By Rich Silverman

We talk a lot in this blog about the financial aspects of Electronic Medical Records (EMRs), and with good reason – they can entail a substantial investment in time and money. But it’s sometimes easy to lose sight of the purpose of all that investment – to save lives.

There has been a great deal of research conducted into how much it will cost to implement an EMR, yet there has not been a lot of research into their impact on patient outcomes. A recent study shows that the adoption of Electronic Medical Records and Radiology Information Systems (RISs) in hospitals in the U.S. actually lowers infant mortality in this country. Research conducted by Amalia Miller of the University of Virginia and Catherine Ticker of MIT’s Sloan School of Business showed that when hospitals adopt EMRs and RISs, their infant mortality rates drop.

Using data on births and infant mortality already collected by the U.S. Government, and statistics on health care information technology adoption provided by the Health Information Management Systems Society (HIMSS), the researchers compared infant mortality in selected areas of the country where data was available (privacy laws limited that data pool) with the adoption of EMRs and RISs in those same areas.

After correcting for a wide range of variables, the researchers came to the following conclusions:

The adoption of EMRs by one additional hospital in a county reduces infant mortality by 13%.

The average cost of the HIT used to save that baby is about $450,000.

The reduction of infant mortality is twice as great for African-Americans than non-African-Americans.

The median cost to implement EMR in a hospital, according to a 2007 America Hospital Association study was $5,556 in capital costs per bed and $12,060 per bed per year in maintenance costs.

The authors studied “bare-bones” HIT implementations of EMRs, and only looked at the impact on neonatal and infant health outcomes. They suggest that more robust implementations of HIT, including decision-support and computerized physician order entry, as examples, will extend the beneficial effects of HIT to other classes of patients.

This research serves as a gentle reminder that the HITECH Act was intended to provide incentives for physicians and hospitals to implement and use Electronic Medical Records because EMRs will improve patient outcomes and save lives. This research shows that they do.

Above article publish on http://blog.pchealthstop.com/?p=985

Emergency Physician’s have relied on electronic medical records, in some form, for decades now. From stat laboratory data and patient locator software to integrated Zoll monitors that streamline the recording of codes, the accuracy and reliability of these data systems are paramount for delivering high quality emergency care. The sophisticated technology is undermined, however, when power failures hit and communication channels are compromised. Fortunately, contingency programs can be integrated into Electronic Medical Records Systems (EMRs).

EMERGENCY MEDICINE-SPECIFIC EMRS

The EMR System you choose needs to interface with the various systems in place throughout the hospital. From the time a patient sees the Triage Nurse and is put into a room, an ideal system would have a single interface that integrates these data with the patient’s medical history, imaging, and patient records from regional hospitals. The dozens of small steps in the process of patient care in your unique Emergency Department should be able to seamlessly integrate into a user-friendly experience. For example, if you do physical exams, x-rays and ultrasounds all in different rooms, you need your EMR to be able to automatically migrate all of the patient’s data so that it is accessible from any computer. Therefore, we will begin here with the assumption that all patient records will be easily accessible from one user interface, not multiple software programs for different types of records.

VERIFY EQUIPMENT AND SOFTWARE COMPATIBILITY

Many trauma transfers and referral patients bring CD-ROM’s and documentation from hospitals and physicians that use different machines and software than your hospital. Choosing an EMR based on the myriad of consultant’s and referral hospitals’ equipment is difficult at best. For example, if you use the Siemens AR Star CT Scanner, but an outside hospital transfers a trauma patient with CT images on a CD-ROM from a Toshiba Asteion ER004, you need to make sure that your department’s software will be able to read the disk. The days of needing a double-dose of IV contrast to repeat a CT scan because of incompatibility are nearing an end.

BUILDING TRUST IN YOUR EMR SYSTEM

In addition to software and equipment compatibility, the right EMR for your Emergency Department should make your workflow easier, not harder. Your daily operations and patient flow through the department should not have to adapt to accommodate an antiquated EMR. It should be the other way around.

In the event of a disaster, make sure you have contingency plans for power and communications failures. Investigate the EMR you’re considering thoroughly to determine if it has the ability perform data recovery and system backup. Be sure you have a system in place that you can trust to alert you to critical developments.

EASILY TRACK STAFF AND PATIENTS’ ACTIVITIES

Verify that your EMR will seamlessly integrate triage notes, ER visit history, previous elopements, as well as all past medical history. Automatic visual and/or auditory notification of critical laboratory tests and contraindications for medication administration will improve outcomes. From documenting triage decisions and patient contact times, to tracking which personnel log into the EMR, many repetitive tasks can be integrated into an EMR system that curbs human error and improves department efficiency.

DICOM COMPATIBILITY

Digital Imaging and Communications in Medicine (DICOM) is a standard construct used increasingly by Health Information Systems, but it is not universal. Specifically, DICOM covers handling, storing, printing, and transmitting information in medical imaging.

Typically, different imaging systems and software are used to render different modalities, such as ultrasound, CT, and MRI. The danger of putting all imaging modalities in one viewing system is that it could fail. Therefore, redundancy and parallel backup systems are needed. Because you will view color video of Doppler ultrasounds along side plain x-rays and graphical data, the EMR System you choose will likely need to meet the DICOM standard with PACS compatibility.

Above article publish on http://www.emrconsultant.com/education/emergency-physicians-guide

The new requirement for all physicians to use electronic medical records has challenged today’s Family Physicians, who already rely heavily on electronic data. This guide is intended to help you navigate this increasing complex area without losing site of your priority – patient care. From patient monitors and new patient surveys of medical history, to the sophisticated imaging and records systems your consultants use, the accuracy and reliability of these data systems are paramount for delivering safe, high quality primary care. Failure of your Electronic Medical Records (EMR) system is not an option, nor can you allow files to be lost or consultant records to be incompatible with the EMR you choose for your busy practice.

FAMILY MEDICINE-SPECIFIC EMR’S

The EMR System you choose needs to be able to integrate into your office setting. For example, if you do physical exams, EKG’s, and x-rays all in different rooms, you need your EMR to let you view updates to the patient record immediately, from any computer. Improved efficiency for your daily operations will help your office run more smoothly and with less interruptions, allowing your to spend more time with your patients and see more of them each day. The ideal EMR for you will depend on your specific office’s workflow, the equipment you and your consultants use, and the types of procedures and capabilities you plan to add to your practice as you grow. Therefore, we will begin here with the assumption that to allow for your next level of efficiency and capabilities, your ideal EMR will let you view all patient records from one user interface, not multiple software programs for different types of records.

VERIFY EQUIPMENT AND SOFTWARE COMPATIBILITY

When you send your patients to a consultant, you frequently don’t get the benefit of viewing their ultrasounds, CT scans, or electrophysiological data to help you best interpret the test for your specific patient. As the patient’s primary physician, only you take the time to understand all of their circumstances and an EMR System that can let you see all the data that the specialists see will better equip you to do just that. The trouble is that, for example, many imaging centers and radiologists use different machines and software, so even if they send you a CD-ROM your computer can’t read it. This prolific problem is getting dramatically worse over time, as more and more technologies hit the market and you can’t predict which direction your consultants will choose. For example, if your favorite cardiologist uses iCardia Holter Monitors you may have no way of seeing the EKG tracings of your patient’s arrhythmias for yourself. If you figure out how to see the EKG tracings and then the cardiologist switches brands to Braemer you have to start all over again. Solving the endless technology challenges is not, we suspect, why you went to medical school.

EASILY TRACK STAFF AND PATIENTS’ ACTIVITIES

The last thing your EMR System should be is a burden to those that use it the most – your office personnel. Verify that your EMR will integrate automatic patient appointment reminders, preventive health maintenance protocols and other scheduling details unique to your practice. Mammograms, Pap smears, follow-up stress tests, and immunizations are a few issues that your new EMR System can address. This will ensure that no tests are forgotten and no one slips through the cracks on your busiest day, thereby improving compliance.

Special tests such as fasting oral glucose challenges often require that your staff spend time sending out reminders and tracking down results prior to their appointment with you. An EMR System that could integrate automatic emails or phone calls one week prior to an appointment would improve efficiency. Suffice is to say that many repetitive tasks can be integrated into an office system that curbs human error and improves your practice’s measurable outcomes.

DOCTORS OFFICE QUALITY – INFORMATION TECHNOLOGY (DOQ-IT)

The Centers for Medicare and Medicaid Services created the DOQ-IT program to encourage of adoption of EMRs and focuses on improved patient outcomes for small and medium-sized physician practices. Choosing an EMR that is compliant with DOQ-IT will provide effective billing practices, optimum pay-for-performance reporting, and improved patient outcomes.

DICOM COMPATIBILITY

Digital Imaging and Communications in Medicine (DICOM) is a standard construct used increasingly by Health Information Systems, but it is not universal. Specifically, DICOM covers handling, storing, printing, and transmitting information in medical imaging. A popular imaging viewer is the PACS system, but it does not have the best interface for some media such as video loops of Doppler ultrasounds. You will want to make sure that the EMR you choose will allow you to view imaging from your own office and that from your consultants.

Above article publish on http://www.emrconsultant.com/education/family-physicians-guide

Today’s cardiologists rely heavily on electronic data. From echocardiogram and stress test machines to catheterization suites, the accuracy and reliability of these data systems are paramount for delivering high quality cardiology care. The sophisticated technology is undermined, however, if each piece of the cardiologist’s arsenal isn’t integrated into a comprehensive Electronic Medical Records (EMR) system.

CARDIOLOGY-SPECIFIC EMR’S

The EMR System you choose needs to be able to integrate into your office setting. For example, if you do physical exams, echocardiograms and stress testing all in different rooms, you need your EMR to be able to automatically migrate all of the patient’s data so that it is accessible from any computer. The days of manually scanning, uploading, and transferring patient data are over. Therefore, we will begin here with the assumption that all patient records will be easily accessible from one user interface, not multiple software programs for different types of records.

VERIFY EQUIPMENT AND SOFTWARE COMPATIBILITY

Many cardiologists send their patients for tests that use different machines and software than they own in their office. Choosing an EMR based on the myriad of consultant’s equipment is difficult at best.

BUILDING TRUST IN YOUR EMR SYSTEM

Besides equipment compatibility, the right EMR for your office should make your life easier, not harder. The daily operations of your cardiology practice should not have to adapt to accommodate an antiquated EMR. It should be the other way around. For example, if a patient is in your Philips Integris Cath Lab suite and their latest potassium result is 7.4, a combination of audible and visual notifications should be triggered. You shouldn’t have to wait in the Emergency Department to receive all of your laboratory results before taking the patient to the cath lab; rather you should have a system in place that you can trust will alert you to critical developments.

EASILY TRACK STAFF AND PATIENTS’ ACTIVITIES

The last thing your sophisticated cardiology suite and EMR System should do is be a burden to those that use it the most – your office personnel. Verify that your EMR will seamlessly integrate patient appointments, reminders, and other scheduling details. Special tests such as fasting lipid profiles often require that your staff spend time sending out reminders and tracking down results prior to their appointment with you. An EMR System that could integrate automatic emails or phone calls one week prior to an appointment would improve efficiency. From ordering special materials prior to nuclear studies, to tracking who logs into the EMR, a lot of repetitive tasks can be integrated into an office system that curbs human error and improves your practice’s measurable outcomes.

DICOM COMPATIBILITY

Digital Imaging and Communications in Medicine (DICOM) is a standard construct used increasingly by Health Information Systems, but it is not universal. Because you will view color video of echocardiograms, roentgenograms, and graphical data, the EMR System you choose will likely need to meet this standard.

Specifically, DICOM covers handling, storing, printing, and transmitting information in medical imaging. To ensure that all of the equipment and software you use can be accessed and viewed within your EMR interface, it will be important to navigate the technical areas of licensing fees versus free viewers and custom integration programming.

Above article publish on http://www.emrconsultant.com/education/cardiologists-guide

Many of today’s modern anesthesiologists have relied heavily on electronic patient records for quite some time. From medical histories during pre-op, to intraoperative hemodynamic monitoring, the accuracy and reliability of these data systems are paramount for delivering high quality anesthesiology care. The sophisticated technology is undermined, however, if the pieces of the anesthesiologist’s record systems aren’t integrated into a comprehensive Electronic Medical Records (EMR) system.

ANESTHESIOLOGY-SPECIFIC EMR’S

Unless you’re in a private anesthesiology group, you may not have much choice in the EMR System you use, but consider this. An EMR system designed by anesthesiologists will be more relevant to your daily workflow with much less after market modification than other systems. It would be ideal if you could find an EMR that would let you have a complete compliment of anesthesiology-specific content and integrate its data with the existing EMR software that you use in the hospitals where you hold privileges.

The EMR System that you choose needs to be able to allow for the particular way your practice operates and your daily workflow. For example, if you take preoperative patient histories using on hospital-based EMR system, but the anesthesiology-specific EMR suite that you want is different, you need your EMR to automatically migrate all of the patient’s data so that it is instantly accessible from your office, the operating room, or any other computer workstation. The days of manually scanning, uploading, and transferring patient data are over. Therefore, we will begin here with the assumption that all patient records will be easily accessible from one user interface, not multiple software programs for different types of records.

VERIFY EQUIPMENT AND SOFTWARE COMPATIBILITY

Many surgeons send their patients for tests that use different machines and software than they the hospital has access to. Choosing an EMR based on the myriad of consultant’s equipment is difficult at best. For example, if cardiologists cleared a C.A.B.G. patient using the Welch Allyn Propaq Stress Testing System and you want to see the EKG tracings yourself, you need to make sure that the EMR you choose will let you grow your practice in all of these circumstances.

BUILDING TRUST IN YOUR EMR SYSTEM

In addition to software compatibility between all of the records systems that you access, the right EMR for your practice should make your life easier, not harder. The daily operations of your anesthesiology practice should not have to adapt to accommodate an antiquated EMR; it should be the other way around. For example, if a patient’s most recent intraoperative hematocrit drops by eight points, a combination of audible and visual notifications should be triggered. You shouldn’t have to manually check everything and lose precious time before replenishing blood products; rather you should have a system in place, which acts as an adjunct to your traditional methods of ensuring patient safety. Over time, you will build trust that your new EMR will alert you to critical developments.

EASILY TRACK STAFF AND PATIENTS’ ACTIVITIES

Don’t waste time learning complicated software systems that seem to drain more energy than you expect. Your new EMR should be convenient, easy to use, and save you time. If you have other personnel, such as secretaries or nurses that access your EMR, it should make their life easier too, not increase their burden. Verify that your EMR will seamlessly integrate patient appointments, reminders, and other scheduling details.

From ordering special materials and gases for inventory, to tracking who logs into the EMR, a lot of repetitive tasks can be integrated into your anesthesiology practice’s unique system. This will help curb human error and improve your practice’s measurable outcomes.

DICOM COMPATIBILITY

Digital Imaging and Communications in Medicine (DICOM) is a standard construct used increasingly by Health Information Systems, but it is not universal. Because you will view color video of Doppler ultrasounds, plain radiographs and graphical data, the EMR System you choose will likely need to meet this standard.

Above article publish on http://www.emrconsultant.com/education/anesthesiologists-guide

By: Michael Young

The medical industry has changed significantly over the past decade. One of the major changes is that many medical offices are moving from paper to electronic medical records. There are also a number of practice management software packages available to medical practitioners. This makes their lives easier, but what does it mean for patients? To understand the answer to that question, it is first important to understand what an electronic medical records system is.

Generally EMRs, electronic medical records, and EHRs, electronic health records, are synonymous. These systems keep track of medical information. These systems keep medical records stored in a central location so that they can be made available to pharmacies, specialists and other providers. What this means for the patient is that medical care is becoming more portable.

President Bush created the Office of the National Coordinator for Health Information Technology (ONC) in 2004. This office was headed by David Brailer in the beginning. Brailer addressed interoperability issues and established a National Health Information Network (NHIN). Regional Health Information Organizations (RHIOs) have been established under the ONC in many states for the purpose of promoting the sharing of health information. Currently, Congress continues to create legislation to increase funding for these programs and programs like them.

Moving from paper systems to EMRs is a process that is still in the beginning stages within the medical community. It is a work in progress. Many concerns exist, and privacy is one of those concerns. While a moving to an EMR would potentially give many providers, pharmacists and other medical professionals access to a patient’s records, these records are kept very secure. The adoption of electronic medical records systems is clearly what the future holds, from a technology as well as legislative standpoint. In the end, the patient benefits because it is easier to fill prescriptions, transfer records and receive consistent care than with paper systems.

As medical records systems continue to move from paper to electronic, look for the ability of systems to communicate with each other to also become important. As the patient, you will benefit because of the portability of electronic health records and you will no doubt benefit from the increased continuity-of-care that they can offer.

Above article publish on http://www.sooperarticles.com/health-fitness-articles/general-health-articles/electronic-medical-records-more-prevalent-now-2926.html

By Peter Polack

A good electronic medical records system must be able to demonstrate a process for maintaining the legal integrity of its records. Here we cover some of the top considerations when moving your practice from paper to digital.

As a practice makes the transition from paper to electronic medical records, they may encounter a variety of legal concerns. Some important decisions must be made to ensure the legal integrity of digital records. Additionally, there will be some surprises in store regarding compliance, privacy, and security. In matters of electronic medical records, the best offense is a good defense. Here are some issues to consider:

When you write a medical exam on a piece of paper and sign it, you’ve created a legal document. By now you are probably well aware of the importance of documentation, and the dangers which alterations to medical records invite. A paper chart’s integrity is usually rather simple to determine. However, an electronic chart is often more complicated. According to the Healthcare Information and Management Systems Society, an electronic record must be stored in a legally correct manner - otherwise it may be considered hearsay, challenged as legally invalid.

So, why is this important? Well, if your electronic medical records don’t meet the Federal or State requirements for a medical record, payors can deny a claim. Or, even worse, you may subject your practice to an increased risk of an adverse outcome in litigation. It’s not only important to be sure your electronic medical records are not altered, but you also need the ability to demonstrate the procedures which prove this fact.

How do you make sure an electronic record cannot be altered? The ideal system must balance the user’s desires, including ability to correct mistakes and make changes, with the legal integrity of the record itself.

- Does your EMR system “time stamp” each entry to produce an audit trail? This could include an unalterable record of every entry and event in order to prove the validity of the record.

- Does it restrict access to certain templates or features? You wouldn’t want a front desk employee changing patients’ intraocular pressures, for example.

- Does the system keep track of which person documented what? You wouldn’t want your name associated with another user’s entry.

- Does it have a strict but not too time-consuming security protocol? Some solutions include alphanumeric passwords that are changed periodically, biometric access, and automatic logout after a period of inactivity.

- Does it have a secure yet practical “lock-out” feature? A typical one might allow the doctor to make changes at the end of the day, but after 24 hours the record locks. This may seem a bit harsh, but it could actually serve to protect you by preventing unauthorized changes.

Above article publish on http://www.buzzle.com/articles/some-of-the-legal-issues-with-electronic-medical-records.html

By Kenneth Corbin

Sen. John Kerry is continuing his push to accelerate the adoption of electronic medical records.

The Massachusetts Democrat on Tuesday introduced legislation to spur family doctors and small-scale practitioners to migrate their paper records to digital format, a goal that most everyone agrees would improve care and lower costs, but one that entails a significant initial expense.

“Electronic medical records and prescriptions are the common sense solution to restricting costs, reducing errors and reforming a broken system,” Kerry said in a statement. “Doctors don’t need convincing — they’ve seen the results.”

Kerry’s bill, the Small Business Health Information Technology Financing Act, would make small-scale doctors eligible for grants from the Small Business Administration to move to electronic records.

“This legislation helps small practices acquire the technology that will allow them to be more efficient and to focus on patient care,” Kerry said.

The federal government has already made it clear that digital records are a priority, earmarking $19 billion for the cause in the February stimulus bill.

In 2007, Kerry introduced legislation to push doctors use digital systems when issuing prescriptions. The 2008 Medicare bill passed with provisions establishing a timetable offering bonus payments to early adopters of the technology, and eventually phasing in penalties for the laggards who continue issuing paper prescriptions.

Above article published on http://blog.internetnews.com/kcorbin/2009/11/kerry-backing-bill-to-boost-el.html

BY DR. SCOTT RANSOM

When Dr. Henry Plummer developed the concept of the “unit record” nearly 100 years ago, his idea was to place all of a patient’s records in a single file that traveled with the patient and could be stored in a central repository. His concept of medical care continuity quickly became the standard for medical record keeping worldwide.

I wonder what Dr. Plummer would make of today’s adoption of electronic medical records (EMR) by U.S. health care providers? After all, the concept is basically the same, just expanded to take advantage of today’s capacious electronic storage and retrieval methods.

Even the federal government has gotten into the act, defining a complete EMR system as containing four basic functions: computerized orders for prescriptions, computerized orders for tests, reporting of test results and physician notes.

In a perfect world, an EMR system tracks a patient’s entire health and medical history in a computerized, electronic format that is accessible wherever the patient is. These records are more easily retrievable than manual systems, and can make a patient’s navigation through the health care system much safer and more efficient.

But it’s hardly a perfect world. Even though the American Recovery and Reinvestment Act of 2009 has made the promotion of a national, interoperable health information system a priority, EMRs have not been adopted nearly as quickly in the U.S. as one might expect. Issues, including the high cost, lack of standardization, security and privacy have stood in the way of implementation.

A recent study from the New England Journal of Medicine points out that hospital EMR adoption rates are still abysmal, concluding that only about 8 percent of the 3,000 hospitals studied by researchers used even a basic EMR in a single unit, which included nurse or physician notes. And only 1.5 percent of non-federal U.S. facilities use a comprehensive EMR.

This seems counter-intuitive, especially when one considers the numerous advantages of EMRs, starting with efficiency. Information stored in an electronic format can be retrieved easily at the touch of a button or the click of a mouse. Search and retrieval times are a fraction of what they would be in manual systems. At the very least, this saves time by eliminating the need to complete the old manual medical history forms at a new physician’s office. This also reduces the chance for error when a patient forgets to list certain prescribed medications or supplements. It’s all there in one easily accessible record.

But efficiency isn’t the only benefit. For patients, access to good care becomes easier and safer when records can easily be shared. Important information — such as blood type, prescribed drugs, medical conditions and other medical history aspects — can be accounted for much more quickly. Doctors and other medical personnel can retrieve these medical records from anywhere using handheld devices like an iPhone, which allows them to continue treatment no matter where they are. And, in case of emergency, information can be shared with emergency room physicians who can then order diagnostic tests and share results online.

Another benefit is safety. It’s estimated that nearly 98,000 patients die annually by preventable medical errors of some type. It’s entirely possible that these numbers could be greatly reduced by a comprehensive medical history information generated through an EMR system.

The Mayo Clinic is setting the standard for EMR implementation. With one of the largest such systems in the world, all medical documentation relating to a patient’s care – physician notes, laboratory reports, surgical dictations, copies of correspondence, appointment schedules, X-rays, ultrasounds, CT and MRI scans, echocardiograms – is instantly available to caregivers via more than 16,000 computer terminals on Mayo’s three campuses. The efficiencies created by simply typing a few identifying keystrokes to retrieve a patient’s record saves a doctor’s practice or a hospital many thousands of dollars. That’s even taking the cost of the electronic system into account.

Even the federal government thinks electronic record keeping is important. Veterans’ hospitals across the country share an electronic system called VistA, which shares records of veterans in its health system. Should a patient find him or herself in a VA hospital, even away from home, the hospital will have the same access to his or her records that the hometown hospital does.

It’s interesting to note that a recent report from PricewaterhouseCoopers’ Health Research Institute contends that Medicaid penalties might do more to boost EMR adoption than incentives, like available funding to physicians to purchase and implement EMRs. According to the report, “Provisions in the stimulus law that call for cuts in Medicare reimbursements, rather than a multibillion-dollar incentive program, will do more to push the adoption of electronic medical records among hospitals and doctor practices by 2015.”

However EMR adoption happens, it’s critical that it happen sooner rather than later. The health care industry’s ability to provide efficient, coordinated, safe and high-quality care is only enhanced by the rapid availability of accurate data. And with the availability of solid data, researchers can also use the EMR to analyze large amounts of patient information more efficiently, speeding the application of new research findings and vastly improving patient care in the future.

Just as Dr. Plummer saw beyond the information exchange limitations of his era, we can see the benefits of using the latest technologies for the practice of continuity in 21st century medicine. But the goal, just as it was in Dr. Plummer’s time, or even going as far back as Hippocrates and his famous oath, is still nobly laudable: “First, do no harm.”

Above article published on http://www.fwbusinesspress.com/display.php?id=11302

The health care industry is trying to catch up when it comes to technology.

“Other businesses have been able to figure out how to make it work, such as the finance business. You can get money wherever you go. Health care is really behind,” said Helen Connors, executive director for Kansas University Center for Health Informatics.

Connors said it is unreasonable to ask patients to recall their medications and past history every time they see a doctor.

“Why are we asking the patient for that information? We can’t rely on the patients or providers to remember everything, so it’s got to change,” she said. “I think eventually consumers are going to drive it because they are not going to put up with it.”

The federal government has earmarked $34 billion in stimulus funds to address the issue.

“That’s a lot of money,” said Dave Garets, CEO and president of HIMSS Analytics, which collects and analyzes health care data related to information technology. “The federal government has never allocated much of any money to provide incentives to hospitals and doctors to get in gear. But boy, they did this time.”

The goal is to offer incentives for health care providers to move from paper charts to computers during the next five years, and after 2015 penalize those who don’t by, for example, providing lower reimbursements for Medicare patients.

Congress is working on the details with some preliminary regulations expected by year’s end, Garets said.

High-tech advantages

The ultimate goal is for doctors, hospitals and pharmacies to be able to access any patient’s information in a more efficient and timely manner by using electronic medical records, commonly called EMRs.

For example, if an out-of-town patient is taken to an emergency room and has allergies, an EMR would immediately alert the physician. EMRs also allow doctors to order and see lab results at the click of a button. Research has shown that EMRs significantly reduce medical errors.

For example, they can alert a doctor if he or she prescribes a medication that would not interact well with a current medication. EMR prescriptions also are more legible than their hand-written counterparts. Dr. Jon White, health information technology director of the Agency for Healthcare Research and Quality, said EMRs can help doctors manage more information better and more quickly. An EMR can contain patients’ medical information, lab work, the latest research in health, insurance information, pharmaceutical data and messages from other office workers, to name a few applications. “You can still practice without those tools, and in fact, people do every day. It just becomes more challenging to do it as time goes by,” he said.

High-cost process

White said doctors and hospitals have been dragging their heels on changing over to EMRs primarily because of costs. “They are expensive. But, we think that they will get back the money that they put into it,” he said. “Ultimately, everyone who successfully implements electronic medical records say they would never go back, but that’s a big hurdle to get over.”

The agency estimates that it costs about $30,000 for a provider that isn’t in a hospital setting.

Lawrence Memorial Hospital and Kansas University both started moving to an electronic system several years ago. LMH has spent more than $12 million just for software. KU Hospital has budgeted $52 million for the entire process.

“It’s probably one of the largest single activities that any hospital will pursue,” said Chris Hansen, chief information officer at KU Hospital. “It’s monumental, which is why there haven’t been a lot of hospitals that have gotten there.”

According to a 2008 survey in the New England Journal of Medicine, only 4 percent of physicians reported having an extensive, fully functional electronic records system and 13 percent had a basic system.

Hospitals are doing better.

Garets, of HIMSS Analytics, said 83 percent of hospitals nationwide have a basic system, but in Kansas, only 62 percent of the 132 hospitals do. More startling, he said, is that 29 percent — or 38 — of the state’s hospitals have no basic system and have no plans to purchase one, compared with 12 percent nationally.

“That is craziness,” Garets said, laughing. “It’s like what, ‘Are you living under a rock?’”

Connors, of KU’s Center for Health Informatics, is chairwoman of the state’s new e-Health Advisory Council, which is working to recommend a health information exchange plan for the state. She said some states already have a plan and are applying for federal money to begin implementing those plans. However, Kansas is applying for funding to develop a plan.

“Right now, we are fact-finding, looking at what other states have done, what do we need and what is going to be best for Kansas,” she said.

The first mission is to help health professionals get electronic systems and then figure out how they can exchange that information. Ultimately, the state’s systems will plug into a national one.

Learning curve

But, change isn’t easy.

“Almost every single one of us that is out there now grew up writing words on charts, writing notes on charts and using a pen,” White said. “Until not too long ago, we were taught that the pen was the mightiest instrument available to a doctor.”

Dr. Sabrina Prewett, 54, medical director in the LMH Emergency Department, would agree. In January, the emergency room will be one of few nationwide that is paperless.

“It was very challenging,” Prewett said of the five-year process. She worked alongside IT personnel to implement the software and then helped train staff.

“That’s why I became the one that helped develop it because if I can do it — anybody can do it,” she said, laughing.

But, Prewett said it has been worthwhile. It is safer, quicker and the information is legible.

“The impetus is for patient safety,” she said.

Above article published on http://www2.ljworld.com/news/2009/nov/02/health-industry-finally-moving-toward-computerized/?city_local