Paging Dr. Wal-Mart

There's a new player on the health policy scene, one with enough muscle to change the way things get done. It isn't a federal agency, and it's not a state or locality.

It's the retail giant, Wal-Mart -- the very one that came in for all that grief for failing to insure its low-income workers and pushing them to sign up for Medicaid. But new leaves have been turned and in its new role as health policy maven, Wal-Mart is not only offering its customers $4 generic drugs at its pharmacies and $60 check ups at its retail clinics, it's about to tackle that most elusive -- and expensive -- of health care reforms: electronic health records.

In partnership with Intel Corp., British Petroleum and a few others, Wal-Mart and companies are planning to provide digital health records to their employees and to store them in a data warehouse so that their hospital, doctor and pharmacy records can be linked. The hope in health-care circles is that EHRs will cut costs by allowing patients and their providers to coordinate care. And so it is for Wal-Mart and its partners -- they hope to save money on their employee health care costs.

But Wal-Mart is no do-gooder for do-gooding's sake.

Wal-Mart does not do something unless it sees the profit in it. In talking to Medicaid officers about Wal-Mart's $4 generic pill program, Bill Simon, the retailer's executive vice president for pharmacy, assured his audience that the program was profitable and that, "because it is profitable, you can rest assured it is sustainable."

So Wal-Mart and its partners must see a way to make EHRs make money -- or at least cut enough costs to turn a profit. So far, most everyone else has gotten bogged down in interoperability, privacy and who'll-pay-for-it issues. So it will be interesting to see how these business partners come to grips with all the little and big glitches involved in getting EHRs up, running and accepted by the key providers -- and whether the system they develop can be replicated elsewhere until, voila, without the intervention of the federal government or a regional pact of states, the health care system has the blueprint for a digital medical record system that works for everyone.

Could Wal-Mart, the company so many of us love to hate, be the health-care savior?