U.S. Health and Human Services Secretary Michael Leavitt invited health care and community leaders yesterday to participate in a new effort to expand electronic health record systems in physician offices.

During a visit to Pittsburgh, Mr. Leavitt urged local leaders to support a Medicare demonstration project that will give incentive payments to doctors who install the systems and meet certain guidelines for improving care.

Implementing electronic systems that meet uniform standards would help transform the nation's health care sector into a health care system, Mr. Leavitt told about 40 representatives of physician, hospital and business groups, consumer advocates and others at the Regional Enterprise Tower, Downtown.

Pittsburgh is among a number of cities across the United States that Mr. Leavitt is visiting to promote the initiative. Communities have until early May to apply for the program and 12 will be selected in June. Four will begin implementing the program this year, and the rest in 2009.

Each selected community will help identify 100 primary care practices that agree to participate in the five-year project.

Incentive payments would be higher for those using more complex electronic systems and meeting certain benchmarks of quality care. Total payments over five years could be up to $58,000 per physician or $290,000 for a medical practice.

In an interview, Mr. Leavitt said electronic systems have the potential to lower health care costs by reducing multiple medical tests, preventing errors and hospital admissions, and improving management of chronic disease.

He acknowledged that the demonstration would not provide funding to help doctors purchase electronic systems. Jack Krah, executive director of the Allegheny County Medical Society, said small practices could especially have trouble paying for the systems, which can cost $40,000 or more.

Officials have said that perhaps 15 percent of physician practices in Pennsylvania have electronic systems.

Efforts have been made before to help doctors' practices obtain the systems. Highmark, for example, has made about $20 million available through the Pittsburgh Foundation, but the grants have not been made because of concerns raised by the Internal Revenue Service.

About 4,000 applications have been received for the grants, "but the IRS has told us we can't move forward," said Dr. Donald Fischer, chief medical officer for Highmark.

Some who attended the meeting suggested that the federal demonstration project work with similar efforts, like a state initiative to help Pennsylvania doctors better manage chronic disease.

That effort will provide doctors with a free electronic registry to help track the needs of patients with chronic health problems like diabetes. But the registry does not have the capabilities of other systems that allow doctors, for example, to prescribe drugs or enter notes on patients, said Phil Magistro, information technology director for the state Office of Health Care Reform.

Mr. Leavitt also recognized the Pittsburgh Regional Health Initiative as a Chartered Value Exchange, one of a number of groups around the nation that will be given access to Medicare information on the quality of care delivered to patients. Officials said the information could be combined with private-sector data to provide more information about care in the Pittsburgh area.