Paperless healthcare is more than just a buzzword for Orange County’s hospital executives.
Hospitals throughout OC have been busy putting in electronic medical records in their facilities and linking them up with providers that practice within their walls.
EMRs are used by providers instead of traditional paper charts to keep track of patient care. A doctor who puts a patient who’s had a heart attack on an aspirin regimen, for example, can enter that information into an EMR; other healthcare providers can review such data. The idea is to avoid duplicative costs and potentially dangerous errors in medications or other treatments.
EMRs started to receive more attention when the federal government’s economic stimulus bill was passed in 2009 with financial incentives to help healthcare providers step away from paper charts. The trend picked up steam with the crafting of federal healthcare reform that was signed into law in 2010.
The Business Journal’s healthcare Reporter Vita Reed asked a couple of Orange County hospital professionals and the chief executive of a healthcare software company about results that have come from EMRs and where the trend is going.
—Edited excerpts of their responses follow.
Marcia Manker
Chief Executive, Orange Coast Memorial Medical Center, Fountain Valley
MemorialCare’s systemwide transformation to electronic medical records enables us to provide more collaborative and integrated care, use evidence-based guidelines to optimize patient outcomes, and constantly improve patient safety.
Since we became Orange County’s first health system to offer a comprehensive electronic medical record seven years ago, we’ve witnessed remarkable results from our physicians, nurses and other clinicians having immediate access to a patient’s health information and medical history at every point of the care process.
A key to success is our extremely high physician adoption of computerized physician order entry. Doctors using computerized physician order entry directly enter their own orders, access relevant clinical alerts, advisories and reminders to assist in creating the best possible orders for their patients.
While many hospitals report computerized physician order entry usage rates of 30% to 40%, more than 98% of MemorialCare physicians have already transitioned from paper to digital entries. In addition to clinical advantages, electronic medical records are also effective for scheduling, admitting, discharges and other activities.
Using electronic medical records each step of the way streamlines processes and reduces unnecessary delays.
MemorialCare has also deployed more than 1,000 clinical order sets, grouping medical orders around best practices and published clinical evidence, making it even easier for doctors and nurses to choose the best care for their patients.
Through our ambulatory electronic medical record, hundreds of physicians are now linked to our hospital records, and patients are increasingly accessing their records through an online portal.
This creates a seamless, longitudinal record of care for our patients.
Physicians and other clinicians caring for hospital patients have access to all information from the patient’s office records. Physicians seeing those patients in their office after discharge have immediate access to all results, reports and consultations occurring during the hospitalization. Silos of information that often resulted in disjointed care are a thing of the past.
Our vision is to create a continuum of care offering clinicians instant access to integrated and comprehensive medical records whether the patient is in a physician’s office, seen in our retail clinic, walking into our emergency department or admitted to one of our hospitals.
This is best expressed in our electronic medical record strategic vision, “One Patient One Record.”
An integrated inpatient and outpatient electronic medical record allows a deeper partnership among the hospital, physicians and other medical providers. Most importantly, effective use of electronic medical records furthers our ability to meet our commitment to evidence-based practice and the best possible clinical outcomes for our patients and their families.
Steven Plochocki
Chief Executive, Quality Systems Inc., Irvine
Our hospital division had an estimated 1,200% growth in demand for implementing the electronic medical record during 2012. A primary driver for adoption was quite simply meaningful-use [regulations]—stage one—and 100% of the clients who implemented [electronic medical records] toward that goal achieved successful attestation.
While the effect of rapid deployment on daily operations can be a challenge, many clients report that several work flows were dramatically improved “almost overnight.”
Here are a few examples of what the QSI/NextGen hospital customer has reported:
“Prior to an online electronic health record, I would have to physically search for the chart and/or make phone calls to locate paper records. But when everyone uses the system, the chart is just there. Anywhere I can get to the computer, I can get to the chart. That makes a huge difference in my daily workflow and in improving communication across the care team.”
“As a provider, I used to write my orders on paper. What I have noticed [with electronic medical records] is that while it seemed to slow me down getting used to placing orders in the computer, I get the results much faster and can view them online. I can then make a decision sooner about treatment options. A huge win.”
In the smaller critical access settings, communication within the care team tends to be very close. One of our hospital customers’ CEO said:
“Our patients are the same people we see in the grocery store, at the local high school football games, and in church. We know them; their care is very personal. Knowing that we can now organize the charts online, whether a patient is seen in the clinic or in the hospital, is a huge win for all of us.”
Julie Miller-Phipps
Senior Vice President, Kaiser Permanente Orange County, Anaheim and Irvine
KP HealthConnect is Kaiser Permanente’s comprehensive health information system that includes one of the most advanced electronic medical records systems. The implementation of HealthConnect across a fully integrated healthcare delivery system has provided a number of different benefits. It allows Kaiser to coordinate patient care between the physician’s office, the hospital, home care, radiology, laboratory and pharmacy services. It is the bridge for providing vital information at every point of care, across all care settings, at all times.
We have reduced waste by eliminating unnecessary testing and prescribing, as all previously performed lab tests, radiology tests and medications are immediately available to any user caring for the patient. Hospital readmissions have dramatically decreased by easily tracking reasons for readmission and ensuring our patients are receiving timely discharge telephone calls and outpatient appointments.
Permanente physicians have secure access to members’ medical information regardless of whether they are logging in from home or their office.
Our members have instant and secure access to portions of their personal health record via our Web site or from anywhere they travel using their smart phones. They can refill medications, see lab results, schedule appointments and securely email their physician’s office. The system has greatly improved the ability to communicate with their physician and be better engaged with their healthcare team.
On quality of care and patient safety initiatives, bringing decision support to the care provider while seeing the patient via electronic medical records has improved many of our initiatives. Our patients are reminded to have mammograms, colon cancer screening, vaccine(s) or any number of recommended preventive screening tests at all visits, regardless of whether the visit is with their primary care physician or specialty care.
Users are prompted with safety alerts, potential drug interactions, and appropriate drugs specified for age and diagnosis.
In addition, we are already seeing advances in the way we prevent manageable diseases from becoming life-threatening crises.
Kaiser Permanente conducts transformational health research with the data collected through the HealthConnect system. It connects our researchers to one of the most extensive medical databases available, facilitating studies, and important medical discoveries that shape the future of health and care delivery for patients and the entire medical community.
Recent studies have shown that the use of online tools and services was associated with improved monitoring and risk-factor control among patients with diabetes; improvement in cholesterol; and blood pressure screening and control; asthma; coronary artery disease; and depression.
With more than 9 million members on HealthConnect, we are beginning to write evidence-based practices to improve the health of our nation.
