HIPAA Regulatory Alert

Tennessee sets up medical info exchange

The State of Tennessee has expanded an existing contract with AT&T to provide the country's first statewide system to electronically exchange patient medical information. Officials say the system is designed to securely transmit detailed patient information between medical professionals, allowing doctors to access medical histories, prescribe medicines over the Internet, and transfer images such as X-rays and MRI and CT scans.

"As patients, we really want our information to be available to physicians whenever and wherever it's needed," says AT&T director of health care marketing Diane Turcan. "And we certainly don't want to be copying paper records." She says the program is likely to be a model for other states and a springboard for interstate information-sharing networks.

To make the system work, AT&T is developing a private portal within the secure network it already provides for Tennessee state agencies. Doctors can use the system to remotely evaluate patients in rural areas who have less access to medical facilities. It also will link to the state health department for access to that agency's immunization and disease registries, death certificate processing, and medical license renewals.

Tennessee eHealth Council Director Antoine Agassi says the council and state legislature worked with AT&T to amend the current statewide network agreement so health care providers could tap into the network and purchase services at an attractive price.

"We're allowing doctors to leverage the state's purchasing power," he says, "and offering them a very sophisticated catalog of services. Doctors are not required to participate. But the state is offering them grants of $6,000 to help them get started. They can always choose not to participate, but we think we're offering very attractive pricing."

So far, Agassi says, the plan has been received enthusiastically by physicians, and agreements were reached with 165 sites within the first 45 days. "We're very encouraged," he says. "The feedback has been tremendous."

Doctor fee less than local Internet providers

Doctors will pay between $100 and $750 per month, depending on the bandwidth they need. Agassi says that monthly fee is considerably less than they would pay local providers.

Privacy is a major concern for the system, Agassi says. It is running on a private network that has firewalls and will require authentication of the physician users.

Not able to wait for a national data standard to be adopted, Tennessee has published its own minimum data standards that will be applied to the program.

"We believe we have made this attractive enough that it would be difficult for someone in health care not to participate," Agassi says. "The incentives are so great they will really have to do it."