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providers, health plans, Medicaid programs and public health agencies.  Michigan and Washington are state leaders in establishing electronic patient registries.48

Current Status of California

A small fraction of California’s health care providers use health information technology:

13 percent of hospitals;49

20 percent of long term care facilities;50

13 percent of medical practices and 2 percent of independent practice associations;51and

3 percent of community clinics. 52

While data on HIT use among Medi-Cal providers is not available, the very low rate of use by community clinics indicates the challenges safety net providers face in making the significant investment HIT implementation requires.  Despite the high start-up costs, California could reap significant benefits from encouraging HIT use by Medi-Cal health plans and providers.  

Change Options

More thought is needed on how Medi-Cal can leverage ARRA funding in the context of an 1115 waiver.  Other ideas include:    

Promote Electronic Medical Records (EMR).  On a demonstration basis, create an electronic records network for Medi-Cal and uninsured through public facilities.

Create Incentive Payments for EMR.  Medi-Cal could pay providers using EMR more than others.

Offer Grant Funding for Disease Registries.  Given the savings potential, it may be possible to argue that Medicaid dollars should fund the creation of a disease registry.

5-C. E-Prescribing

Governor Arnold Schwarzenegger has proposed universal e-prescribing in California by 2010.  Nearly half of all Medicaid programs expect to have some level of either e-prescribing, electronic medical records or both in place by 2009.53  This is critical for achieving affordable and safe health care.  For example, electronic prescription programs help prevent adverse drug

48 CDC. Guide to Community Preventive Services: Systematic reviews and evidence-based recommendations. http://www.thecommunityguide.org/vaccine/vpd-int-target-prov-remind-alone-r.pdf Accessed September 15, 2008.

49 California HealthCare Foundation, “The State of Health Information Technology in California: Use Among Hospitals and Long Term Care Facilities,” 2008.

50 Ibid

51 Ibid

52 Ibid.

53 Kaiser Family Foundation, Kaiser State Health Facts, available at www.statehealthfacts.org.

Health Management Associates/Harbage ConsultingPage 41

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