City to Pay Doctors to Contribute to Database
By ANEMONA HARTOCOLLIS The New York Times December 30, 2008
For Dr. Harvey Benovitz, who graduated from medical school in 1962, it is as profound a shift in the way he treats patients as advances in diabetes drugs.
Instead of jotting down notes on charts and filling out prescriptions in his small, meticulous handwriting, Dr. Benovitz, whose patients have always thought of him as a reassuringly old-fashioned internist, tapped a patient's blood pressure and other vitals into a laptop next to the examining table during a checkup the other day.
Not only will this new electronic record-keeping system eliminate the rows upon rows of bursting manila folders stuffed into what could be another examination room in the back of Dr. Benovitz's cramped office on the Upper West Side. It allows him to compare the patient's blood pressure management with all his other patients' - and with those in hundreds of private medical practices across New York City.
Dr. Benovitz is among about 1,000 primary-care physicians who have given up their doctor's pens over the past year to collect the smallest details of their patients' lives in a database as part of a $60 million city health department project.
Experts say it is the most ambitious government effort nationwide to harness electronic data for public-health goals like monitoring disease frequency, cancer screening and substance abuse. It follows the Bloomberg administration's aggressive focus on everyday health concerns - which has included startling anti-smoking advertisements in subways and requirements that chain restaurants post calorie counts - and frequent use of statistics to drive public policy on crime, homelessness and other issues.
And echoing the city's cash-incentive experiments in the school system, the health department will soon start offering doctors bonuses of perhaps $100 for each patient who hits specified targets like controlling blood pressure or cholesterol, up to $20,000 for each doctor.