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A bright prognosis for EMRs

This article appears in the issue May 2007, [Vol 16, Issue 5]
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Although electronic records management has been around for a number of years, it’s still in its early stages in the medical community, according to healthcare consultants and providers.

“Healthcare is moving slowly to adopt EMR (electronic medical records),” says Gwen Hughes, director of e-health information management systems for Care Communications, a healthcare consulting company in Chicago.

Potential benefits of electronic records— reduced storage costs, fewer errors, more complete record transfer capabilities—were acknowledged by healthcare providers and consultants years ago. But the expense of the hardware and software, which can run into seven figures, and the reluctance to change to a new system have adoption in its infancy, according to Hughes.

Due to the expense of those systems, many healthcare providers have taken a long look at the technology before making the decision to implement it. Many healthcare providers have spent years researching systems and have piloted them for as much as a year before going live, according to Steve Woodall, director of records management for the University of North Texas Health Science Center at Fort Worth, which has piloted the NextGen (nextgen.com) system for nine months and expects to go live with it by the end of the year.

“We’re still in the initial phases of implementation,” Woodall says, echoing the thoughts of others in the industry. “A lot of [physicians] were reluctant to change from the way they had been doing things.”

More consistent care

But the need to avoid omissions or duplication of care is driving more healthcare providers to adopt electronic medical records and related systems, according to Donna Coomes, director of medical records at the Mountain States Health Alliance, a locally owned and managed healthcare system based in Johnson City, Tenn.

Mountain States has piloted the Siemens (siemens.com) Sorian Health Information Management system since the middle of 2006 and plans to go live with the technology in June. The system enables Mountain States to join electronic files such as magnetic resonance images (MRIs) and X-rays with, for example, physician reports, so that all of a patient’s medical records are accessible by authorized personnel in a single repository.

Although many of the physicians who work with Mountain States still take down patient information by hand on paper forms, those forms are scanned at the time of discharge to minimize the paper in the system, according to Coomes.

Having all records available in a single location helps ensure consistency of care, says Robert Calway, VP of clinical services for Joslin Diabetes Center in Boston, which has been using the NextGen EMR system for a little more than three years.

“Historically, we had kept all of our records on paper, but when records came in from other sources, they were typically in summary form. That led to very disjointed care,” Calway says.

A patient referred to the center might have had some blood work or other tests already, but if the summary information didn’t include that data or all of the pertinent material about previous tests, treatments, etc., it could mean the tests would be run again, according to Calway.

Billing advantages

Even when all care is done by the same provider, missing or misfiled charts can be an issue, says Katie Peterson, business manager for the practice of Dr. Russell Peterson in Roanoke, Ala. Electronic records offer more consistent and quicker billing and reimbursements from government and private health insurance, she says.

Dr. Peterson’s medical office uses the AdvancedMD suite, which links record keeping to billing. The software enables automated entry of care (office visits, different tests), providing quicker bill processing, according to Peterson.

Better storage solution

Coomes, of Mountain States Health Alliance, says the new technology saves the healthcare system from paying for off-site storage of paper files. Older files are still in paper form, and there are no immediate plans to convert those files to electronic records. Coomes and several other healthcare providers point out that the older the files are, the less relevant they are to a patient’s current healthcare.

“In Tennessee, you only need to keep an adult’s records 10 years,” Coomes says, “so we are destroying those records after 10 years anyway. The law is 19 years for records of minors, so we might start scanning some of those paper records [that are archived off-site].”

Research facilities might have more reason to convert older paper records to electronic records, because they tend to keep files for a longer period of time, Coomes adds.

Like Mountain States, the Joslin Diabetes Center has a combination of older paper and electronic records. The most pertinent ones are those less than three years old, according to Calway. But some older records are pertinent for some patients, and some older records are being used for research products. So the decision to convert paper records to electronic records is being made on a case-by-case basis there.

Security procedures similar to paper

Securing records while permitting access to authorized personnel is another important issue for healthcare providers. In the case of Joslin Diabetes Center, for example, many records need to be shared between the facility and the nearby

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