The Pittsburgh Regional Health Initiative will participate in a new federal demonstration project to promote the use of electronic health records in doctors' offices.

The Centers for Medicare & Medicaid Services, under the U.S. Department of Health & Human Services, chose the initiative as one of four partners across the country to start the five-year demonstration this year. The other first-phase programs will be in Louisiana, Maryland/Washington, D.C. and South Dakota (including surrounding counties in Iowa, Minnesota and North Dakota).

Next year, programs will start in Alabama, Delaware, Georgia, Maine, Oklahoma and Virginia, as well as multicounty programs in Madison, Wis., and Jacksonville, Fla.

CMS will recruit and prepare a variety of 200 small physician practices in this area to test the advantages of electronic records. Half of the practices will use the records to guide and measure improvements in quality; the other half will serve as a control group.

CMS will give incentives of up to $58,000 per physician or $290,000 per practice based on quality improvements achieved through the use of electronic records. A request for proposals is expected to go out in the next few months.

The area's largest insurer, Highmark Blue Cross Blue Shield, is also part of the effort. It has pledged up to $7,000 per eligible physician to buy the technology needed to participate and to have doctors meet the Medicare test for favored reimbursement.

On Friday, Highmark announced its commitment to contribute $29 million to help doctors get electronic prescribing and health record technology. Highmark made a similar commitment before, but funds were held up due to concerns about the tax-exempt status of the program. Highmark has decided to give grants directly to doctors, and Dr. Kenneth Melani, Highmark president and chief executive officer, said it hopes to begin administering grants later this summer. Highmark will use doctors' grant applications to the previous program to evaluate who will receive money.

Other support for the physicians in the CMS demonstration, including case management, learning collaboratives and on-site coaching is expected from private contributors including Highmark.

A part of PRHI's proposal is a focus on chronic care. This electronic records initiative aims to help doctors reduce emergency room visits, hospitalizations and readmissions by improving care for chronic diseases such as diabetes and chronic obstructive pulmonary disease.