Posted on 12.10.09 by CAFP President Tom Bent, MD

Recent work by CAFP members and staff on health information technology (HIT) opportunities for family physicians shows once again the power of association. The Academy is an ‘association' of physicians, which at times means we gather together as members of a medical specialty, to learn, to teach, and simply to compare notes.  To work together ‘in association' also has an even stronger meaning: the power we have when working as a collective whole rather than simply as individuals.

It takes the power of association to navigate many of the opportunities as well as challenges facing our profession. One new opportunity is the chance for solo, small, and safety net primary care practices to receive up to $65,000 in federal incentives to implement electronic medical records (EMR). The money is expected to be available in California early next year. While these funds won't cover all costs, it's never been a better time to take a step back, analyze the systems and processes that are the backbone of our practices, and determine how technology can improve our practice lives and our patients' health.

As I know personally, instituting an EMR isn't required for a practice to provide excellent patient care and track individual and population health, nor is it required for a practice to qualify as a Level 1 patient centered medical home as defined in NCQA certifying guidelines.  For those primary care practices ready to undertake the transition, however, this is an unprecedented opportunity and CAFP leaders and staff are working to ensure that the entire process goes as well as possible.

One important component of the process is the technical assistance that many practices rely on to prepare for implementation. As part of this federal initiative, money has been set aside to provide a range of resources to practices. Such resources can be accessed through a series of regional extension centers (RECs) now in development throughout California and the nation. On behalf of my many CAFP colleagues, I recently outlined our priorities for technical assistance services in a letter to California Deputy Secretary for Health Information Technology Jonah Frohlich, MPH. My intent is for the letter to serve as a blueprint as the state moves to coordinate all activities related to technology adoption. One of CAFP's priorities is ensuring that medical practices are assisted in focusing on process redesign and readiness before they begin work on EMR implementation. Through CAFP members' successes in our New Directions in Diabetes Care initiative these past few years, we've learned how important this is. As you have likely heard from your colleagues, having an electronic mess instead of a paper mess doesn't help much. I'm hopeful that the thoughtful approach the State is taking will help practices avoid the electronic mess and instead, focus on improving the quality, efficiency, outcomes, and vitality of their practice.

CAFP also is advocating for the RECs to establish the goals of improving patient outcomes and patient experience through the use of technology. We know these important goals will not be reached if use of an EMR is seen as the ultimate goal in and of itself.

CAFP also is advocating for effective, efficient, and transparent coordination by the RECs, including EMR procurement for solo and small practices and close coordination with the State's Health Information Technology Exchange, Medi-Cal ‘meaningful use' incentives, and other programs. We also need to ensure that our silent safety net - that is, practices caring for under- and uninsured Californians outside the clinic system - have the resources and support they need. It's just not possible for most individual family physicians to monitor and influence the State of California's approach to these matters but together, ‘in association,' we can.