MedNet takes patient records securely on the road

“We designed the concept, and we went to Cox about two-and-a-half years ago and asked them if they would be willing to work on the idea and develop a program with us,” Meadows said. “We had two objectives – use their facilities for the extension of technology as efficiently as possible. And also find a better solution to the cost of extending it to the physician practice. The cost needed to be reasonable to the practice and a fair market value as well as the most efficient way.”

From the Cox standpoint, its focus on regional networks fits well into serving regional health care authorities, and health care is a critical customer segment for Cox, said Mike Braham, regional vice president. Cox is able to leverage its fiber backbone to provide permissions-based access to the secure private IP network via any Internet access point, but the company can also upsell doctors’ offices to either hybrid fiber-coax or all fiber access facilities, Braham said. Increasingly, doctors are looking to fiber connections at work and are using HFC connections at home to access records and images as well, he said.

The longer term goal is to use MedNet to link a broad variety of players.

“Cox’s MedNet would link in health care providers, hospitals, insurance companies, pharmacies, telemedicine and distance learning -- the whole continuum -- that would all be able to have a way to pull all of those resources together, to fully exchange this information over this dedicated network and have HIPPA-compliant exchanges of information,” he said.

Security and compliance with HIPPA -- Health Insurance Portability and Accountability Act, the federal standard for patient privacy – are critical aspects of MedNet, Meadows said. While the system was set up to facilitate connections to insurance companies – Sentara has its own insurance company as one default player – that part of MedNet isn’t be implemented today.

Sentara began its efforts well before the current Obama-administration push to improve healthcare IT and create electronic patient records, but the doctors who participate in MedNet may be able to take advantage of its stimulus money – up to $44,000 per doctor or facility – which will be offered through Medicare payments, Spoto said. It is a complex process, and physicians must show “meaningful use” of a certified EMR system, such as EPIC, to get reimbursed based on a percentage of their Medicare bill starting in 2011. As a “back-end” payment system, the program requires physicians to pay up front and be reimbursed later.

Sentara has been offering this kind of service to its affiliates since 2007 and expects to bring on the first non-affiliated offices beginning in 2010, Meadows said. The healthcare provider is able to subsidize the program under a different federal initiative that began in 2006, but that subsidy ends in 2013, and the program needs to be self-supporting by then, with participants paying the monthly ASP fee that covers the cost of the service.

Spoto expects the primary challenges to be on the far end of MedNet’s reach, in the doctor’s offices, where each office is in charge of its own computers and technology.

“Many of these are small practices, and they may be using Cousin Vinnie as their tech support,” she said.

“We expect our challenges to be more application challenges than anything else,” Meadows said.

Cox’s involvement in telemedicine is only going to grow, said Braham, who views MedNet as one stake in the ground for what will be a booming industry that connects not just doctors and hospitals but also people in their homes.

“This is a tremendous opportunity as we look forward to future requirements of the boomer nation,” Braham said. “Whether it’s helping seniors stay in their homes longer and not go to nursing homes or providing remote diagnostics in rural communities or on a ‘follow-the-sun’ basis, we think there is a tremendous amount of things to be done in this area.”