[Photo illustration: Jason Morton]

Within the next five to 10 years every Floridian's medical records may be little more than a click away. The Agency for Health Care Administration and the Governor's Health Information Infrastructure Advisory Board are driving an effort to create an internet-based information network where healthcare providers can share patient records. Proponents of the Florida Health Information Network say it will cut costs, improve the quality of care and reduce medical errors.

So far, the state has invested $3.5 million to set up 10 regional health information organizations (RHIOs), which are creating the infrastructure for local information-sharing. The state will develop the infrastructure to link the regional systems.

Several regional exchanges are already operating small-scale health information projects. The Palm Beach County Community Health Alliance is building an electronic health record system called All-Care that enables providers to share records for uninsured and Medicaid patients receiving care at hospitals, clinics and other locations within the Palm Beach County Health Care District. The South Florida Health Information Initiative recently launched a system linking Mercy Hospital with nine clinics affiliated with the Health Choice Network, allowing providers to share information about patients' admissions and discharges, their lab results, radiology reports and prescription information. The Tampa Bay regional organization has been operating an electronic network that allows Tampa General Hospital, H. Lee Moffitt Cancer Center & Research Institute and All Children's Hospital in St. Petersburg to share records. It was recently tapped to develop a record-sharing network for the Department of Defense and state healthcare providers. There are approximately 700,000 military health system beneficiaries in Florida.

Moving forward, the architects of the Florida Health Information Network face several hurdles.

One problem is that few healthcare providers in the state, or the country for that matter, keep patient data in an electronic format. While approximately 89% of doctors in the United Kingdom use electronic medical records, only 28% in the United States do so, according to a 2006 survey.

Concerns about security and privacy also pose a challenge. Carladenise Edwards, executive director of the South Florida Health Information Initiative, says making such a system secure is not the problem. The challenge is in convincing the public such a system is safe. "People want the electronic world to be more secure than the paper world now is," says Edwards.

Funding, however, is the project's biggest hurdle. The Florida Health Policy Center estimates it will ultimately cost $51 million to get the system operational. With funding likely to be sparse, regional organizations are already examining other potential funding sources. "As we look at building RHIOs, it's like building a small entrepreneurial business. Once we're able to show our products, we should be able to attract investment capital," says Laura Kolkman, a project consultant for the Tampa Bay organization. Ultimately, says Kolkman, the system "should pay for itself."

Next page, Digital Hospitals

Digital Hospitals

While the adoption of electronic medical records has been slow in the U.S., some Florida hospitals are ahead of the curve.

» The Cleveland Clinic in Weston (Broward County) offers patients and doctors online access to medical records through secure websites. Patients can view lab results, prescription records and doctors' health recommendations as well as schedule appointments and refill prescriptions. Doctors can track treatments and review diagnostic images and notes through the system.

» Baptist Medical Center South in Jacksonville opened in 2005 as a paper-free facility. It maintains patient charts, prescriptions, lab results, X-rays and all other medical information in an electronic format. Physicians update patient records via computer tablets.

» Pepin Heart Hospital in Tampa and Memorial Hospital in Miramar in Broward County both boast of operating in a "near paperless" environment.

» At Mayo Clinic Jacksonville, every patient's medical record is digital. The electronic record tracks a patient's condition, tests and prescription history.