How electronic records are taking the guesswork out of health care communication
Pardon the handwriting. Through better
technology, this method of medical documentation may become obsolete.
When was the last time you wrote a check
for cash and handed it to a bank teller? With
online banking, debit cards and global ATM
networks, those days are virtually gone.
Thanks to advances in information technology, this change is coming to health care, as
well — providing convenience and greatly
improving safety and patient satisfaction.
Smart Business spoke to MemorialCare
President and CEO Barry Arbuckle, Ph.D., to
learn how new technologies revolutionize
health care, replace today’s reactive care with
a proactive patient-centered model focusing
on prevention and wellness and offer anytime, anywhere access to information.
What is an electronic medical record (EMR)?
Electronic medical records place a patient’s
full medical history onto computers and
information systems, allowing clinicians to
better coordinate care through immediate
access to secure patient data. This facilitates
clinical workflows and handoffs — minimizing waste and inefficiency of manual and
paper-based processes, maximizing clinical
quality through real-time decision support at
points of decision-making and eliminating
most paper used in patient documentation
and education since paper slows care and
creates environments ripe for error. Efficient
care delivery prevents unnecessary orders
and diagnostic tests, reduces medical errors
and improves health.
Is this technology new to health care?
Yes and no. Hospitals are laden with technology but are not necessarily automated.
For example, many bedside instruments produce vast patient data that must be observed
and manually transcribed. EMRs electronically capture, record and trend such data for
viewing remotely 24-7 by multiple health
care providers.
More than a decade ago, MemorialCare
began offering physicians secure remote
access and connectivity among our hospitals.
More significantly, in summer 2006, we
installed a comprehensive new electronic
health record and pharmacy module at
Saddleback Memorial Medical Center-Laguna Hills just as the Institute of Medicine
called for all prescriptions to be written electronically by 2010 to improve patient safety.
Why are hospitals slow to adopt EMRs?
Extraordinary purchase, implementation
and maintenance costs are occurring as reimbursement to hospitals and doctors is shrinking [particularly government reimbursement
discussed in this Smart Business January
2008 column] while labor, facilities, supplies
and life-saving equipment costs are two to
three times higher. While EMR inpatient
costs for an average hospital run about $15
million with another $15 million for affiliated
clinics and physician offices, economic benefits accrue primarily to state and federal government and health plans — not those making the investments. There’s understandable
resistance from physicians and caregivers to
adopt complicated new information systems.
Implementation requires thousands of
hours for physicians and staff and significant
changes to clinical and administrative work-flow. More than automating work processes,
EMR requires continual review and reengineering to fix inefficient processes and new
ways to process, store and retrieve information used every minute of every day.
Is it worth the cost and challenges?
Absolutely. Technology transforms patient
care in ways unimaginable under a paper system. At Saddleback Memorial, for example,
less than five prescriptions out of 3,000 per
day are done by hand. Most patient orders
are entered into computers, reducing turnaround time in getting information on the
patient chart, making notes more legible,
simplifying access to patient information and
improving safety and quality.
What does the future hold?
The government’s goal is for all Americans
to have a personal health record by 2014. By
2009, EMRs will be implemented at all our
facilities. A nationwide network with medical
data will follow patients across clinical settings and continents. Empowered consumers will make smarter choices about health
care and be knowledgeable about cost and
quality of treatments and providers.
Treatment decisions will be based on effectiveness, and reimbursement driven by outcomes. Technology helps us realize this
vision of health care.
What can employers do?
Partner with local hospitals and physicians
to learn how new technologies impact your
work force. Advance efforts to establish standards for sharing data among health providers through legislative advocacy. And encourage government, foundations and other
relevant organizations to financially support
health information technology acquisition
and implementation.
BARRY ARBUCKLE, Ph.D., is president and CEO of MemorialCare Medical Centers (www.memorialcare.org) and chair of the
California Hospital Association. He can be reached at [email protected] or (562) 933-9708. MemorialCare Centers
include Saddleback Memorial in Laguna Hills and San Clemente, Orange Coast Memorial in Fountain Valley, Anaheim
Memorial, Long Beach Memorial and Miller Children’s Hospital in Long Beach.