By Brian Smith / Register News Writer

The days of a white-coated doctor taking a pen from his pocket and making notations in a file are long gone.

With computers becoming smaller, cheaper and more portable, health care professionals are replacing paper records with electronic records that can be instantly accessed.

The Madison County Health Department’s home health division, MEPCO Home Health, is in the process of implementing an electronic medical records (EMR) system, department spokesperson Christie Green said, and will begin using the system on Sept. 1.

“EMRs will make things faster, more efficient and will provide a huge space savings,” Green said. “For example, MEPCO will be moving from nearly 200 square feet of filing space to electronic records housed in a server room of less than 40 feet.”

Federal health care reform efforts have focused on transitioning health care providers to EMR systems to increase efficiency and reduce spending.

Local public health director Jim Rousey said that an EMR system frees personnel to spend more time treating patients instead of making records.

“Every year, our home health nurses were spending more and more time fulfilling documentation requirements for patient care,” Rousey said.

“This interfered with what nurses really wanted to be doing, which was taking care of patients.

“Employing an electronic medical record system should reduce the amount of time it takes to document the care and ultimately provide more time with the patients,” he said.

Rousey said that using an EMR can take some adjustment for practitioners experienced in maintaining paper records.

“At the beginning, there is a steep learning curve for everyone. Sometimes it actually takes longer to use the EMR in the beginning, but the efficiency becomes apparent as everyone gets accustomed to the system,” Rousey said.

At Pattie A. Clay Regional Medical Center, which switched to an EMR system in 2004, the system has paid large benefits, said Joy Barnes, information technology director.

“The nurse at the bedside may need to spend more time to initially gather and document patient information, but the administration and reporting side of nursing has seen efficiency improvements in both time and accuracy of the patient chart,” Barnes said.

Cost is still a concern when transitioning to an EMR system, Green said, despite the decrease in equipment costs over the past few years.

“Less than a tenth of our total outlay for an electronic medical records system in MEPCO was for the hardware,” Green said. “The cost of installing, licensing, and maintaining a quality system is still extremely high — in the 100s of thousands of dollars, even for a small family practice.”

Security can be another concern, said Martin Hensley, information technology specialist for the health department.

“Controlling access and ensuring security is a problem that exists on a bigger scale than it did in the past,” Hensley said. “In the past, we could just lock a file room and the charts would be secure. Now, everyone in the agency must be more conscious of security. Each computer terminal or laptop can be a doorway to confidential medical information.”

Barnes and Green also both pointed to making wise choices about the systems that are implemented as a key component of implementing an EMR system.

“In the past, we used carts with laptop computers that were wheeled into each patient room,” Barnes said. “The carts were cumbersome and not the best option, especially in a semi-private room with two patients.

“With the new renovations in place, the nursing staff are testing hand-held computers developed specifically for the health care environment,” Barnes said.

“We have to be aware of the potential for the computer to come between the provider and the patient,” Green said. “For example, large screens may block a patient’s view, or a computer’s location in the room may cause the provider to turn her back to the patient.”

Despite the costs and concerns, Green said EMRs and other health technology have a benefit to patients.

“In the long run, electronic records will increase the speed and accuracy of the flow of information between providers,” Green said.

“This translates into improved quality of care for patients, as various providers can communicate about an individual’s health needs.”

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