TALLAHASSEE -- Four years ago, Florida jumped on the bandwagon to create a nationwide health information network that would allow doctors and hospitals to share the electronic medical records of patients -- replacing an outdated paper-based system that still relies on fax machines and snail mail for the exchange of patient files.

But state budget restraints over the last two years have slowed development of an electronic system in Florida, leaving regional organizations that are working on their corners of the network largely to fend for themselves.
After a push to offer grants totaling $9 million was killed last year, Rep. Denise Grimsley, a Lake Placid Republican, returned with a bill providing matching grants and no-interest loans to help develop a statewide health information exchange. While HB 637 was approved 109-0 by the House on Friday, it has not been funded. Grimsley said she is hoping to get at least $2 million allocated in meetings next week. But amid dwindling state finances that will likely lead to deep cuts in healthcare programs, there is no guarantee the money will be approved.

That leaves the South Florida Health Information Exchange in a precarious position, as well as the fragile infrastructure under construction across the state. Six similar groups have been trying to get their systems off the ground. The funds are needed to build a backbone that can link electronic medical records systems that some hospitals and private companies already have. The three year-old SFHIE, a coalition of Miami-Dade County healthcare providers and volunteers, is about to launch a project it believes will demonstrate how cost effective such networks can be.

Advocates have said sharing the electronic sharing of patient records can reduce medical errors and duplicate services and lower costs. If, for instance, a doctor knows the results of recent tests run on a patient, he or she won't have to run them again.Some note that's why many providers are reluctant to share patient information. Reducing duplicate services cuts into the bottom line since hospitals are paid each time they run tests, scans and blood work.

From her home office in Coconut Grove, SFHIE's executive director, Dr. Kate Callahan has been hashing out the final details of the Tri-County Uninsured Patient Information Exchange that links emergency rooms. Initially, Jackson Memorial Hospital and 12 clinics in South Florida belonging to the Health Choice Network, including Camillus Health Concern, have agreed to begin sharing files on uninsured patients via a common Web-based portal. From there, the network would expand to include the emergency departments at hospitals in Broward and Palm Beach counties, Callahan said.

'It would save taxpayers' dollars and improve patient care,'' Callahan said, noting Florida had the third largest uninsured population in the country, ``Everyone wants to look at how we can deliver quality service to the uninsured but decrease the money we spend," she said.

With funding in jeopardy, it remains to be seen whether the organization can reach its goal. Similar organizations, called regional health information organizations have folded around the country for lack of funding.

Callahan said the group has about $200,000 left in state grant money from two years ago. As they bring the uninsured project to life, that money will likely see them through July. They are ready to begin looking for money from other sources. ''We have a project/product that is a win-win. We will decrease duplicate services for the uninsured, which saves everybody money and increases the quality of healthcare,'' she said.