studies suggest that customisation of any EMR system be slow and incremental to account for the preferences of practice environments. 66,67 Development of a non-profit government organisation tasked with creating standards for healthcare data organisation could also facilitate the HIT adoption process.…”

Massachusetts E-Health Project Increased Physicians’ Ability To Use Registries, And Signals Progress Toward Better Care

“…Additional details about the program are presented elsewhere. 5,7 Our study evaluates one aspect of the potential impact of this program on the quality of health care. Because effects on patient outcomes and costs of care are likely to require several years to become measurable, we identified the ability to generate patient registries as an early proxy measure for the Massachusetts eHealth Collaborative's potential impact on the quality of care.…”

“…One of the most visible examples of such programs is the Massachusetts eHealth Collaborative, a statewide consortium of health care stakeholders founded in 2004 to improve the quality and safety of health care through community-based adoption of health IT. [5][6][7][8][9][10] During 2006-08, the Massachusetts eHealth Collaborative sponsored a program to implement electronic health records within ambulatory medical practices and establish health information exchange. With a $50 million grant from Blue Cross and Blue Shield of Massachusetts, the collaborative used a competitive process to select three communities to participate in the program.…”