Participants in Nebraska's electronic medical records project met Thursday in Kearney to raise a toast to the success of a 90-day systems test and plan its statewide rollout.

Because electronic records are a health reform priority - and because Nebraska's shovel-ready initiative has outpaced other statewide efforts - participants anticipate an infusion of federal stimulus funds to speed development of a national model.

"We are - from what we can see - the first statewide health information exchange," project consultant Deb Bass said.

Actually, full state coverage won't occur for some time, but the elements of the system have proved themselves.

"The pilot far exceeded expectations," Bass said.

During the 90-day Omaha-area pilot of the Nebraska Health Information Initiative that ended June 30, the budding system took in 1,012,455 patient records, which allowed it to fill 82,978 records requests in less than 2 seconds.

The system's usefulness will grow with the records history and the numbers of users.

The pilot involved Alegent Health, Children's Hospital and Medical Center, Methodist Health System, Nebraska Medical Center, BlueCross BlueShield of Nebraska, plus about 100 physicians and pharmacists. Software was developed by Axolotl out of Silicon Valley.

Success occurred on a number of levels, not the least of which was public acceptance, Bass said. Patients could voluntarily opt out of electronically sharing their records, but only 11,690, or 1.2 percent, of those approached did so. And of those, 526 later opted back in.

Bass said informational campaigns will accompany the spread of the records system as it hops into Nebraska communities. Next in line are Mary Lanning Memorial Hospital in Hastings and Great Plains Regional Medical Center in North Platte. Full deployment could take years.

Ultimately, Nebraska health care providers - hospitals, physicians, pharmacies, labs, imaging centers - expect the system will save time, lives and millions of dollars. A patient's prior X-rays will be immediately available to ER doctors. Full prescription records will travel instantly to pharmacies. Patients won't have to repeatedly fill out the same forms and answer the same questions.

The beauty of the system is its simplicity, said Roger Hertz, chief information officer of Methodist Health System. Physicians can be trained on the system in half an hour.

It was the policies and politics, not the technology, that absorbed the bulk of efforts. Hertz said he hopes organizations in other states will build upon the heavy lifting done by Nebraskans.

Ken Lawonn, chief information officer of Alegent Health, said the strength of Nebraska's project was in bringing major players together to work in the best interests of patients.

"It's about what's best for patient care," Lawonn said, "and not about what's best financially for us."

Simplifying the process to obtain prior patient tests flies against the incentive to rerun those tests to get paid for them again, he said. Instead of using past patient records to maintain market share, Lawonn said, competitors will share them.

"There are some significant implications going forward," he said.

Most of the politics were addressed prior to the pilot. What the 90-day test told participants, Lawonn said, is how much work is involved in running the system - a reasonable amount, less technical and more verification.

A big issue was meshing privacy and security policies of the various organizations.

Lianne Stevens, chief information officer of the Nebraska Medical Center, said the process was rigorous.

"But I have a comfort level that we did do due diligence in assuring protection of patient information," she said.

Perhaps as many as 150 people from the various agencies contributed something - defining policies, designing the training and writing the manuals.

Forty people from the Nebraska Medical Center recently celebrated their contribution, Stevens said.

"It was really amazing when we looked back and saw all that we had accomplished in such a short time," she said.

In other places, efforts to create an electronic medical records system have met with less success. Some, Stevens said, failed because they lacked a viable business plan, and the effort ended with the grant funding.

But, she said, representatives of the software vendor were amazed at the collaboration they saw here.

"We're competing hospitals all coming on board because … we're committed to community benefit," she said.

"This is for health care."

Reach Mark Andersen at 473-7238 or mandersen@journalstar.com.