The Tribune

By YOURI KEMP

Tribune Business Reporter

ykemp@tribunemedia.net

The National Health Insurance (NHI) scheme yesterday said its newly-launched electronic health record (EHR) system will achieve the "highest standards" of data protection by being hosted offshore.

Graham Whitmarsh, pictured, NHI's managing director and chief executive, said the contract with eClinicalWorks, which he described as the largest digital medical records provider in the US, would attract a yearly cost of $4 per patient. He suggested that the healthcare financing scheme would "struggle" to achieve the necessary data protection in The Bahamas.

"When the NHI Authority was established with a board, the very first mandate they gave to me was to develop some technology that would allow us to demonstrate value to the government and the public for the significant amount of money that's being invested in NHI," Mr Whitmarsh said, "and also to make sure we have technology that could support our understanding of whether the services we were providing would be effective. That's why we have the EHR today.

A modern, properly functioning electronic medical records system is vital to NHI's smooth operation as it will give participating doctors and providers instant access to a patient's health history. Besides enabling faster and more efficient diagnosis, and better treatment, this system will also create a paper trail enabling the NHI Authority to better monitor treatment outcomes, track costs and eliminate fraud and waste.

"I know the biggest thing on everybody's mind is about privacy and security, and I want to assure everybody that this appears to the highest standards," Mr Whitmarsh said yesterday. "The information itself is kept on an encrypted server, and access to that information is controlled by the physician and the patient.

"No one gets to see it without the patient's permission. The information is owned by the physician just as a paper record is today. But it will give a beneficiary much better insight into the care that they are getting, the prescriptions that they may have, allergies, other elements of their care through a web-based portal."

Explaining that the NHI Authority, rather than doctors and their patients, will cover the system's costs, Mr Whitmarsh added: "We have acquired the system. We have paid for it on a per month basis, and the average cost per beneficiary is about $4 per year. We pay about $4 per patient per year."

The health records data will be housed in an encrypted server based in Massachusetts, which the NHI Authority says will offer "best in class" mechanisms for safeguarding Bahamian privacy and security regarding their health information. Each server contains individual databases that are unique to each client, meaning that NHI providers will not mistakenly co-mingle patient data.

Mr Whitmarsh said: "The facility is governed by the US Health Information Protection Act, which has some of the most stringent standards in the world. eClinicalWorks, the provider, is the biggest electronic health record provider in North America - they are approaching 60 percent market share.

"So we have actually gone with a mainstream system and, to us, it's a great comfort that we are governed by those rules in the US because I think we would have struggled to achieve those levels of security here."

Mr Whitmarsh said doctors and beneficiaries will now be able to access medical records via the Internet, thereby reducing paperwork and any confusion that may result when patient files are not transferable across services providers.

"No more paper," he added. "When a beneficiary arrives at a clinic they can register by using an iPad that's there, and then the physician during the encounter will enter the information into the health record.

"Immediately the beneficiary will be able to see that visit in their own personal health portal. If there were results from a laboratory test, or a prescription, for example, then they will be able to go in and see that. That's going to mean that they will have much better visibility to the care that they are getting."