ScienceDaily — A new framework of recommendations created by health informatics researchers may help doctors and hospitals prepare for a federal initiative to expand the use of electronic health records (EHRs).

The recommendations from faculty at The University of Texas Health Science Center at Houston, the Michael E. DeBakey Veterans Affairs Medical Center and Baylor College of Medicine appear in a commentary in the Sept. 9 edition of JAMA, the Journal of the American Medical Association.

“With high-quality, well-designed, and carefully implemented systems, highly-reliable, safe health care will be achieved,” said Dean Sittig, Ph.D., commentary author, associate professor at The University of Texas School of Health Information Sciences at Houston and member of The University of Texas - Memorial Hermann Center for Healthcare Quality and Safety.

The American Recovery and Reinvestment Act of 2009 created approximately $20 billion in incentives for individuals and organizations to “meaningfully” use electronic health records beginning next year. Previous studies report that 4 percent of physicians in the outpatient setting and 1.5 percent of U.S. hospitals have a comprehensive electronic health record system.

“This framework can help make sure that electronic health records are used safely and effectively as doctors continue to adopt them,” said Hardeep Singh, M.D., M.P.H. co-author and assistant professor of medicine and health services research at the VA Health Services Research and Development Center of Excellence and Baylor in Houston.

This framework of recommendations proposed by Sittig and Singh provides guidance for key stakeholders who are either currently involved or who will soon be involved with electronic health records.

“While using electronic health records, we not only have to consider issues related to technology, but also issues related to people who use them, how they interact with technology and how the electronic health record fits with the work flow of the clinic or organization that adopts it,” said Singh, who noted that if the Computerized Patient Record System developed by the Department of Veterans Affairs was included in the EHR-use study, the percentage of U.S. hospitals with a comprehensive electronic health record system would nearly double to 2.9 percent.

VA’s electronic health record system covers many aspects of patient care, including reminders for preventive health care, electronic entry of orders, display of laboratory test results, consultation requests, and pathology and imaging studies.

“The American Recovery and Reinvestment Act stipulates that clinicians and healthcare organizations can receive incentive payments for ‘meaningful use’ of EHRs. Depending on the definition and timeline for ‘meaningful use,’ this legislation could result in a rush to implement sub-optimal systems,” said Sittig, co-author of a new book that addresses EHR issues and is titled “Clinical Information Systems: Overcoming Adverse Consequences.”

For Americans to realize the full potential of electronic health records, which include reduced cost, less duplication and greater quality, Sittig and Singh believe all eight essentials, which are based on a systems engineering model for patient safety, should be followed.

1. Hardware and software - Before implementation starts, the clinician and healthcare organization must have the proper hardware and software. “Anything that slows or disrupts the clinician’s work flow could negatively affect patient safety,” the authors wrote. “While free electronic health record software available is available, such as Veterans Information Systems and Technology Architecture (VistA ) developed by VA, all of the other seven essentials in the framework must also be addressed for safe and effective use,” Sittig said.
2. Content - To make sure that information is shared effectively, the federal government has taken steps to standardize the terms used to describe clinical findings. “Adoption of a standard vocabulary is prerequisite to implementing advanced clinical decision support,” the authors wrote.
3. User interface - The information should be easy to access and to enter. Ideally, the interface should present all the important patient information in a way so that clinicians can rapidly recognize problems, and respond to them appropriately.
4. Personnel - For EHRs to work safely, healthcare organizations will need to hire trained and knowledgeable software designers, developers, trainers and implementation and maintenance staff. The American Medical Informatics Association has identified the knowledge and skills necessary for many of these jobs. The School of Health Information Sciences at Houston currently offers educational programs and degrees in these areas.
5. Work flow and communication - The EHR system needs to be thoroughly tested within the clinic or hospital prior to implementation. Any bugs in the system should be fixed ahead of time.
6. Organizational characteristics - There should be a system to report errors and identify obstacles to care. “Innovation, exploration and continual improvement are key organizational factors for safe EHR use. The VA is a model of many of these organizational features,” the authors state.
7. State and federal rules and regulations - Care must to be taken to make sure regulations protect patient safety and privacy.
8. Monitoring - Oversight, even after initial adoption and use, is crucial to the success of the switch from paper-based patient records to electronic records.

“These issues are essential to maximize patient care benefits and minimize unintended errors from technology,” Singh said.

The commentary is titled “Eight rights of safe electronic health record use.” The authors received support from the National Library of Medicine, the VA National Center of Patient Safety, the Houston VA Health Services Research and Development Center of Excellence and the Agency for Health Care Research and Quality.

Above article published on

http://www.sciencedaily.com/releases/2009/09/090908193440.htm

HUDSON, IA – Full-practice automation seems to pay off for many small physician offices, but others who choose only select areas to convert are feeling the positive financial effects as well.

Kurt Kastendieck, MD, a family practitioner in Sante Fe, N.M., is in the process of automating his practice and finds his e-prescribing tool to be particularly useful.

“It works well,” he said. “Things like refill communications are automatically sent back. It saves an amazing amount of time.”

The e-prescribing program came with Kastendieck’s EHR, which he installed two years ago. He also bills through the system.

Larger pharmacies are better equipped for e-prescribing, but not many smaller pharmacies are, Kastendieck said. Some still take prescriptions by phone or fax.

The e-prescribing tool calculates and produces a 24-hour turnaround bill through the clearinghouse and on to the insurance company. Kastendieck said reimbursement now averages two weeks from a patient’s visit.

Automation, such as e-prescribing, helps improve a doctor’s quality of life, said Kastendieck. one doesn’t need a complete EHR, only Internet access.

Theresa Dickson, who manages her husband’s solo general surgery practice in Dennison, Texas, says electronic billing technology brings the money in quicker, even without an EHR.

“The few practices I know of out there that paper bill their claims simply budget the practice to allow for the 45 day delay in payment as opposed to 20-30 days that we experience,” she said.

Dickson said many IT companies say an EHR will save money because physicians will need less room to store charts. However, Dickson says the monthly fees for the use of an EHR often outweighs the cost of hard copy storage.

“I have seen monthly fees of $500 to $1,500 a month for one doctor,” she said. “We are not being reimbursed by our major carriers enough to offset that cost. In our particular community, real estate is relatively inexpensive, so for me personally it would cost me less to store charts.”

James Selenke, a family practitioner based in Hudson and Reinbeck, Iowa, fully automated his practice with an EHR and e-prescribing system.

He said that he is amazed at where people get numbers for cost of EHRS – to many it seems to be a tremendous amount of money, but other than hardware, which cost him $16,000 in 2004, he is only paying $870 per month to service two physicians on the EHR.

“Cost was a major factor,” said Selenke. “The fees are good for my size practice.”

Above article published on

http://www.healthcarefinancenews.com/news/docs-see-money-faster-automation

By Andis Robeznieks / HITS staff writer

Policies on security breaches, open source code, and government subsidies of electronic health-record systems have been adopted by the American Medical Association’s House of Delegates.

The policies concern physicians’ responsibilities in case of computer security breaches and support of electronic health-record systems based on open-source code. Another policy calls for the removal of penalties that are scheduled to affect physicians who are not using electronic prescribing by 2015, and another says that the AMA wants government subsidies for the implementation and maintenance of EHR systems to be adjusted for inflation.

AMA policy now dictates that, in response to a security breach, physicians are to place the interest of patients above those of themselves, their practice or institution. On open-source, delegates approved a resolution calling for the AMA to support law and public policy that makes open source EHR systems that meet certification and “meaningful use” requirements available to physicians at nominal cost.

The Florida delegation had introduced a resolution that would declare federal EHR incentive programs to be “noncompliant with AMA principles” and essentially a pay-for-performance program. After hearing testimony on June 14, a committee drafted a substitute resolution that stated federal programs should be made compliant with AMA principles by removing penalties for nonadoption.

“Resolved, that our AMA support the concept of electronic prescribing, as well as the offering of financial and other incentives for its adoption,” read the new resolution that was approved by delegates, “but strongly discourage a funding structure that financially penalizes physicians that have not adopted such technology.”

Above article published on http://www.modernhealthcare.com/apps/pbcs.dll/article?AID=/20090617/REG/306179993/1153&AssignSessionID=373357728181706

Technically Speaking. By Pamela Lewis Dolan, AMNews staff.

If you talk to 10 physician practices after a major technology implementation, you’ll likely get 10 different stories about the lessons they learned.

So what is the biggest mistake? Experts say it’s not listening to those doctors and learning from their experiences.

Consultants say no matter whether you are a hospital or small physician practice, or whether you are implementing an electronic medical record or an e-prescribing system, there are patterns in the mistakes made during the shopping for and implementing of technology.

“In medicine, there will be times when people try things and they will turn out to not be the best things to do. You don’t want to be in a situation of making a mistake when “all you had to do is check with somebody to find the appropriate way to do things,” said James Jose, MD, a pediatric critical care doctor who is chief information officer of Children’s Healthcare of Atlanta.

Richard C. Howe, PhD, vice president of business development at Healthcare Informatics Associates, said he, too, has seen several implementation projects fail after trying to go it alone without asking for advice from experts or peers. HIA, based in Bainbridge Island, Wash., provides health IT consulting and implementation services.

Experts such as consultants, trade groups and user groups, have a wider pool of experiences to draw from, Howe said. And peers are important because they can provide an overview of what problems they ran into and how they solved them.

Finding the right practice to talk to, and figuring out the best questions to ask, may take some homework and planning. But it’s worth the time and effort.

Karen Colorafi, RN, an independent consultant from Phoenix, said most practices start with a long list of possible vendors. Once that list is narrowed down to two or three, “I would definitely recommend not just picking up the phone but, if you can, do a site visit” to a practice using the system.

Every vendor has a list of references for potential clients to talk to. While references can be helpful, they shouldn’t be your only source of information, Dr. Jose said. National conferences are a great place for networking and meeting people, he said. Other references often can be found through national organizations such as the Healthcare Information and Management Systems Society or the American Medical Informatics Assn.

But the best source, according to Dr. Jose, are the “benchmark organizations” that you look up to. Find the practice that is where you want to be five to 10 years from now. Talk to the people there and find out how they got there and what was learned along the way. Dr. Jose said most practices are willing to share their experiences.

What to ask EMR veterans

Experts say there are a handful of key questions that should always be asked of references, whether you found them on your own, or through your potential vendors:

• If you had it to do over again, what would you do differently?
• Would you recommend the same vendor?
• Did you budget correctly?
• What are the ongoing maintenance costs?
• How long did the system take to implement and what were the problems you encountered?
• How did you handle converting data from paper to electronic? How was data abstracted?

Just being aware of the most common problems can help guide you through the process, experts say. HIA’s Howe said even if a practice is satisfied with its vendor overall, chances are things did not go perfectly and something was learned along the way.

Sidestepping pitfalls

The following are among the most common mistakes that have clearly been defined, and can be avoided.

• Underestimating workflow changes. Talking to practices of similar size and scope will help give you realistic expectations. Dan Rodgers, president and CEO of MedCo Data, a Tampa, Fla.-based consulting practice said practices also should evaluate workflow before implementation and develop the ideal workflow for postimplementation.
• Not allowing enough time for training. Howe said he has heard several vendors use the sales pitch that their systems require no training. Talking to someone who uses the system will verify that’s likely not the case. There are no plug-and-play systems, experts say.
• Treating the project solely as an IT project as opposed to a business decision. “If you are a pediatrician, you are in the business of treating kids; if you are an orthopedic [specialist], you’re in the business of running an orthopedic group,” said Howe. Whatever system you select should support that business.
• Failing to consider future needs in negotiations. Rodgers said just implementing the core will likely mean the practice will have to go back to that vendor for more. Rodgers said practices should negotiate those prices at the time of the initial implementation and have the vendor sign off on a statement of intent to purchase. Otherwise, you are stuck with a vendor who, after the fact, can set any price, he said.
• Not defining a clear path for return on investment. Rodgers said many practices jump in, accepting the vendors promise of profit, but don’t sit down and develop a plan to get them there.
• Not having a legal expert review the contract. “When you are getting ready to sign a $50,000 contract, it’s worth a couple hundred bucks to have someone review that contract for you,” Colorafi said.
• Going cheap on the infrastructure. Rodgers said he has heard from several practices that say their systems aren’t performing the way they were promised. In reality, he said, they were running the systems on older, less-expensive computers and servers that weren’t allowing the system to run at optimal levels.
• Delegating the implementation to nonphysicians. Colorafi said she has seen many implementations fail because the job of selecting a system was delegated to a practice manager instead of a physician who will be using it. Others can be used to gather background information, she said, but taking the systems for a test run should fall to the physician.

Above article published on

http://www.ama-assn.org/amednews/2009/06/22/bica0622.htm

More than 50% of healthcare providers surveyed by IVANS do not believe the federal stimulus package will successfully encourage health IT adoption.

By Marianne Kolbasuk McGee InformationWeek

Although a majority of healthcare providers remain skeptical about how they’ll benefit by the federal government’s $20 billion stimulus program, many plan to forge ahead anyway, according to a report released this week.

About seven in 10 healthcare providers believe electronic medical records will have a positive impact on their businesses and patient care, but 80% say the lack of money is their biggest obstacle to deploying health IT systems, said the new report by IVANS, a supplier of EDI and network services to the insurance industry.

The nationwide, e-mailed survey of 508 healthcare providers — including hospitals, clinics, private medical practices, nursing homes, home healthcare organizations and medical billing companies — found that while nearly 40% plan to forge ahead with e-medical record deployments within the next 12 months, more than 50% of healthcare providers do not believe the federal stimulus package will successfully encourage health IT adoption.

Healthcare providers’ doubt appears to be rooted to several factor, most notably uncertainty about the specifics of the government’s eligibility requirements for receiving HIT-related rewards. Starting in 2011, the federal government is expected to begin awarding approximately $20 billion over the next five years, rewarding higher Medicare and Medicaid reimbursements to doctors and hospitals that demonstrate “meaningful use” of health IT.

However, the details of what will constitute “meaningful use” haven’t been worked out yet. The federal government is in the process of investigating and defining the scope of what “meaningful use” of health IT will qualify for the American Recovery and Reinvestment Act of 2009’s HITECH (Health Information Technology for Economic and Clinical Health) stimulus funding incentives. Just this week, a federal advisory panel — the HIT Policy Committee — unveiled some of its recommendations for the “meaningful use” definition.

“They’re on the right track,” said Clare DeNicola, IVANS CEO, of the HIT Policy Committee’s recommendation so far to the U.S. Dept. of Health and Human Services about the “meaningful use” definition. “It’s not about technology, it’s about the care — we can’t lose sight of that,” she said about the committee’s suggestions for how IT can be used for improving quality of patient care and public health.

Also fueling uncertainty among healthcare providers participating in the survey was this: Home healthcare providers and nursing homes were among the 508, healthcare providers polled. However, so far the HITECH federal stimulus legislations is vague on how those healthcare providers will participate in the new programs, despite the growing population of aging baby boomers who’ll likely increasingly require their services in coming years.

In fact, despite their skepticism and uncertainly about the government incentive programs, about four in 10 healthcare providers are planning to implement e-medical record systems over the next 12 months.

Many are already making investments in IT, including those that can help support e-medical record deployments, including wireless networks, business continuity technologies and connectivity to remote locations.

“Healthcare providers are wary but they are moving forward with technology innovations,” said DeNicola. “They’re not driven so much by the stimulus funds as they are in their belief that these technologies can help improve their businesses and patient care,” she said.

Finally, when survey participants were asked who should take the lead on driving adoption of healthcare IT to ensure its success, 47% of healthcare providers named themselves; 21% suggested the government should lead; 14% said healthcare insurers/payers should have that responsibility; and 18% were divided between industry associations and consumers leading the charge, according to the report.

Above article published on http://www.informationweek.com/news/showArticle.jhtml;jsessionid=RAI3YIPOK35Z2QSNDLOSKHSCJUNN2JVN?articleID=218000238&pgno=2&queryText=&isPrev=

O’Malley expected to sign bill that would aid in creating national health information network

Maryland is poised to jump ahead of the rest of the nation in health information technology on Tuesday when Gov. Martin O’Malley signs a bill intended to coax doctors into using electronic medical records.

The computerized files are seen as the foundation of a national health information network that proponents say will improve care, advance medical knowledge and save the country tens of billions of dollars annually. But with the startup costs to individual doctors in the tens of thousands of dollars, many smaller practices have been slow to move from clipboard to computer screen.

With today’s bill signing, Maryland will become the first state requiring private insurance companies to offer doctors financial incentives to adopt the technology, state officials say. Doctors who do not bring an electronic medical records system on line by 2015 could face penalties.

“This is where government and private health care providers can come together to really improve not only the quality of care but also, hopefully, create some costs savings as well,” O’Malley said. “Health IT is the future of health care in our country, and we want Maryland to lead the way.”

The bill also requires the state to develop a health information exchange, a computer network that would link all of Maryland’s physicians, hospitals, medical laboratories and pharmacies. It could be linked in turn with those of other states to create the national network envisioned by President George W. Bush and affirmed by President Barack Obama. O’Malley calls it “creating one common gauge of railroad track.”

Obama, who has promised to spend $50 billion on the effort over the next five years, set aside $17.2 billion in the economic stimulus package to encourage the adoption of electronic medical records - sophisticated computer programs that record a patient’s history, incorporate the latest medical research and propose appropriate treatments.

Privacy advocates warn that the features that make the computerized patient files attractive to health care providers - the wealth of personal information, and the ease with which it may be accessed and shared - also make them ripe for potential exploitation by employers, insurers and others. State and federal officials acknowledge such concerns and say safeguards will be incorporated into the new systems.

The stimulus money went to Medicare and Medicaid, which are to give it to doctors who adopt electronic medical records. But because Medicare and Medicaid account for less than half of payments to many providers, state Health Secretary John Colmers said, private insurers are now being enlisted to add incentive, beginning in 2011.

The bill allows insurers to choose among several forms of inducement - increased reimbursements, lump-sum payments or in-kind services - so long as it has a monetary value.

“The goal here in Maryland was to assure that all of the payers pull their oars in the same direction,” Colmers said. “There is a great promise in electronic health records, but the greatest promise comes when it’s done in a coordinated fashion, across all of the payers.”

Bush’s goal was to get all of the nation’s physicians using electronic medical records by 2014. The next year, insurers in Maryland may begin to reimburse holdouts at lower rates, according to the state measure.

Jeff Valentine, a spokesman for CareFirst Blue Cross Blue Shield, congratulated O’Malley and the state legislature on what he called “an important first step to maximize federal stimulus funding.”

The largest health insurer in the mid-Atlantic, CareFirst, already offers increased reimbursements to doctors who use electronic medical records, which Valentine said would lead to “improved patient outcomes and safety, lower costs associated with care delivery and an overall improved patient experience.”

The state began work on a health information exchange last summer, when the Maryland Health Care Commission asked two very different physicians groups to develop pilot programs and advise the state on how a statewide exchange should function.

The Chesapeake Regional Information System for our Patients, or CRISP, included several large Baltimore medical institutions, Johns Hopkins Medicine, MedStar Health and Erickson Retirement Communities among them. The Montgomery County Health Information Exchange Collaborative brought together community hospitals, the county health department and clinics that serve the poor and the uninsured.

“It’s a population that is, in many ways, invisible and not so well-connected to health care,” said Montgomery County group member Dr. Tom Lewis, who helped launch an electronic medical record initiative in a group of county clinics in 2003. “They may get care in emergency rooms and a web of free clinics, but we want to bring individual patients’ data together in one place.”

Because low-income patients tend to receive fragmented care, Lewis said, they have the most to gain from the sharing of electronic medical records among healthcare providers. For example, without such sharing between community clinics and hospitals, he said, emergency room doctors who provide much of the primary care for these patients may be unaware of their health histories, leaving the patients at risk of receiving unnecessary or unsafe procedures.

The group’s pilot project created a health information exchange that links 10 community clinics with Montgomery County General Hospital’s emergency room. So when a patient arrives at the ER, doctors can access an electronic synopsis of his or her medications, allergies, lab results and medical visits.

The emergency room can send discharge information directly to a patient’s clinic, which might not otherwise know about the visit. The group hopes the effort will cut down on unnecessary emergency room visits, by better connecting patients with clinics.

The pilot program is set to roll out in a few months, Lewis said. He said his group doesn’t plan to bid on a statewide information exchange, but has been eager to share its findings with the Maryland Health Care Commission.

Applications from groups hoping to design a statewide health information exchange are due to the commission by June 12. The commission is to award a contract in August. Startup costs are to be funded in part by stimulus money and in part by the rates that hospitals may charge.

The statewide network is likely to be phased in over time, said Colmers, the state health secretary, with the first elements coming on line as early as this fall.

“I expect fairly rapid adoption,” he said. “And with the incentives in the stimulus package and in this bill beginning to go into effect in ‘11, it will be important for it to be certainly ramped up and ready to operate by then.”

Above article published on

http://www.baltimoresun.com/health/bal-md.health19may19,0,6118960.story

by Julekha Dash Contributing Writer

Maryland Gov. Martin O’Malley will sign legislation Tuesday that provides incentives for health care organizations to implement electronic health records.

House Bill 706 allows the state to make use of federal stimulus dollars available for electronic health records and coordinate those efforts with the state’s own plan to create a state wide health information exchange.

The federal stimulus money provided $19 billion toward electronic health records. State health officials do not know how much of that money will flow to Maryland.

State and federal health officials are pushing electronic health records because they believe they will reduce medical errors and lower costs by eliminating the need for running multiple tests.

The stimulus package enables physicians to receive incentives between $44,000 and $64,000 over the next five years through Medicare and Medicaid.

It costs, on average, $50,000 for a physician practice to implement electronic health records. The incentive payments begin in 2011, and physicians who do not adopt an electronic health records will be penalized through lower Medicaid and Medicare payments starting in 2015.

In the past, the biggest obstacle in getting physicians to install an electronic health record was cost. The federal stimulus money and the state’s health information exchange overcomes that obstacle by providing incentives to adopt health records.

“It’s trying to create a business model to make [health IT] work,” Department of Health and Mental Hygiene Secretary John Colmers said.

While the federal money provides payments to physician practices, the state is taking its own steps to ensure that hospitals can share electronic information. The legislation requires the Maryland Health Care Commission and the Health Services Cost Review Commission to designate a state health information exchange by Oct. 1. State health insurers will provide incentives to hospitals, which include a lump sum payment or increased reimbursement, to adopt electronic health records.

Erickson Retirement Communities, Johns Hopkins Medicine, University of Maryland Medical System and more than a dozen companies and health care institutions have submitted their own plan to the state’s health care commission to create a health information exchange, known as the Chesapeake Regional Information System for our Patients.

Above article published on

http://www.bizjournals.com/washington/stories/2009/05/18/daily1.html

Rep. Bryan Cutler Proposes Using $25M In Stimulus

LANCASTER, Pa. — The use of electronic medical records could become more widespread in Pennsylvania if new legislation passes.

Rep. Bryan Cutler, R-100th district, is introducing a bill that would create a grant program for health care providers to implement the health information technology.

The systems used in parts of Lancaster General Hospital and some of its doctors offices put a patient’s medical records in one electronic chart.

Cutler wants to use $25 million in stimulus money to fund the program.

“This technology needs to be adopted for patient safety and for decreasing costs,” said Cutler.

Sixty percent of the doctors in its health system will have computerized medical records by July and all of them will have the system by 2010, Lancaster General officials said.

The medical record system will be shared with physicians outside its health system, Lancaster General officials said.

Above article published on

http://www.wgal.com/wgalhealth/19396405/detail.html

Former Gov. Mark Warner said sharing medical records among providers will improve care and reduce costs.

By Sarah Bruyn Jones
With nearly $20 billion in federal funds about to hit the world of health care information technology, Virginia’s health sector and political leadership are trying to prepare to capture their share of the money.

The money is part of the federal stimulus bill signed by President Obama in February and is intended as a financial incentive to get the health care industry to embrace using electronic medical records. Still, the timeline and details of how the money will be distributed have not been finalized.

“This represents a big leap forward for health technology, so we are excited about it,” said Virginia Secretary of Health and Human Resources Marilyn Tavenner. “We just want to be positioned to take maximum advantage of it.”

Some monies will likely go directly to the states to be distributed, while other funds will be allocated through a competitive grant process.

Tavenner said a significant amount of money coming to Virginia could boost job growth for information technology specialists as more health providers implement electronic record-keeping systems.

To help ready Virginia for coming funding, U.S. Sen. Mark Warner has arranged for a health IT summit Monday in Richmond. The national coordinator for health information technology, recently appointed by Obama, will be at the summit.

“This is going to be one of the areas that is going to drive health care reform,” Warner said.

The state will form an advisory group to help Virginia providers access the federal money and implement effective electronic medical record systems.

Between 15 and 20 people will be named to the group, including four people already named to the newly created Health Information Technology Standards Advisory Committee, which was established by the 2009 General Assembly, Tavenner said.

Warner said establishing electronic medical records in hospitals, nursing homes and physicians’ offices throughout the state will improve care and reduce costs.

“There is no reason why health care can’t get some of the efficiencies that every other field has,” he said, pointing to manufacturing and telecommunications as examples.

While the guidelines for exactly how the money will be distributed are still being worked out, Warner said he believes that cooperation between different health care providers will be the key to attracting government dollars. That includes requirements that different hospital systems and physicians’ offices be able to share information.

Warner, who has a background in telecommunications, said the system should be similar to the way cellphone companies operate: There are different providers, but a call from a Verizon phone can be received by a Sprint phone. Financial incentives will be needed to push a working system into operation, he said.

Questions remain about the security of such a system. And some medical providers don’t want to share all their data with another business due to competition in the industry.

Carilion Clinic’s chief information officer, Daniel Barchi, said it is important for system administrators to talk to each other as electronic records become the standard. Carilion began rolling out its new multi-million-dollar record system last year and has been in discussions with some other hospital systems in the state to share experiences, he said.

“The more that health IT leaders get together, the better off we are going to be,” Barchi said.

He is one of the four people already appointed to the advisory committee.

“By cooperating and choosing a common data record, there is a way we can share — with patient permission — information across all these health systems,” Barchi said. “And I think the government is doing an admirable job of putting incentives out there for the providers to make their systems more interoperable.”

The state-led efforts also focus on helping providers who don’t already have electronic medical records systems establish one. That’s because much of the federal funding will be tied to providers who already have an electronic record in use.

Above article published on

http://www.roanoke.com/business/wb/205025

Switch is four years ahead of schedule

By CAROL REITER
President Barack Obama has decreed that all medical files be electronic by the year 2013.

Mercy Medical Center Merced is ahead of the game by about four years.

By next week, the local hospital will have all its medical records on computers. Loretta Stuart-Edgerton, director of the health information department, said that with the old handwritten charts, data were input by hand and could only be looked at by one person at a time.

MARCI STENBERG

Merced Sun-Star - Rachel Minor, a tech with the health information management team at Mercy Medical Center Merced, files a paper chart at the hospital on Tuesday afternoon. The hospital is changing over to electronic medical files within the next week.

“We had three different storage areas for the charts,” Stuart-Edgerton said. When the crossover to electronic records is complete, there will only be one offsite, long-term storage site.

Shawn Withrow, who is in Merced helping Mercy with the transition, is an employee of Catholic Healthcare West, Mercy’s parent company. He said the new way of putting records on computers will be cost effective for the hospital.

“There will be quicker retrieval and more than one person at a time can look at a medical record,” Withrow added.

For people worried about many sets of eyes looking at their medical records, Withrow said that is exceptionally hard to do. If anyone is caught, it’s a fine and jail time.

Recently, Farrah Fawcett’s medical records from UCLA were leaked to tabloids. The specialist who leaked Fawcett’s records pleaded guilty to a felony charge of violating federal medical privacy laws. The specialist, Lawanda Jackson, died of cancer in March before she could be sentenced.

“It’s a fireable offense,” said Stuart-Edgerton. “Mercy’s human resources has policies in place about what would happen if a person does look at medical records.”

Carol Caceres, a systems analyst for medical information at Mercy, said putting records on computers will make it easier for physicians. “Now multiple doctors can look at a chart at the same time, and discuss it,” Caceres said.

Although doctors notoriously oppose change, especially when it comes to computers, Caceres said local physicians have been satisfied with the change.

“A lot of our doctors also go to Emanuel Medical Center (in Turlock) and Children’s Hospital Central California,” she said. “Those hospitals already have electronic files. Plus, we are holding classes for doctors to learn the system.”

The staff in medical records has put about 90 percent of the charts online already, and everyone seems to be pleased with the new system.

“Now doctors can log on in their own office,” said Stuart-Edgerton. “Saves them a trip down here.”

Above article published on

http://www.mercedsunstar.com/167/story/842570.html