With the help of private medical companies in need of a skilled workforce, UT-Austin is training everyone from recent college graduates to practicing nurses and doctors in the emerging field.
"The practice of medicine is changing," said Dr. Zacharia Varghese, a physician with a master's degree in public health who completed the university's Health IT Certificate Program in the fall. At a reception to celebrate the launch of the program's new simulation laboratory last week, Varghese demonstrated the software systems that allow medical providers to share patients' electronic health records and explained how they can be used as the foundation for a performance-based health care model.
"You can build a quality matrix into the software and a government regulator or insurance company can go through your patient records and find out whether [medical providers are] meeting quality standards," he said.
Varghese is a model student: When he finished the certificate program, he was hired as a content developer for e-MDs, a company that builds electronic health record systems for physicians' offices and was one of 45 companies to donate resources to the university's Health IT program.
At the height of the recession in 2009, e-MDs had 60 job openings in Austin but could not find a qualified workforce to fill the positions. For help, the company turned to Nora Belcher, director of the Texas e-Health Alliance, an advocacy group for improving health care technology. Within weeks, UT's Health IT program was conceived: Private companies would provide the expensive hardware and software for the program and the university would find a qualified faculty. In less than six months, students had begun their training.
"Never heard of H-I-T? That's OK. It's all about the J-O-B," the program's website boasts. Ninety-seven percent of students in the inaugural class have found jobs in the health IT field. More than 40 percent of students from the sixth class, who graduated from the program this fall, have already found jobs.
The program trains students to use multiple electronic health record systems and health information exchange platforms on computer systems set up in the program's high-tech simulation laboratory. Private companies have also stocked a mock physician's office with cutting edge technology, like telemedicine equipment, so that students can actively demonstrate how electronic health records would be used in the field.
Dr. Leanne Field, the director of UT's Health IT program, said their laboratory mimics what is being done around the state and the nation to build a "super highway for health care data."
"It's not unlike [how] our nation created the interstate highway system back in the '50s, except now it's a system to exchange health care data," she said.
Fields gave the hypothetical example of someone from Austin who gets into a car wreck while traveling in Houston and falls into a coma. With electronic health records, the emergency room physician in Houston could pull up the patient's electronic health record from Austin to immediately determine the patient's blood type, allergies to medications and other pertinent information that could help save the patient's life. "That really is what this is about, improving the quality of care and giving physicians the information that they need to get," Fields said.
The federal government has passed a variety of policies to push medical providers to switch to electronic health records. As part of the 2009 stimulus funding, the federal government offered incentives to Medicare and Medicaid providers that implemented electronic health records. Each year the agency overseeing the incentive funds pushed the eligibility criteria a little farther, requiring providers to continue improving their electronic systems.
Texas medical providers received more federal incentive funds for improving the use of electronic health record systems than providers in any other state -- more than $719 million from January 2011 to October 2012.
Belcher said a provision in the federal Affordable Care Act that penalizes medical providers that have a poor rate of patient readmissions by reducing their Medicare reimbursement rates also incentivizes providers to switch to electronic health systems. By utilizing electronic health records to track which patients are most likely to be re-admitted to the hospital, providers can attempt to avoid the penalty and curb negative health care trends.
Sixty percent of Texas physicians currently use electronic health records, according to the Texas Medical Association. That's up from 33 percent in 2007 and 27 percent in 2005.
Although she's sympathetic to some doctors' frustrations with the new technology, Belcher said they "can't defend staying on paper." Unless paper health records are scanned for fingerprints, it's impossible to know who has viewed the record, she said, whereas the electronic health records have built-in security measures. A scheduler, for example, could only see certain patient information, like a home address and phone number, while a nurse could see the patient's basic health information. A physician treating the patient would have the greatest access and the ability to edit and add documentation to the record. Electronic records also keep an audit trail, Belcher said, so that a patient or auditor can see who has viewed the record and at what time.
Last legislative session, state lawmakers also enhanced the consumer protections for electronic health records. Texas workers with access to electronic health records are required to receive training on the use of protected health information. And the attorney general may now assess civil penalties of up to $1.5 million annually for the unlawful sharing of private health information.
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