Highmark Inc. is learning that if you want to get something done, you have to do it yourself.

After three years of waiting for the Internal Revenue Service to approve its mechanism for disbursing millions in grants to Pittsburgh-area physicians to help them upgrade their electronic record-keeping capabilities, Highmark announced yesterday that the company was tweaking the plan to get around the need for IRS clearance.

In 2005, Highmark, the region's dominant health insurer, announced plans to establish a $26.5 million fund, called the Highmark eHealth Collaborative, which would have distributed grants of up to $7,000. Physicians were to use the money to invest in computers and gadgets that would allow them to write drug prescriptions electronically, for example, or store and easily transmit a patient's health files.

But because the money was funneled through the eHealth Collaborative -- itself to be maintained by The Pittsburgh Foundation -- before reaching the doctors, the collaborative needed to obtain tax-exempt, 501(c)(3) charitable status from the IRS. The IRS has been "conducting a lengthy review of this and other initiatives that support the adoption of health information technology by physicians and has not yet rendered an opinion as to the tax exemption," according to Highmark.

Yesterday, Highmark said it would disburse the money itself, instead of through an intermediary. The ground rules for the $29 million fund are the same -- Highmark will pay up to 75 percent of the physician's equipment costs, up to a maximum of $7,000 per physician's office. The physician is to pay for the balance of the investment.

"Under this model, tax-exempt status is not required before funds can be allocated," said Dr. Ken Melani, CEO of Highmark. Highmark will not be accepting new applications for the grant program, however -- it will disburse the money to the applicants who already signed up for the original e-health collaborative plan.

Many physicians still rely on pads and paper to write out prescriptions, and many hospitals rely on thick folders to keep patients' records. Industry groups say full adoption of electronic record keeping could speed service, save hundreds of billions for hospitals and insurers, and cut down on the million or so medication errors that occur each year in American hospitals due to poor record keeping or illegible writing.

Highmark hopes to distribute the first of the grants by the summer.