When it comes to advancing health IT, New York State and New York City really put their money where their mouths are. The latest endeavor by the City is a Panel Management Program, which is administered by the New York City Dept. of Health and Mental Hygiene's Primary Care Information Project (PCIP).
PCIP's goal is to improve population health through the use of health IT and health information exchange. Funded by Pzifer, PCIP has helped more than 2,200 primary care providers in New York City's underserved communities in its five boroughs implement a version of eClinicalWorks called Take Care New York. The EHR is prevention oriented. Now with the Panel Management Program, those participating PCPs will have no-cost access to prevention outreach specialists who will use their EHR's registry to help identify patients who need preventative health services and then encourage them to make appointments for care and treatment.
The practices' EHRs track and document outreach activities, and the EHRs are even set up to alert PCPs when barriers to their patients' preventive care and health goals arise.
One of the many historical problems with EHRs and EMRs is the lack of business case. Absent a total overhaul of the payment system, currently if providers are taking better care of their patients, use of their services goes down, along with revenue. In this model, however, patients who otherwise would not have gone to the doctor's office are presented with compelling evidence to take care of their health issues. This brings in more patients to the practice and improves the quality of care and reduces more costly service down the road with preventative care. I understand that patients have to be proactive about their health as well, that this is an important part of the equation. We'll have to wait and see if the outreach specialists can persuade patients to do the right thing and continue down the path of wellness and prevention.
It's worth the effort of trying: Consider the numbers. According to the City's health commissioner, less than half of the 25 percent of New Yorkers who suffer from hypertension have their blood pressure controlled. That's a lot of New Yorkers to take care of in prevention mode. Furthermore, the City health commissioner noted that more than 120,000 preventable hospitalizations among New York residents age 18 years and older in 2006 could have been avoided with appropriate treatment in a primary care setting. It goes without saying: Prevention is cheaper than a disease or event being treated down the road when left unchecked. That's when we all pay.
Consider this number, as well. The participating PCPs under the PCIP serve more than 2 million patients in New York City. That's a pretty big safety net to flag preventable health issues and do something about it.
I don't know how the partnership evolved between the Dept. of Health and Mental Hygiene and Pfizer, but other public health departments might want to look into this type of a program. It delivers a compelling business case.
