Bredesen looks to Vanderbilt to help reform TennCare
NASHVILLE (AP) — Gov. Phil Bredesen needs to reform TennCare’s finances, but the former health care executive also wants to make the program a “model for other states” by using technology from Vanderbilt University Medical Center.
He’s particularly interested in the electronic medical record-keeping technology developed by the Informatics Center at Vanderbilt, which makes treatment safer and more efficient.
Bredesen said he wants to use a version of the system at Memphis’ Regional Medical Center, known as The Med, and eventually expand it to other hospitals and doctor’s offices that care for TennCare patients.
The governor plans to meet Wednesday with officials from Vanderbilt and The Med to begin working toward that goal.
“We’re sitting here in the same town with what is probably the world leader in this field,” Bredesen said Tuesday in an interview with The Associated Press. “So I called them up and said, ‘This is something we’d like to bring into TennCare and how can you help us?'”
Vanderbilt’s system lets doctors, nurses and lab technicians access medical records from a computer — instead of having to chase down a paper copy when time is critical, said Informatics Center director Dr. William Stead.
Stead estimates only between 5 percent and 10 percent of medical practitioners have moved to electronic record keeping.
Bredesen said the system would be particularly useful because so many TennCare patients “go to different doctors, who get care in emergency rooms without continuity of care.
“To have medical records that could follow a person around seems to me to buy you more in TennCare than almost anywhere else you could think of,” the governor said.
Bredesen first mentioned the work of Stead and his center during a speech last month outlining his proposed reforms of TennCare, the state’s troubled health care program for the poor, disabled and otherwise uninsured.
Budgeted to cost $7.8 billion next year, TennCare is expected to use up to 90 percent of the state’s new tax money within five years if it isn’t changed.
The governor plans to control TennCare spending by putting monthly limits on prescriptions, annual maximums on physician visits and the institution of a tiered co-pay system.
Bredesen does not know exactly how much it would cost to implement Vanderbilt’s technology at The Med, but any money the state spends on information systems would receive a 90 percent match from the federal government.
“I’d love eight years from now for this to be something that would be in doctor’s offices across the state,” he said.
Bredesen also is interested Vanderbilt’s WizOrder program, which uses computer databases to inform doctors about the best practices for treating patients.
For example, if a doctor prescribes treatment that may now be out of date, WizOrder suggests an alternative. It also warns physicians if a medication conflicts with a patient’s allergies or if an incorrect dose has been prescribed.
“The ability of informatics to really take standards of care that have been agreed upon by the most capable physicians and find some ways to enforce them — or at least remind people when they’re getting outside of the collars of the standards of care — seems to me to be a very valuable thing,” Bredesen said.
Since the technology was put in place at Vanderbilt last June — the electronic record system took less than a year to build and cost under $500,000 — the hospital has seen dramatic results.
Among them, 1 million fewer portable chest X-rays taken in a year, along with a 60-percent drop in the number of basic blood chemistry lab tests, Stead said.
Dr. Charles Safran, president of the nonprofit American Medical Informatics Association, said Vanderbilt leads the way in this field.
“They’re probably one of a half-dozen to a dozen places across the country who have that degree of sophistication,” he said. “They’re both a national treasure and a nationwide (model of) best practice.”
Vanderbilt’s interest in helping Bredesen isn’t just charitable. As one of the state’s leading TennCare providers — 27 percent of the hospital’s 804,216 admissions, outpatient and emergency room visits last year were by TennCare recipients — it will feel the impact of any changes to the program.
“Tennessee has a critical mass in new science, and we’re right here,” Stead said. “… Vanderbilt is absolutely committed to making TennCare work.”
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On the Net:
Vanderbilt University: www.vanderbilt.edu
TennCare: www.state.tn.us/tenncare