As electronic patient records become more vital to medical practices, West Virginia could serve as a national model by linking its free health clinics together in a single computerized network, experts say.

Nineteen free clinics in the state are linked through a Web-based electronic records system maintained through the National Technology Transfer Center at Wheeling Jesuit University. The clinics began coming online in 2006, with the most recent joining the network this month.

But such networks are a rarity in general medicine, must less among clinics serving the poor: a New England Journal of Medicine study released this week shows that only 17 percent of doctors in the U.S. use some kind of electronic records system.

“To have a network with all the same materials connecting the clinics is very, very rare,” said Nicole Lamoureux, executive director of the National Association of Free Clinics. “West Virginia is definitely on the cutting edge.”

Where they’ve been adopted, the response to the electronic records systems has been overwhelmingly positive, the journal’s survey reported. But the adoption of such systems nationwide has been slowed by the costs, which can start at tens of thousands of dollars, well beyond the reach of many clinics.

The funding situation is particularly critical for the nation’s free clinics, which by definition treat many patients with no health insurance at all, and hence no one to bill. That’s why West Virginia’s system is getting so much national attention.

Thanks to a $4 million federal grant, the clinic’s costs are minimal, amounting in some cases to upgrading existing computers. Clinic staffers say that’s essential: the state’s free clinics, which serve about 48,000 patients a year, operate on tight budgets.

Once the system is in place, doctors can access patient charts anywhere there’s an Internet connection and can prescribe medication through the same system. Doctors also can access recommended treatments for chronic diseases such as diabetes and hypertension, widely prevalent in the state.

Clinic staffers in West Virginia say the electronic records network has not only increased the speed of treatment, but eased paperwork burdens, enabling them to handle administrative tasks in minutes that once took hours.

“We’re kind of the envy of other free clinics around the country,” said Kathie Brown, executive director of Wheeling Health Right, the first clinic to adopt the system. “A lot of them are still doing all of this by hand.”

Clinics from Virginia, Pennsylvania and Ohio have all inquired about how the program works, according to J. Davitt McAteer, vice president for sponsored programs at Wheeling Jesuit.

In Ohio, two of 40 clinics in the Ohio Association of Free Clinics have electronic medical records systems, according to Marjorie Frazier, the group’s executive director.

“It is too expensive,” she said. “There will come a time when it’s more accessible to our clinics, but right now we’re very interested in getting federal funding.”

While West Virginia’s federal grant, officially called the HEALTHeWV is strictly for free clinics and based on a similar military program, the federal government is beginning to look at funding more networks.

This month, Medicare launched a $150 million program to offer doctors’ offices incentives to switch from paper to electronic records. Individual doctors can receive up to $58,000 over the five years of the project.

That’s the kind of money needed to put such systems in place, which is partly why doctors have been slow to do so, according to the New England Journey of Medicine survey.

“This never would have happened without the federal grant,” said the Wheeling clinic’s Brown. “We just couldn’t have afforded it.”

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