Beth Israel Deaconess Medical Center (BIDMC), a Harvard teaching hospital and major medical institution based in Boston, is connecting four diverse, local physician offices to its community electronic health record (EHR) infrastructure and anticipates data sharing among the small offices by August.


Through the program, 300 doctors in 150 practices in the New England region will have the capability to share protected health information by 2010 and within five years all clinicians will be on EHRs, said John Halamka, MD, CIO of BIDMC and CIO of Harvard Medical Center.


The broad program is BIDMC’s answer to enabling all physicians in the community to deliver continuity of care through the use of an EHR system, said Halamka, who is also CEO of MA-SHARE, chair of the U.S. Healthcare Information Technology Standards Panel and a practicing emergency physician.


BIDMC’s own electronic medical record system, which manages 3 million patient records, delivers seamless integration of hospital data to the private physician office, he said.


The next step is enabling data sharing among physicians’ offices. “This is a policy issue, not a technology issue,” Halamka said, and one that BIDMC is still working through.


BIDMC has worked with its numerous partners – healthcare services firm Concordant, EHR software vendor eClinicalWorks, security solutions provider Third Brigade – to build its world-class, yet economical infrastructure, said Halamka. The Massachusetts eHealth Collaborative has provided the training and practice transformation from paper to electronic.


Concordant has been providing strategic services in the areas of budgeting and architecture planning and design. Mike Levinger, president of Concordant, said that total cost of ownership, including timing of cost and cost projection, is often overlooked in the healthcare environment. He stressed that total cost of ownership is critical to any organization’s success in deploying an EHR system.


BIDMC understood what was required, Halamka said. With physicians financially unable to buy their own EHR system and no budget allotted from federal and state governments, hospitals must step in, he said. “If we all think this is important, hospitals have to facilitate it.”


For BIDMC’s program, funding translates to approximately $50,000 per physician. Normal cost is anywhere between $40,000 to $60,000, Halamka pointed out. While the total cost of $15 million for 300 physicians may seem prohibitive, the payoff, when the data sharing capability is finally in place, will be significant.


The ability for hospitals to extract de-identified population health data is required for Massachusetts’ pay-for-performance programs, such as diabetes.


“The only way to achieve that is through clinical integration,” he said.


Continuity of care for patients will be preserved, and just as important, equality among physicians in the community will be achieved, which Halamka said is an important component of the program.


Levinger noted that Halamka and BIDMC had great vision of what they wanted to do and how to do it. “That’s the promise of technology – can we improve the quality of care while at the same time managing costs?” he said. “I believe the answer is yes.”