Saturday, February 23, 2008


Inland Empire Regional Health Information Organization

Gary M. Levin MD, Coordinator

20032 Sweetbay Road

Riverside, Ca.


Tel: 951-746-9145

Press Release: A Letter to CMS regarding Electronic Health Records

CMS Demonstration Project: Electronic Health Records Demonstration 2008

Dear sirs;

For the past four years I have been involved with promoting and developing a regional health information exchange for the Riverside and San Bernardino County region of Southern California. This is a rather large geographic area east of Los Angeles and includes some rural and remote desert communities as well as urban and suburban areas.

I also publish a weblog devoted to information technology as a resource for area physicians and interested parties regarding RHIO progress in our area, which I might add has had dismal response. .

Despite the encouragement of the California Regional Health Information Organization and their “framework” for developing such entities there has yet to be made any significant progress, with multiple failures as we have seen in other RHIO efforts.

In my search for funding I was very encouraged to see the projected CMS Electronic Health Record Demonstration Project that was announced several weeks ago. However your recent email update surprised me and discouraged me greatly. The entire state of California is excluded from applicants and eligibility for these grant(s).

I am curious as to how and why this decision was made by policy makers? California represents a spectrum of health providers and has a large population as well as regional diversity. There is also a significant taxpayer base here, as well as CMS recipients. While there are several large health care entities who are adopting electronic heatlh records here, the adoption of EMR in smaller practices is very low. There also remains no connectivity between these groups and individual providers as well as academic medical centers.

California in the past has been on the forefront of developments in healthcare. Our state is certainly stressed in regard to healthcare for all its’s citizens. It’s hospital system has been decimated by reduced reimbursement as well as caring for uninsured as well as undocumented aliens. Our chaotic health insurance underwriting is chaotic and discriminatory for those who lose employment or have pre-existing conditions. The secondary economic toll is staggering and saps our potential wasting many lives.

The impact of granting CMS grants to our region would be great. The funds would do the greatest good for the most people. Most CMS grants seem to go to rural, underserved, or disadvanated counties or subsets of health issues. There has been a definite bias against the vast majority of insured and seemingly independent citizens who are imagined to be able to produce a system for Health Information Exchange.

The recent increased interest has produced a “feeding frenzy” amongst IT vendors whose main interest is “great profit” from medical providers . Numerous health care interests, insurance providers, CMS, have projected enormous savings and improved quality of care from health IT. Yet, some studies have failed to demonstrate this as true.

The adoption of EMR and HIE is much more than installing systems. It requires “change management” and few smaller practices have these resources available. Estimates for cost effectiveness fail to include training expenses, nor maintenance of systems which can amount to 15 or 20 percent/annum of the initial investment.

I and all the other health care providers will be interested in your important response to my question

Very truly yours,

Gary M. Levin MD

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