[Infowarrior] - WalMart to market digital health records system

[Richard Forno]

  Wal-Mart plans to market digital health records system
By Steve Lohr
Wednesday, March 11, 2009

http://www.iht.com/bin/printfriendly.php?id=20745624

Wal-Mart Stores is striding into the market for electronic health  
records, seeking to bring the technology into the mainstream for  
physicians in small offices, where most of America's doctors practice  
medicine.

Wal-Mart's move comes as the Obama administration is trying to  
jumpstart the adoption of digital medical records with $19 billion of  
incentives in the stimulus package.

The company plans to team its Sam's Club division with Dell for  
computers and eClinicalWorks, a fast-growing private company, for  
software. Wal-Mart says its package deal of hardware, software,  
installation, maintenance and training will make the technology more  
accessible and affordable, undercutting rival health information  
technology suppliers by as much as half.

"We're a high-volume, low-cost company," said Marcus Osborne, senior  
director of health care business development at Wal-Mart. "And I would  
argue that mentality is sorely lacking in the health care industry."

The Sam's Club offering, to be made available this spring, will be  
under $25,000 for the first physician in a practice, and about $10,000  
for each additional doctor. After the installation and training, the  
continuing annual costs for maintenance and support will be $4,000 to  
$6,500 a year, the company estimates.

Wal-Mart says it had been exploring the opportunity in health  
information technology long before the recent presidential election.  
About 200,000 health care providers, mostly doctors, are among Sam  
Club's 47 million members. And the company's research showed the  
technology was becoming less costly and rising interest among small  
physician practices, according to Todd Matherly, vice president of  
health and wellness at Sam's Club.

The financial incentives in the administration plan — more than  
$40,000 per physician over a few years, to install and use electronic  
health records — could accelerate adoption. When used properly, most  
health experts agree, the migration from paper to digital records can  
curb costs and improve care.

But especially among physicians in small offices, many doubt the  
wisdom of switching to electronic health records, given their cost and  
complexity. Only about 17 percent of the nation's physicians are using  
computerized patient records, according to a government-sponsored  
survey published last year in The New England Journal of Medicine. The  
use of electronic health records is widespread in large physician  
groups, but three-fourths of the nation's doctors work in small  
practices, of 10 physicians or fewer.

But Wal-Mart has the potential to bring not only lower costs but an  
efficient distribution channel to cater to small physician groups.  
Traditional health technology suppliers, experts say, have tended to  
shun the small physician offices because it has been costly to sell to  
them — a large market in total, but scattered.

"If Wal-Mart is successful, this could be a game-changer," observed  
Dr. David Brailer, former national coordinator for health information  
technology in the Bush administration.

In the package, Dell is offering either a desktop or a tablet personal  
computer. Many physicians prefer the tablet PC because it more closely  
resembles their familiar paper note-taking and makes for easier  
communication with the patient, since the doctor is not behind a  
desktop screen.

eClinicalWorks, which is used by 25,000 physicians, mostly in small  
practices, will provide the electronic record and practice management  
software, for billing and patient registration, as a service over the  
Internet. This software-as-a-service model can trim costs considerably  
and make technical support and maintenance less complicated, because  
less software resides on the personal computer in a doctor's office.

Dell will be responsible for the installation of the computers, while  
eClinicalWorks will handle the installation, training and maintenance  
for the software. Wal-Mart is using its buying power for discounts on  
both the hardware and software.

Wal-Mart's role, according to Osborne, is to put the bundle of  
technology into an affordable and accessible offering. "We're the  
systems integrator, an aggregator," he said.

The company's test bed for the technology it will soon offer  
physicians has been its own health care clinics, staffed by third- 
party physicians and nurses. Started in September 2006, Wal-Mart now  
has 30 such clinics in stores in eight states. Those clinics make use  
of the technology the company will be offering physicians. "That's  
where the learning came from, and they were the kernel of this idea,"  
Osborne said.