Wyoming Uses No-Cost EHR as Platform for Population Health

Bush says a good example of how Wyoming was able to drill down on its population to effect change was analyzing the usage of Synagis, a medication used to prevent respiratory syncytial virus infections for children who have required treatment for chronic lung disease or been born prematurely. In 2010, Synagis was one of the top three drugs administered in the state, with 967 prescriptions being written at a cost of $1.8 million. The next year new criteria were implemented based on updated American Academy of Pediatrics guidelines that set age and time recommendations for the medication. Over the next two years, Synagis dropped to 587 prescriptions at a cost of $1.6 million. “Kids who did not meet clinical criteria were getting the drug, so we were able to affect significant savings with no adverse problems,” says Bush, “and that was a pretty cool example of how you can identify a problem, affect a change in policy, and give at least as good of care at a significant savings.”

In addition to the no-cost EHR, the state added a personal health record (PHR) (NoMoreClipboard; Fort Wayne, Ind.) to the offering last month. This system is intended to encourage high cost and high risk Medicaid patients to manage and improve their healthcare plans. Bush says that his department is in the process of implementing an awareness campaign for the PHR.

The costs for the EHR and HIE are coming out of the Medicaid budget. The vendor contracts were secured before ARRA money was distributed, so favorable rates were received, says Bush. Bush concludes the cost savings for providing better care has more than paid for the initial technical investment his department has made.